Adolescent sunscreen use in springtime: a prospective predictive study informed by a belief elicitation investigation

How Individuals Apply and Perceive Sunscreen: Empirical Evidence from Germany

INTRODUCTION

This study explores how individuals in Germany use and perceive sunscreen, aiming to identify the factors that influence their sunscreen choices. The research focuses on key elements such as convenience, environmental awareness, openness to new technologies, and preferences for different sunscreen products.

METHODS

We gather data with a questionnaire among 203 individuals from Germany.

RESULTS

The findings reveal that the majority of participants prioritize convenience when selecting sunscreen, often choosing products that are easy to apply and carry. Detailed information about the sunscreen's ingredients or health benefits tends to be less important in their decision-making process. Notably, many participants did not consider important factors such as the environmental impact of sunscreen or its effectiveness after reapplication, suggesting a gap in awareness regarding these issues. Additionally, the study investigates the relationship between demographic factors, including age and sex, and sunscreen usage patterns. It was found that these demographic variables do play a role in shaping individuals' attitudes and behaviors regarding sunscreen. For instance, younger participants showed more openness to new technologies and innovative products, while older individuals tended to rely on traditional options.

CONCLUSION

Overall, this research provides valuable insights into how people perceive and use sunscreen in Germany, highlighting the need for further studies to delve deeper into these factors. Understanding these perceptions is crucial for developing effective public health strategies and enhancing product design to better meet the needs and preferences of consumers.

INTRODUCTION

This study explores how individuals in Germany use and perceive sunscreen, aiming to identify the factors that influence their sunscreen choices. The research focuses on key elements such as convenience, environmental awareness, openness to new technologies, and preferences for different sunscreen products.

METHODS

We gather data with a questionnaire among 203 individuals from Germany.

RESULTS

The findings reveal that the majority of participants prioritize convenience when selecting sunscreen, often choosing products that are easy to apply and carry. Detailed information about the sunscreen's ingredients or health benefits tends to be less important in their decision-making process. Notably, many participants did not consider important factors such as the environmental impact of sunscreen or its effectiveness after reapplication, suggesting a gap in awareness regarding these issues. Additionally, the study investigates the relationship between demographic factors, including age and sex, and sunscreen usage patterns. It was found that these demographic variables do play a role in shaping individuals' attitudes and behaviors regarding sunscreen. For instance, younger participants showed more openness to new technologies and innovative products, while older individuals tended to rely on traditional options.

CONCLUSION

Overall, this research provides valuable insights into how people perceive and use sunscreen in Germany, highlighting the need for further studies to delve deeper into these factors. Understanding these perceptions is crucial for developing effective public health strategies and enhancing product design to better meet the needs and preferences of consumers.

An explorative study of beliefs in two groups of community health promoters of adolescent reproductive health in Indonesia: informed by theory of planned behavior

OBJECTIVE

To explore beliefs in specific social context and potential individual-level behavioral strategies used by two groups of community health promoters to foster their participation of promoting ARH.

DESIGN

Two phases of formative studies based on the Theory of Planned Behavior (TPB) was conducted with community health promoters in the integrated service center (pos pelayanan terpadu/posyandu), posyandu cadres and peer educators of three villages in Tengger, East Java, Indonesia.

RESULT

The phase one, conducted with posyandu cadres (n = 20) and peer educators (n = 21). A survey using open-ended questions and focus group discussion was carry out to elicit accessible behavioral (advantages and disadvantages), normative (references of who have significant roles for promoters) and control (personal or situational factors) beliefs related to ARH promotion. The content analysis, elicited 15 salient beliefs for posyandu cadre and 21 for the peer educators. In phase two, the participants who previously participated in phase 1 (posyandu cadres (n = 14 and peer educators (n = 21))), completed two questionnaires to measure the belief strength and evaluation of the beliefs.

CONCLUSIONS

The result showed that each group has different characteristic in the strength of their beliefs in promoting reproductive health. The findings highlight the social context underlying beliefs associated with ARH promotion and opportunities to enhance engagement with the different groups of community health promoters.

Knowledge and Attitude of General Population toward Effects of Sun Exposure and Use of Sunscreens

Background

Sun exposure causes extensive intrinsic as well as extrinsic changes in the skin. Pathogenic effects of sun exposure such as tanning, melasma, skin cancer, and aggravation of various photodermatoses such as systemic lupus erythematosus (SLE) may be prevented by the use of sunscreens. We conducted the present study to assess the knowledge and attitudes regarding sun exposure and use of sunscreens.

Methods

Two thousand and thirty-seven volunteers answered the questionnaire over a period of 2 years. All adults aged 18 years and above who voluntarily agreed to participate in the study after written informed consent were included.

Results

Out of 2037 volunteers, 1242 volunteers had no knowledge of sunscreens. Sixty-eight percent of the volunteers from the upper class of society knew about sunscreens, and 86% of the volunteers from the lower middle class did not know about sunscreens. Eight-one percent of the volunteers did not suffer from sunburns. Eight-four percent of the volunteers were aware that sun exposure caused darkening, but awareness about other effects of sun exposure such as wrinkling, melasma, allergy, and photo-induced cancers was less. Most of the volunteers agreed that sunscreens protected against sun damage and tanning. Fifty-eight percent of the volunteers applied sunscreen before venturing out, and 78% of the volunteers applied sunscreen only on the face. Prevention of tanning was the most common reason for the usage of sunscreens. Cosmetic appeal and irritant potential were the prominent deciding factors in choosing sunscreens.

