Discussion: Despite certain study limitations, PRISME take into consideration several known methodological gaps. The study's results will enable to evaluate the efficacy of the promising appearance-based approach in France, and to identify vulnerable sub-populations and mechanisms to improve sun-protection behaviors of French tourists.
Objectives: Summer intermittent sun exposure is a major risk factor for melanoma. Socioeconomic position, cognitive and psychosocial factors play a role in sun protection behaviors but the underlying mechanisms are unknown. This study aimed to measure the influence of educational level on sun protection behaviors in French summer vacationers on the Mediterranean coastline, and to identify the mediating psychosocial factors in this pathway.Methods: In summer 2019, French vacationers aged 12–55 staying in coastline campsites were asked about their holiday sun protection behaviors, their knowledge, attitudes, perceived control, and social norm relative to sun protection. A structural equation model measured the direct and indirect effects of educational level on protection behaviors via cognitive and psychosocial factors.Results: Sun protection during vacation increased with educational level. Theoretical knowledge partially mediated this association, from 22% to 86%, particularly for intermediate educational levels.Conclusion: Our results highlight the importance of implementing suitable sun prevention interventions for vacationers, especially those with a lower socioeconomic position. Improving theoretical knowledge around sun protection may be an important part of broader efforts to encouraging improved preventive behaviors.
The theory of planned behavior (TPB) has been criticized for not including interaction effects between its major constructs and for not dealing with the processes involved in the intentions-physical activity (PA) relationship. This study tested an extended TPB model including interaction effects between TPB constructs (i.e., attitudes, subjective norms, perceived behavioral control [PBC], and intentions) and additional variables hypothesized to be moderators of the intentions-PA relationship (i.e., planning and perceived built environment). TPB variables, planning, perceived built environment, and PA were measured at Time 1 (N ϭ 612). PA measure was repeated 3 months later at Time 2 (N ϭ 219). Two hierarchical linear regressions were performed to examine the determinants of intentions at T1 and the determinants of PA at T2. Analyses demonstrated significant Attitudes ϫ PBC and Subjective Norms ϫ PBC interactions on intentions (ps Ͻ .05). A high level of subjective norms and attitudes strengthen the relationship between PBC and intentions. Analyses also highlighted a significant Intentions ϫ Planning ϫ Perceived Built Environment triple interaction on PA (p Ͻ .05). The relationship between intentions and PA is only significant for participants with a medium or high level of planning and a high perceived proximity to PA facilities. Future studies should test interaction effects between TPB variables and explore the interplay between psychosocial and environmental variables when focusing on the intentions-PA relationship.
ObjectivesSun‐seeking vacationers are particularly vulnerable to melanoma. Appearance‐based interventions (ABi) showing skin damage of ultraviolet exposure may be a promising prevention tool to improve skin protection. This study aimed to measure and compare the efficacy of an ABi and a health‐based intervention (HBi) on French summer vacationers' behaviours and to identify differences between subpopulations.DesignA cluster randomized crossover trial with three intervention groups (control, ABi, HBi) was conducted in eight campsites on the French Mediterranean coast in summer 2019.Methods1355 vacationers of both sexes and aged 12–55 years were included and followed up after 4 days (T1) and 14 months (T2). Efficacy of interventions was evaluated using multilevel mixed‐effect models comparing groups on three outcomes: self‐reported sun protection behaviours, sunbathing and skin colour measures. Protection behaviours were analysed according to subpopulations.ResultsCompared to controls, the ABi group had a higher protection and sunbathed for fewer hours at T1 and T2. In the HBi group, the skin colour was lighter than controls at T1. When comparing ABi to HBi, ABi participants had lower exposure than HBi at T1 and T2. The protection of people with a 3‐years university degree was higher in the HBi group than in others groups while that of people with a secondary school certificate was higher in the ABi group.ConclusionsOur study provides further evidence of individual sun protection interventions effect in a touristic setting and highlights the relevance of ABi messages to supplement HBi messages, particularly in certain subpopulations with low to intermediate education levels.
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