Abstract
The incidence of skin cancer among U.S. Hispanics increased 1.3 % annually from 1992 to 2008. However, little research has focused on skin cancer prevention among the rapidly growing Hispanic population. In this study, we examined theory-driven, psychosocial correlates of sun protection behaviors in a population-based sample of 787 Hispanic adults (49.6 % female, mean age = 41.0 years) residing in five southern or western U.S. states. Participants completed an English- or Spanish-language online survey in September 2011. The outcomes of focus were sunscreen use, shade seeking, and use of sun protective clothing. The correlates included suntan benefits, sun protection benefits and barriers, skin color preference, perceived natural skin protection, photo-aging concerns, perceived skin cancer risk, skin cancer worry, skin cancer fatalism, and sun protection descriptive norms. Results of multiple linear regression analyses revealed the following: sun protection barriers were negatively associated with each outcome; descriptive norms were positively associated with each outcome; perceived natural skin protection was inversely associated with sunscreen use; skin cancer worry was positively associated with shade seeking and use of sun protective clothing; skin cancer fatalism was negatively associated with shade seeking; and skin color preference was negatively associated with use of sun protective clothing. A number of additional statistically significant associations were identified in bivariate correlation analyses. This study informs the potential content of interventions to promote engagement in sun protection behaviors among U.S. Hispanics.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
There is a lack of consensus on usage of the terms Hispanic and Latino (Jaimes et al., 2013). For ease of presentation, we use the term Hispanic for the remainder of the paper.
References
American Cancer Society. (2013). Cancer Facts and Figures, 2013. Atlanta, GA: American Cancer Society.
Andreeva, V. A., Unger, J. B., Yaroch, A. L., Cockburn, M. G., Baezconde-Garbanati, L., & Reynolds, K. D. (2009). Acculturation and sun-safe behaviors among US Latinos: Findings from the 2005 Health Information National Trends Survey. American Journal of Public Health, 99(4), 734–741.
Bond, S., & Cash, T. F. (1992). Black beauty: Skin color and body images among African-American college women. Journal of Applied Social Psychology, 22(11), 874–888.
Bränström, R., Kasparian, N. A., Chang, Y. M., Affleck, P., Tibben, A., Aspinwall, L. G., et al. (2010). Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiology, Biomarkers and Prevention, 19(9), 2199–2210.
Coups, E. J., Stapleton, J. L., Hudson, S. V., Medina-Forrester, A., Natale-Pereira, A., & Goydos, J. S. (2012). Sun protection and exposure behaviors among Hispanic adults in the United States: Differences according to acculturation and among Hispanic subgroups. BMC Public Health, 12, 985.
Coups, E. J., Stapleton, J. L., Hudson, S. V., Medina-Forrester, A., Rosenberg, S. A., Gordon, M., et al. (2013a). Linguistic acculturation and skin cancer-related behaviors among Hispanics in the southern and western United States. JAMA Dermatology, 149, 679–686.
Coups, E. J., Stapleton, J. L., Hudson, S. V., Medina-Forrester, A., Rosenberg, S. A., Gordon, M., et al. (2013b). Skin cancer surveillance behaviors among US Hispanic adults. Journal of the American Academy of Dermatology, 68, 576–584.
DiSogra, C. (2009, November 11). Overview of KnowledgePanel® statistical weighting protocol. Retrieved from http://www.knowledgenetworks.com/ganp/docs/KN-Weighting-Synopsis.pdf
Ennis, S. R., Rios-Vargas, M., & Albert, N. G. (2011, May). 2010 Census briefs—the Hispanic population: 2010. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf
Fast Stats. (2013, August 12). An interactive tool for access to SEER cancer statistics. Surveillance Research Program, National Cancer Institute. Retrieved from http://seer.cancer.gov/faststats
Glanz, K., Yaroch, A., Dancel, M., Saraiya, M., Crane, L., Buller, D., et al. (2008). Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Archives of Dermatology, 144(2), 217–222.
Glasgow, R. E. (n.d.). Perceived barriers to self-management and preventive behaviors. National Cancer Institute. Health behavior constructs: Theory, measurement, & research. Retrieved from http://dccps.cancer.gov/brp/constructs/barriers/index.html
Gloster, H. M., Jr, & Neal, K. (2006). Skin cancer in skin of color. Journal of the American Academy of Dermatology, 55(5), 741–760.
Hay, J., Coups, E. J., Ford, J., & DiBonaventura, M. (2009). Exposure to mass media health information, skin cancer beliefs, and sun protection behaviors in a United States probability sample. Journal of the American Academy of Dermatology, 61(5), 783–792.