Conclusion

Awareness about protective spectrum of sunscreens, their correct method of application, and misconceptions need to be focused on. Better product development keeping in mind the Indian conditions would help in increasing the usage of sunscreens.

Quantifying the visual appearance of sunscreens applied to the skin using indirect computer image colorimetry

BACKGROUND

There is no accepted method to objectively assess the visual appearance of sunscreens on the skin.

METHODS

We present a method for sunscreen application, digital photography, and computer analysis to quantify the appearance of the skin after sunscreen application. Four sunscreen lotions were applied randomly at densities of 0.5, 1.0, 1.5, and 2.0 mg/cm² to areas of the back of 29 subjects. Each application site had a matched contralateral control area. High-resolution standardized photographs including a color card were taken after sunscreen application. After color balance correction, CIE L*a*b* color values were extracted from paired sites. Differences in skin appearance attributed to sunscreen were represented by ΔE, which in turn was calculated from the linear Euclidean distance within the L*a*b* color space between the paired sites.

RESULTS

Sunscreen visibility as measured by median ΔE varied across different products and application densities and ranged between 1.2 and 12.1. The visibility of sunscreens varied according to product SPF, composition (organic vs inorganic), presence of tint, and baseline b* of skin (P < .05 for all).

CONCLUSION

Standardized sunscreen application followed by digital photography and indirect computer-based colorimetry represents a potential method to objectively quantify visibility of sunscreen on the skin.

Systematic and Iterative Development of a Smartphone App to Promote Sun-Protection Among Holidaymakers: Design of a Prototype and Results of Usability and Acceptability Testing

Background

Sunburn and intermittent exposure to ultraviolet rays are risk factors for melanoma. Sunburn is a common experience during holidays, making tourism settings of particular interest for skin cancer prevention. Holidaymakers are a volatile populations found at different locations, which may make them difficult to reach. Given the widespread use of smartphones, evidence suggests that this might be a novel, convenient, scalable, and feasible way of reaching the target population.

Objective

The main objective of this study was to describe and appraise the process of systematically developing a smartphone intervention (mISkin app) to promote sun-protection during holidays.

Methods

The iterative development process of the mISkin app was conducted over four sequential stages: (1) identify evidence on the most effective behavior change techniques (BCTs) used (active ingredients) as well as theoretical predictors and theories, (2) evidence-based intervention design, (3) co-design with users of the mISkin app prototype, and (4) refinement of the app. Each stage provided key findings that were subsequently used to inform the design of the mISkin app.

Results

The sequential approach to development integrates different strands of evidence to inform the design of an evidence-based intervention. A systematic review on previously tested interventions to promote sun-protection provided cues and constraints for the design of this intervention. The development and design of the mISkin app also incorporated other sources of information, such as other literature reviews and experts’ consultations. The developed prototype of the mISkin app was evaluated by engaging potential holidaymakers in the refinement and further development of the mISkin app through usability (ease-of-use) and acceptability testing of the intervention prototype. All 17 participants were satisfied with the mISkin prototype and expressed willingness to use it. Feedback on the app was integrated in the optimization process of the mISkin app.

Conclusions

The mISkin app was designed to promote sun-protection among holidaymakers and was based on current evidence, experts’ knowledge and experience, and user involvement. Based on user feedback, the app has been refined and a fully functional version is ready for formal testing in a feasibility pilot study.

Aware, motivated and striving for a 'safe tan': an exploratory mixed-method study of sun-protection during holidays

Background: This article presents an exploratory study, aiming to explore the correspondence between knowledge, motivation and sun-protection practices during holidays. Methods: Seventeen participants aged 21-62 years old, recruited from community settings took part in individual face-to-face semi-structured interviews, completed sun sensitivity questions and an objective assessment of sunscreen use. Holidaymakers' knowledge about sun-safe messages, intentions and perceptions of barriers and facilitators for sun-protection were assessed. Qualitative data were analysed using thematic analysis and integrated with quantitative data, using a pragmatic theory-informed approach to synthesise the findings. Results: Participants were well informed about sun-safe messages, highly motivated to protect themselves from solar UV radiation (UVR) and they perceived themselves as well protected. However, they did not seem to use effective protective practices. Sunscreen was the preferred method of sun-protection, but most participants used considerably less than the recommended amount and significantly overestimated the amount of time they could be safely exposed. Seeking shade was the least used method of sun-protection and covering-up strategies were mostly implemented as a partial protection (i.e. hats or sunglasses). The desire to reach an optimal balance between getting a tan and using sun-protection to avoid sunburns was preeminent. Several additional barriers and facilitators for sun-protection were identified. Conclusions: Holidaymakers might have a false sense of security when it comes to sun-exposure. They are aware of the need to protect from solar UVR, but the motive for a safe tan, the overreliance on sunscreen, the overestimation of the safe sun-exposure time for their skin type and the insufficient application of sunscreen leaves holidaymakers motivated to protect their skin at significant risk of overexposure, sunburn and skin cancer. Public health messages need to address how to implement effective sun-safe strategies.

