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Are Interventions to Promote Sun-Protective Behaviors in Recreational and Tourist Settings Effective? A Systematic Review with Meta-analysis and Moderator Analysis

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Intermittent sun exposure and sunburn are risk factors for skin cancer that mostly occur in recreational/tourist settings. This review assesses the efficacy of skin cancer prevention interventions designed to promote sun-protective behaviors in recreational/tourist settings.

Methods

Systematic review with meta-analyses of controlled trials with outcome measures of sun-protective behaviors and/or sunburn published until January 2011.

Results

Twenty-three studies were included. We found no evidence for the efficacy of current interventions in reducing tanning or promoting protective clothing and seeking shade. Meta-analyses show a small heterogeneous effect for interventions on sun-protective behavior indices. Larger but heterogeneous effects were observed for self-reported sun exposure and sunburns. Modest methodological quality suggests risk of bias. Effective interventions were more likely to stimulate social norms supporting sun-protective behaviors and provide appearance-based information about photoaging illustrated with ultraviolet photographs.

Conclusion

There is weak and inconclusive evidence for the efficacy of interventions in promoting sun-protective behaviors.

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Notes

  1. For a total of 17 out of the 23 trials included in the review, it was possible to compute an effect size for an sun-protective behavior (SPB) outcome—either an index of SPBs (the most common outcome of studies in this review), or, for studies not reporting an overall SPB index, on the reported outcome most similar to the SPB index (e.g., sunscreen use).

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Acknowledgments

Angela Rodrigues is funded by a PhD fellowship from the Portuguese Science and Technology Foundation (FCT) (reference: SFRH/BD/60392/2009). Falko F. Sniehotta is funded by Fuse, the Centre for Translational Research in Public Health, a UKCRC Public Health Research Centre of Excellence. Funding for Fuse from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Health Psychology Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

    Angela Rodrigues M.Sc., Falko F. Sniehotta Ph.D. & Vera Araujo-Soares Ph.D.

  2. Medical Faculty, Institute of Health and Society, Newcastle University, Baddiley-Clarke Building, Richardson Road, NE2 4AX, Newcastle upon Tyne, UK

    Falko F. Sniehotta Ph.D.

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  1. Angela Rodrigues M.Sc.
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Correspondence to Falko F. Sniehotta Ph.D..

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Rodrigues, A., Sniehotta, F.F. & Araujo-Soares, V. Are Interventions to Promote Sun-Protective Behaviors in Recreational and Tourist Settings Effective? A Systematic Review with Meta-analysis and Moderator Analysis. ann. behav. med. 45, 224–238 (2013). https://doi.org/10.1007/s12160-012-9444-8

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