Sun awareness in Maltese secondary school students

Awareness and Knowledge of the Effect of Ultraviolet (UV) Radiation on the Eyes and the Relevant Protective Practices: A Cross-Sectional Study from Jordan

Background: Overexposure to ultraviolet (UV) radiation is linked to serious adverse health effects that are cumulative in nature and affect children more than adults. UV radiation has also been reported to have serious complications for the eye, particularly in areas with a high UV radiation index. Increasing public awareness about the harmful effects of UV radiation on the eye and promoting awareness about protection against UV radiation may prevent eye disease related to UV radiation damage and help in the improvement of public health in general. This study aims to assess public awareness and knowledge of UV radiation and practices toward UV protection in Jordan, which is a country recognized as having a relatively high UV index throughout the year. Methods: A cross-sectional study was performed using an online questionnaire using Google Forms^® to assess people's awareness, knowledge, practices toward eye protection from UV radiation, and the reasons for not wearing UV-protective eyeglasses in Jordan. Sociodemographic information of participants including age, gender, education level, and employment status was also acquired. People's knowledge on UV protection and harmfulness was measured via rewarding their correctly answered knowledge questions with one mark and zero for incorrectly answered questions based on key answers defined from the literature. Results: A total of 1331 participants (77% females and 23% males) with an average age of 26(±10) years completed the online questionnaire. Participants showed generally high levels of knowledge and awareness about UV radiation and its harmful effects. Nevertheless, participants showed a low level of knowledge about the link between UV radiation and some of the ocular diseases in the questionnaire. Practices toward UV radiation protection where inadequate, with 59% of the respondents reporting that they do not use any protective eyewear from natural UV radiation. The main reported reason for not wearing UV-protective sunglasses was uncertainty in the efficiency of UV protection in sunglasses, as reported by 47% of the participants who do not wear UV-protective sunglasses. Conclusions: The awareness of UV radiation and its harmful effects is high in the studied population. Participant knowledge is also relatively high in relation to nature of solar UV radiation, other synthetic sources of UV radiation, and the most dangerous UV exposure time. However, low participant knowledge was measured on the association between UV radiation with ocular disease and the role of UV-protective eyeglasses. Participant practice toward UV radiation protection was found to be insufficient. Thus, it is important to further increase the knowledge of damaging effects of solar and synthetic UV radiation and emphasize the benefits of eye protection from UV radiation. Eye care practitioners should target youth by different strategies including health campaigns, media, and clinics.

Affecting Young Children’s Knowledge, Attitudes, and Behaviors for Ultraviolet Radiation Protection through the Internet of Things: A Quasi-Experimental Study

Prolonged exposure to ultraviolet (UV) radiation is linked to skin cancer. Children are more vulnerable to UV harmful effects compared to adults. Children’s active involvement in using Internet of Things (IoT) devices to collect and analyze real-time UV radiation data is suggested to increase their awareness of UV protection. This quasi-experimental pre-test post-test control group study implemented light sensors in a STEM inquiry-based learning environment focusing on UV radiation and protection in primary education. This exploratory, small-scale study investigated the effect of a STEM environment implementing IoT devices on 6th graders’ knowledge, attitudes, and behaviors about UV radiation and protection. Participants were 31 primary school students. Experimental group participants (n = 15) attended four eighty-minute inquiry-based lessons on UV radiation and protection and used sensors to measure and analyze UV radiation in their school. Data sources included questionnaires on UV knowledge, attitudes, and behaviors administered pre- and post-intervention. Statistically significant learning gains were found only for the experimental group (t14 = −3.64, p = 0.003). A statistically significant positive behavioral change was reported for experimental group participants six weeks post-intervention. The study adds empirical evidence suggesting the value of real-time data-driven approaches implementing IoT devices to positively influence students’ knowledge and behaviors related to socio-scientific problems affecting their health.

Assessment of sun-related behaviour, knowledge and attitudes among nursing students

BACKGROUND

As future healthcare professionals, nursing students will play an important role in social training and promoting healthy behaviours including protection against sunlight. However, few studies to date have focused on their knowledge and attitudes regarding sun-related behaviour.

OBJECTIVE

To evaluate the level of knowledge, attitudes and practices about sun protection and skin cancer among nursing students.

METHODS

This cross-sectional study included 200 all year nursing students from University of Vigo, located in the Vigo, Ourense and Pontevedra campus. Participants completed a validated, self-reported questionnaire with 38 questions regarding their demographic characteristics, sun-related behaviour, knowledge and attitudes.

RESULTS

Approximately 87% of students reported experiencing sunburn last summer and 57% stated that they had sunbathed more than 15 days. Participants showed low level of sun protection behaviours, with the exception of using sunscreen (86%) and wearing sunglasses (72.5%). Knowledge about skin cancer and sun protection was considered high (rate of correct responses 87.7%, 6.14 out of 7). Moreover, positive tanning attitudes were high in the sample overall. Nursing students awarded a high value to tanned skin and showed misconceptions about sun exposure.

