Validity of covering-up sun-protection habits: Association of observations and self-report

O’Riordan, David; Nehl, Eric J.; Gies, Peter; Bundy, Łucja; Burgess, Kristen A.; Davis, Erica; Glanz, Karen

doi:10.1016/j.jaad.2008.12.015

Cited by 45 publications

(37 citation statements)

References 15 publications

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“…However, several studies have been conducted demonstrating the reliability and validity of self-report questionnaires of UV exposure and protection compared to observation and objective measures with no systematic bias identified among various populations. 39,41,78-80 …”

Section: Discussionmentioning

confidence: 99%

Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Heckman

Ritterband

Handorf

et al. 2016

American Journal of Preventive Medicine

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Introduction Skin cancer is the most common cancer, and its incidence is increasing. Young adults expose themselves to large amounts of ultraviolet radiation (UV) and engage in minimal skin protection, which increases their risk. Internet interventions are effective in modifying health behaviors and are highly disseminable. The current study's purpose was to test an Internet intervention to decrease UV exposure and increase skin protection behavior among young adults. Study design RCT conducted in 2014, with data analyzed in 2015. Setting/participants A national sample of adults aged 18–25 years at moderate to high risk of developing skin cancer by a self-report measure was recruited online. Intervention Participants were randomized to one of three intervention conditions: assessment only, the website of a skin cancer organization, or a tailored interactive multimedia internet intervention program (UV4.me) based on the Integrative Model of Behavioral Prediction. Main outcome measures Self-reported overall UV exposure and skin protection assessed at 3 and 12 weeks after baseline. Secondary outcomes were self-reported intentional and incidental UV exposure, sunburns, sunscreen use, and skin cancer screening. Results For the intervention arm, there were significant decreases in UV exposure and increases in skin protection at both follow-up time points compared with the assessment-only condition (p<0.001). The effect sizes (Cohen's d) comparing the experimental and assessment-only arm for exposure behaviors were 0.41 at 3-week follow-up and 0.43 at 12-week follow-up. The effect sizes for protection behaviors were 0.41 at 3-week follow-up and 0.53 at 12-week follow-up. The control condition was not significantly different from the assessment only condition. All three conditions exhibited decreased exposure and increased protection at both follow-ups (p<0.01), but the effect was much stronger in the intervention group. Secondary outcomes were generally also significantly improved in the intervention condition compared with the other conditions. Conclusions This is the first published report describing the results of an RCT of an Internet intervention to modify skin cancer risk behaviors among young adults. The UV4.me intervention significantly improved self-reported skin cancer prevention behaviors. Future research will investigate mechanisms of change and approaches for dissemination.

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Section: Discussionmentioning

confidence: 99%

Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Heckman

Ritterband

Handorf

et al. 2016

American Journal of Preventive Medicine

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“…Also, the present trial used only survey measures to assess behaviors, rather than the Sun Habits Diary used in the two earlier trials (20, 21). Nevertheless, recent research has found that survey measures are reasonably valid indicators of sun protection and exposure practices (29–31). …”

Section: Discussionmentioning

confidence: 99%

Effects of Tailored Risk Communications for Skin Cancer Prevention and Detection: The PennSCAPE Randomized Trial

Glanz

Volpicelli

Jepson

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Prevention and early detection measures for melanoma, such as sun avoidance and skin examinations, are important, but are practiced inconsistently. In this replication of the Project SCAPE trial, we sought to determine whether tailored print materials were more effective at improving adherence than generic print materials for patients at increased-risk of skin cancer. Methods Participants were randomized to receive personalized mailed communications about their skin cancer risk and recommended sun protection, or generic mailings. Participants were Caucasian adults, at moderate or high risk for skin cancer, recruited in outpatient primary care. The main outcomes were overall sun protection behaviors and specific protective behaviors including use of sunscreen, shirt, hat, sunglasses, shade and sun avoidance; recent sunburns; and skin self-examination and provider skin examination. Results One hundred ninety-two (93.2%) subjects completed the study. Six outcome variables showed significant intervention condition effects in mixed effects models: overall sun protection behavior (p = .025); sunscreen use (p = .026); use of sunglasses (p = .011); sunburns in the past three months (p = .033); recency of last skin self-exam (p = .017); and frequency of skin exams by health care provider (p = .016). Conclusions Relative to generic communications, tailored risk communications resulted in improved adherence to six skin cancer protective behaviors, including a composite sun protection behavior measure, sunburns, and health care provider skin examinations. Impact Tailored interventions can be more effective in improving patient prevention behaviors than non-tailored, generic information for patients at moderate to high risk of skin cancer.

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“…Self-reported sun behaviors have been shown to have fair to moderate agreement with direct observation, and in these studies there was no substantial overreporting or underreporting of sun behaviors. 29 Second, by 2007, 19% of the students were no longer in the study, and a disproportionate percentage of these participants were "nonwhite." Although darker phenotype is generally protective against skin cancer, this understudied population could have provided unique and invaluable information regarding sun behaviors.…”

Section: Discussionmentioning

confidence: 99%

Prospective Study of Sunburn and Sun Behavior Patterns During Adolescence

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Childhood UV light exposures, specifically sunburns, have been shown to be associated with melanoma development later in life.WHAT THIS STUDY ADDS: To date, most studies in this age group have been cross sectional in nature. This is the first prospective study of sunburn and sun behaviors in this age group. abstract OBJECTIVES: Early childhood UV light radiation (UVR) exposures have been shown to be associated with melanoma development later in life. The objective of this study was to assess sunburn and changes in sunburn and sun behaviors during periadolescence. METHODS:A prospective, population-based study was conducted in fifthgrade children (∼10 years of age) from Framingham, Massachusetts. Surveys were administered at baseline (September-October 2004) and again 3 years later (September-October 2007). Surveys were analyzed to assess prevalence of reported sunburn and sun behaviors and to examine changes in response over the follow-up period.RESULTS: Data were analyzed from 360 participants who had complete information regarding sunburn at both time points. In 2004, ∼53% of the students reported having at least 1 sunburn during the previous summer, and this proportion did not significantly change by 2007 (55%, P = .79), whereas liking a tan and spending time outside to get a tan significantly increased (P , .001). In 2004, 50% of students reported "often or always" use of sunscreen when outside for at least 6 hours in the summer; this proportion dropped to 25% at the followup evaluation (P , .001).CONCLUSIONS: With at least 50% of children experiencing sunburns before age 11 and again 3 years later, targeting children in pediatric offices and community settings regarding unprotected UV exposure may be a practical approach. Because periadolescence is a time of volatility with regard to sun behaviors, learning more about children who receive sunburns versus those who avoid them is a critical research task.

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Validity of covering-up sun-protection habits: Association of observations and self-report

Cited by 45 publications

References 15 publications

Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults

Effects of Tailored Risk Communications for Skin Cancer Prevention and Detection: The PennSCAPE Randomized Trial

Prospective Study of Sunburn and Sun Behavior Patterns During Adolescence

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