Adding Perspective: Predicting Adolescent Sunscreen Use with an Extended Health Action Process Approach

BACKGROUND

Diseases such as skin cancer often have a very long latency period. For adolescents, especially, it may be difficult to grasp that current risk behavior is related to future health outcomes. This study examines the role of health-related time perspective (i.e. the degree to which short-term outcomes are discounted over long-time health benefits) within the Health Action Process Approach (HAPA). More specifically, based on expectancy*value theory, we tested whether time perspective interacts with self-efficacy, the central variable in this approach.

METHODS

A longitudinal study with three measurement points across one year assessed 156 high school students. Data were analyzed using structural equation models.

RESULTS

While time perspective had no direct association with sunscreen use intentions, there was an interaction effect with self-efficacy; the shorter the time perspective, the smaller the association of self-efficacy with intention. Intention in turn predicted planning and sunscreen use at Time 3 (one year later).

CONCLUSIONS

In order to maximise the impact of early onset measures for skin cancer prevention targeting the motivation for sunscreen use in adolescents, time perspective should be addressed in comprehensive sun protection interventions.

Using UV photoaged photography to better understand Western Australian teenagers' attitudes towards adopting sun-protective behaviors

BACKGROUND

This study aimed to determine whether the viewing of a personal photoaged photograph had the capacity to alter Western Australian teenagers' pro-tanning attitudes.

METHOD

Semi-structured interviews were conducted with fifteen teenagers.

FINDINGS

The teenagers' pro-tanning attitudes prior to viewing their photoaged photograph are encapsulated in the study's central theme: 'You've got to look after your skin and use sunscreen, but I always forget!'. Post-viewing their photoaged facial image many teenagers reiterated their intentions to adopt (when they remembered) skin-protective measures. However, photoaged photography did not alter other teenagers' intention to tan. NEW KNOWLEDGE: Teenagers who choose to continue to tan were aware of the long-term health risks associated with ultra-violet over-exposure. However, their desire remained strong to emulate the media promoted image of bronzed youth being popular individuals. Indeed, the social benefits of being considered attractive to their peers became an attitudinal barrier to the teenagers' adoption of skin-protective behaviours. Those teenagers who changed their pro-tanning attitudes following their viewing of their ultra-violet photoaged photograph did so because of the shock they received when they saw their sun-damaged facial image. This suggests that photoageing photography can be effective with many adolescents because it reduces the cause-and-effect delay that exists between the occurrence of sun-damage and its visual presentation in later-life.

CONCLUSION

Greater effort needs to be focused on increasing teenagers' understanding of how sun-damage occurs, when it is appropriate to apply sunscreen, as well as in changing the prevailing media image of an attractive body being a tanned body.

Perceptions of melanoma risk among Australian adolescents: barriers to sun protection and recommendations for improvement

OBJECTIVES

To explore adolescents' perceptions of melanoma risk, sun protection intervention preferences and perceived barriers to sun protection recommendations.

METHODS

Semi-structured focus groups were held in school classes, stratified by location (coastal, inland) and sector (public, private); discussions were transcribed verbatim and data were analysed using NVivo8 software.

RESULTS

100 students (mean age=14.4 years, SD=0.5; range=14-16 years) from six high schools participated. Students demonstrated a high level of sun protection knowledge and understanding of sun exposure as a primary risk factor for the development of melanoma. There was, however, an under-estimation of melanoma prevalence and mortality rates among youth, and poor understanding of the increased risk associated with sunburn during childhood/adolescence. Adolescents' preferences for intervention focused on first-person accounts of receiving a melanoma diagnosis, communicated by young melanoma survivors. Interventions modelled on youth marketing campaigns or utilising social media were rated poorly.

CONCLUSIONS

Despite young Australians' adequate knowledge of melanoma and related health recommendations, poor adherence continues to place young people at risk. Study findings suggest that social media interventions developed to influence behaviour change, are not necessarily preferred by adolescents.

Predicting sun protection behaviors using protection motivation variables

Protection motivation theory components were used to predict sun protection behaviors (SPBs) using four outcome measures: typical reported behaviors, previous reported behaviors, current sunscreen use as determined by interview, and current observed behaviors (clothing worn) to control for common method bias. Sampled from two SE Queensland public beaches during summer, 199 participants aged 18-29 years completed a questionnaire measuring perceived severity, perceived vulnerability, response efficacy, response costs, and protection motivation (PM). Personal perceived risk (similar to threat appraisal) and response likelihood (similar to coping appraisal) were derived from their respective PM components. Protection motivation predicted all four SPB criterion variables. Personal perceived risk and response likelihood predicted protection motivation. Protection motivation completely mediated the effect of response likelihood on all four criterion variables. Alternative models are considered. Strengths and limitations of the study are outlined and suggestions made for future research.