CONCLUSION

Although most of the students were aware of the side effects of sun exposure, their behaviours and attitudes were unsatisfactory. A high level of knowledge may not be predictive of positive practices and adequate attitudes, even among future healthcare professionals. Further guidance and educational campaigns are utmost important, particularly in a group that will be directly involved in prevention and early diagnosis of skin cancer.

Skin cancer-related coping appraisal among farmers of rural areas: Applying protection motivation theory

BACKGROUND

Skin cancers are the most common malignancies in Iran. According to the statistics, skin cancer is the most prevalent cancer in Ilam city. This study is conducted to evaluate skin cancer coping of farmers in rural areas of Ilam city.

METHODS

This is a cross-sectional study. Samples were collected by multistage random sampling. The required data were collected by a researcher-made questionnaire from 248 farmers in rural areas of Ilam city. Questions were based on the protection motivation theory, and they were related to the subscales of response efficacy, self-efficacy, and response costs. Collected data were analyzed by SPSS software version 16.

RESULTS

Results of this study indicated that efficacy and perceived self-efficacy in farmers were low and response cost was high. The efficacy and perceived self-efficacy were high in 18.1% and 4.8% of farmers, respectively, and only 4.4% of them had low response costs, in association with protective behaviors. Regarding coping appraisal status also results showed that 204 people of farmers (82.3%) were unacceptable, one person (0.4%) was in the borderline, and 43 people (17.3%) were acceptable. There was a statistically significant association between coping appraisal status and education level and also income amount (P < 0.001) but there was no statistically significant association between coping appraisal status and family size (P > 0.670).

CONCLUSION

The founding proved that a coping appraisal is a beneficial approach for predicting cognitive determinants of skin cancer behavior among rural farmers. The most farmers have been the low level of coping appraisal (82.3% were unacceptable).

Use of social networking sites and associations with skin tone dissatisfaction, sun exposure, and sun protection in a sample of Australian adolescents

OBJECTIVE

Previous research has indicated that greater exposure to traditional media (i.e. television, film, and print) predicted skin cancer risk factors in adolescents; however, the relationship between social media usage and these outcomes remains unexplored. We examined whether social networking site (SNS) usage, and the particular manner of this use, was associated with skin tone dissatisfaction, sun exposure and sun protection among Australian adolescents. We also explored sex differences in SNS usage related to tanning.

METHOD

A total of 1856 South Australian secondary school students completed the Australian School Students Alcohol and Drug 2014 survey. SNS usage related to tanning comprised posting pictures, posting text, viewing pictures, viewing text and liking or sharing posts.

RESULTS

Adolescents spent 214.56 minutes, on average, per day using SNSs. Behaviours related to tanning that involved pictures (i.e. viewing pictures, posting pictures, and liking or sharing content) were significantly associated with more skin tone dissatisfaction, more sun exposure and less sun protection. Females performed all SNS-linked behaviours more frequently than did males, with the exception of posting text.

CONCLUSION

Australian adolescents spend a considerable amount of time using SNSs, and their behaviours related to tanning on these SNSs are significantly associated with skin cancer risk factors.

Evaluation of Project Students are Sun Safe (SASS): A University Student-Delivered Skin Cancer Prevention Program for Schools

Skin cancer is the most common cancer in the USA and is increasing in children and young adults. Adolescents are an important target population for sun-safety interventions with ultraviolet radiation as the strongest risk factor for developing skin cancer. Schools are an ideal setting to intervene with adolescents. A novel Arizona skin cancer prevention in-class education-activity program, Project 'Students are Sun Safe' (SASS), was designed to be delivered by university students for middle school and high school students. Participant students completed the pre- and post-program tests and a satisfaction questionnaire; teachers completed reviews. The evaluation examined the program's influence on participants' sun-safety knowledge, perceptions, and behaviors; satisfaction with the program; and intent to change. After exposure to Project SASS, participants were more likely to perceive a high risk of skin cancer, report negative attitudes toward tanned skin, and answer knowledge-based questions correctly. There were minimal differences in self-reported sun-safety behaviors, though participants did report intent to change. Both participants and teachers were satisfied with the program. Project SASS appears to be an effective sun-safety program for middle school and high school students for knowledge and perceptions, and the results confirm that appropriately tailoring program components to the target population has strong potential to impact adolescent perceived susceptibility, knowledge, and behavioral intent. The strengths and weaknesses of Project SASS have many implications for public health practice, and Project SASS may hold promise to be a model for skin cancer prevention in adolescents.