Health Information National Trends Survey. (HINTS). (n.d.). Retrieved from http://hints.cancer.gov
Howlader, N., Noone, A. M., Krapcho, M., Neyman. N., Aminou, R., Altekruse, S. F., et al. (Eds.). (2012). SEER cancer statistics review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute. Retrieved from http://seer.cancer.gov/csr/1975_2009_pops09/
Jackson, K. M., & Aiken, L. S. (2000). A psychosocial model of sun protection and sunbathing in young women: The impact of health beliefs, attitudes, norms, and self-efficacy for sun protection. Health Psychology, 19(5), 469–478.
Jaimes, N., Londono, V., & Halpern, A. C. (2013). The term Hispanic/Latino: A note of caution. JAMA Dermatology, 149, 274–275.
Janssen, E., van Osch, L., de Vries, H., & Lechner, L. (2011). Measuring risk perceptions of skin cancer: Reliability and validity of different operationalizations. British Journal of Health Psychology, 16(1), 92–112.
Kasparian, N. A., McLoone, J. K., & Meiser, B. (2009). Skin cancer-related prevention and screening behaviors: A review of the literature. Journal of Behavioral Medicine, 32(5), 406–428.
Ma, F., Collado-Mesa, F., Hu, S., & Kirsner, R. S. (2007). Skin cancer awareness and sun protection behaviors in white Hispanic and white non-Hispanic high school students in Miami, Florida. Archives of Dermatology, 143(8), 983–988.
Manne, S. L., Coups, E. J., Jacobsen, P., Ming, M., Heckman, C. J., & Lessin, S. (2011). Sun protection and sunbathing practices among family members of patients with melanoma. BMC Public Health, 11, 122.
Manne, S., Fasanella, N., Connors, J., Floyd, B., Wang, H., & Lessin, S. (2004). Sun protection and skin surveillance practices among relatives of patients with malignant melanoma: Prevalence and predictors. Preventive Medicine, 39(1), 36–47.
McCaul, K. D., & Goetz, P. W. (n.d.). Worry. National Cancer Institute. Health behavior constructs: Theory, measurement, & research. Retrieved from http://dccps.cancer.gov/brp/constructs/worry/index.html
Myers, R. E., Ross, E., Jepson, C., Wolf, T., Balshem, A., Millner, L., et al. (1994). Modeling adherence to colorectal cancer screening. Preventive Medicine, 23(2), 142–151.
Pipitone, M., Robinson, J. K., Camara, C., Chittineni, B., & Fisher, S. G. (2002). Skin cancer awareness in suburban employees: A Hispanic perspective. Journal of the American Academy of Dermatology, 47(1), 118–123.
U.S. Census Bureau. (2008). Hispanics in the United States. Retrieved from http://www.census.gov/population/hispanic/publications/hispanics_2006.html
U.S. Census Bureau. (2010). 2010 Census briefs—overview of race and hispanic origin: 2010. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf
U.S. Environmental Protection Agency. (2011, December 6). Monthly average UV index. Retrieved from http://www.epa.gov/sunwise/uvimonth.html
Weiss, J., Kirsner, R. S., & Hu, S. (2012). Trends in primary skin cancer prevention among US Hispanics: A systematic review. Journal of Drugs in Dermatology, 11(5), 580–586.
Wu, X. C., Eide, M. J., King, J., Saraiya, M., Huang, Y., Wiggins, C., et al. (2011). Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999–2006. Journal of the American Academy of Dermatology, 65(5 Suppl 1), S26–S37.
Acknowledgments
We thank Ciara Rivera for help with study logistics and translation of survey items, Knowledge Networks (GfK Custom Research) for assistance with data collection, and the GenoMEL investigators for sharing their questionnaires with us. This research was supported by the Epidemiology Shared Resource of Rutgers Cancer Institute of New Jersey (P30CA072720). This research was supported by a Cancer Prevention and Control Pilot Award from Rutgers Cancer Institute of New Jersey (Coups) and by National Cancer Institute Grants K07CA133100 (Coups) and K01CA131500 (Hudson).
Conflict of interest
Elliot J. Coups, Jerod L. Stapleton, Sharon L. Manne, Shawna V. Hudson, Amanda Medina-Forrester, Stephen A. Rosenberg, Marsha Gordon, Kristina S. Tatum, June K. Robinson, Ana Natale-Pereira and James S. Goydos declare that they have no conflict of interest
Informed Consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Coups, E.J., Stapleton, J.L., Manne, S.L. et al. Psychosocial correlates of sun protection behaviors among U.S. Hispanic adults. J Behav Med 37, 1082–1090 (2014). https://doi.org/10.1007/s10865-014-9558-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-014-9558-5