Messages Influencing College Women's Tanning Bed Use: Statistical versus Narrative Evidence Format and a Self-Assessment to Increase Perceived Susceptibility

Abstract

Understanding the effect of messages and other influences on health decision-making has the potential to decrease risky behavior such as tanning bed use. This study explores the effect of type of evidence, self-assessments of risk for skin cancer, and personality factors on intention to use and use of tanning beds among Caucasian female college students. Specifically, it targeted the perceived susceptibility component of the Health Belief Model and its impact on intention to tan as well as changes in actual tanning behavior. College students (N=141) in the southeast United States read randomly assigned messages and self-assessments, filled out surveys, and were later contacted for a follow-up telephone survey. The statistical message was rated higher on information value and also resulted in decreased intention to tan, decreased tanning behavior, and increased perceived susceptibility to skin cancer. The narrative message, in contrast, increased perceptions of realism and also worked to decrease intentions to tan. Additionally, the self-assessment manipulation resulted in increased susceptibility and decreased intention to tan and post tanning behavior. Personality factors explained small portions of variance. Key limitations and directions for future research are also addressed.

Narrative communication in cancer prevention and control: A framework to guide research and application

“…Personal narratives, which are anchored in the lived world of the narrator, provide important social, environmental, and cultural references that make the narration ''real'' for the audience. Several studies have reported that narratives are indeed perceived as more real, firsthand, and believable than other types of information (23,90,104). Composite stories that integrate narratives from multiple individuals may allow communication developers more control over the accuracy of health content while maintaining the realism of personal experience.…”

Indoor Tanning: A Bio-Behavioral Risk Factor for Skin Cancer

“…Indoor tanning behavior is also influenced by beliefs about its effects on the skin in terms of skin cancer and other skin damage such as photo-aging. Some studies have found higher perceived skin damage susceptibility to be associated with greater indoor tanning behavior (Cafri, Thompson, Roehrig et al, 2006;Coups et al, 2008;Greene & Brinn, 2003;Heckman, Coups et al, 2008), some have found higher perceived threat of or susceptibility to skin harm to be associated with lower indoor tanning intentions Cafri, Thompson, Roehrig et al, 2006;Greene & Brinn, 2003), and at least one has found no association (Hillhouse, Stair, & Adler, 1996). Differences in measurement may account for such varied results.…”

“…Finally, two studies focusing on skin cancer risk and mortality demonstrated some success. Green and Brinn (Greene & Brinn, 2003) found that participants in both a statistical information about skin cancer condition and a personal narrative skin cancer case study condition reduced their indoor tanning at six months. Another study using the Mortality Salience approach also demonstrated reduced interest in indoor tanning (Routledge, Arndt, & Goldenberg, 2004).…”

Support for indoor tanning policies among young adult women who indoor tan

“…Perceived severity and susceptibility to skin cancer-Five items were adapted from previous research to assess participants' perceived severity of skin cancer based on a 5-point scale (1 = strongly disagree, 5 = strongly agree) [24]. Example items include "Skin cancer is not very serious" and "Many people survive skin cancer without scarring or long-lasting effects."…”

“…Responses were averaged to create an overall score with higher values indicating greater perceived severity of skin cancer (Cronbach's α = 0.73). Perceived personal susceptibility to the risks of tanning was measured using seven items adapted from previous research [24]. Items assessed participants' level of agreement with statements about susceptibility to the risks of tanning on a 5-point scale (1 = strongly disagree, 5 = strongly agree).…”