Influence of Social and Psychosocial Factors on Summer Vacationers’ Sun Protection Behaviors, the PRISME Study, France

Abstract

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.

Efficacy of an appearance‐based and a health‐based sun protection intervention on summer vacationers' behaviours, PRISME cluster randomized crossover trial, France

“…Sun protection behaviours were collected by six items using a 5-point scale (never = 0, rarely = 1, sometimes = 2, often = 3, always = 4) and measuring the self-reported frequency of the following recommended behaviours when staying outdoors for more than 15 min: (a) wearing a t-shirt that covered the shoulders, (b) wearing a hat, (c) wearing sunglasses, (d) applying sunscreen every 2 h, (e) staying in the shade and (f) avoiding high-risk hours (i.e., noon to 4 pm). Consistency between these items was analysed in a previous work (Durand et al, 2022). A sun protection score, adapted from Glanz (Glanz, Yaroch, et al, 2008), was constructed with the sum of these six items and ranged from 0 to 24.…”

“…In our study, the impact of ABi on protection of vacationers with only a secondary school certificate supports this finding, although it should be investigated in future studies. As this population has poorer sun protection than those with a university degree (Bocquier et al, 2016; Durand et al, 2022), ABi may thus decrease social inequalities regarding sun protection. The mechanisms involved in the efficacy of the interventions should be analysed with the evolution of intermediate psychosocial outcomes such as knowledge, attitude or social norms.…”

“…Skin sensitivity was self‐reported and collected in the questionnaire for all participants by six items representing the self‐assessed constitutional skin colour (i.e. the colour on an unexposed area of skin from “very light” to “black”), eye and hair colour, presence of moles and skin reactivity to the sun in terms of tanning and sunburn and analysed with a factorial analysis presented in (Durand et al, 2022). Variables related to the survey context were also collected: time since arrival in the campsite, week and campsite.…”

“…Some misconceptions about sun exposure and protection are growing over time, in particular those in relation to the consequences of sunburns in childhood or photoaging (Ménard & Thuret, 2018). Social differentiation exists, with socially and economically disadvantaged people (Bocquier et al, 2016; Durand et al, 2022) and teenagers (Bruce et al, 2017; Falk & Anderson, 2013; Ménard & Thuret, 2018) reporting lower sun protection. With a high level of UV radiation and millions of vacationers each summer, the French Mediterranean coastline is a particularly relevant place to evaluate sun protection interventions, although such evaluations are still rare.…”