Knowledge, attitudes and practices of the general public toward sun exposure and protection: A national survey in Saudi Arabia

Background: Many international studies have been conducted to assess the knowledge, attitudes and practices (KAP) of the public toward sun exposure and sun-protection measures. However, there are scarce data on these factors from the Middle East. Objectives: This study aimed to explore the KAP of the public toward sun exposure and sun-protection measures among Saudis. Methods: A cross-sectional survey using a specially designed questionnaire was conducted on a stratified random sample of the general population in the five geographical regions of Saudi Arabia (central, eastern, northern, southern, and western). Data were collected between October 2010 and March 2011. Multiple logistic regressions were applied to relate the use of sunscreen and skin cancer awareness with various socio-demographic variables. Results: The questionnaire was distributed to 2900 Saudis. A total of 2622 questionnaires were completed, returned, and included in the data analysis, corresponding to a response rate of 90.4%. The mean (SD) age of respondents was 27.8 ± 9.7 years. Fifty percent (1301/1601) of the respondents were males. Fifty-five percent (1406/2544) were aware of the association between sun exposure and skin cancer. Female, young and student respondents were more likely to be aware of the connection between sun exposure and skin cancer (p < 0.001). Likewise, respondents from the middle social class and those with higher education levels were more likely to be informed (p < 0.02). The prevalence of regular sunscreen use among study participants was only 23.7%, and female and employed respondents were more likely to use sunscreen (p < 0.001). Protective clothes were the most commonly used sun protection measure as reported by more than 90% of our participants. Conclusion: This study has shown that sun awareness and protection are generally inadequate in the Saudi population and suggests the need for health education programs.

Knowledge, perceptions and behaviours about skin cancer and sun protection among secondary school students from Central Italy

BACKGROUND

Although sun exposure is a strong risk factor for skin cancer, tanning is very popular among adolescents. Awareness of skin cancer and sun exposure might influence sun protective behaviours in this population.

OBJECTIVES

To investigate the awareness of skin cancer and sun-safe practices among Italian adolescents.

METHODS

A questionnaire about knowledge of skin cancer, perceived severity of sun rays/skin cancer and behaviour toward sun protection was administered to 1204 secondary school students. Predictors of these three components were assessed by case-control analyses considering different combinations of answers. Multiple logistic regression models were used to this scope.

RESULTS

The majority of participants had heard of skin cancer in the past (97.0%), correctly identified possible causes (58.6%) and names (64.2%) of skin cancers and judged appropriately the perceived danger of sunrays (70.2%) and skin cancer (80.6%). Nonetheless, students' behaviour was poor: only 13.5% stated to always use sun-safe practices and 39.1% never used any. Independent predictors of proper knowledge were: Lyceum school, and family or TV/media as information source; of appropriate perceived severity: Lyceum school, a darker skin type, and dermatologists as information source; of acceptable behaviour: female sex, a darker skin type, and dermatologists or general practitioners (GPs) as information source.

CONCLUSIONS

Despite a fairly good knowledge about skin cancer and sun exposure, students' behaviour was unsatisfactory. Knowledge is not sufficient to produce a positive behaviour, as determinants of these two aspects are different. Dermatologists and GPs should be considered as key-figures for future multicomponent intervention strategies in this field.

Awareness to sun exposure and use of sunscreen by the general population

Sun exposure has a pathogenic effect on the development of skin cancer, whose prevalence increases worldwide. Educational programs are carried out to change high risk sun exposure behaviours. The aim of this study was to evaluate the knowledge of Saudi population regarding sun exposure and the risk of skin cancers, as well as to study their sun-protective attitudes and practices. A cross-sectional population-based survey using specially devised questionnaire on a stratified random sample of general population in Qassim Province between January and March 2010. One thousand three hundred and seventy six persons participated in the study. A high sun exposure of more than 10 hours per week was reported by 661 persons (48%). Fifty six percent of respondents were aware of the association between sun exposure and skin cancer but the rate of sun screen use was only 8.3%. Socio-demographic factors more likely to be associated with sunscreen use were: females, higher social class, higher levels of education, type 4 skin and married individuals. This study has indicated a low rate of sunscreen use by our population despite reasonably good knowledge about the hazards of sun exposure. This necessitates the need for health education program. We hope that the results of our study will be used for setting up a sun policy for Saudi general public.

[Representations and attitudes toward cancer in the French general population]

Cancer has become a major public health issue. It is thus crucial to measure the general population's behaviours, opinions and perceptions about cancer and its associated risk factors. This article describes some of the main findings of a 2005 French survey (n = 4,046). Cancer is considered by a large majority to be the most serious disease, far before HIV/AIDS and cardiovascular diseases. The carcinogenic risk that is associated to main risk factors, such as sun exposure, tobacco-smoking and alcohol use appears to be well-known. However, many people justify dangerous behaviours with strongly-anchored beliefs, which maintain dangerous behaviours for health on the long-term. What's more, the perception of risk proliferation can also generate risk denial. Because self-exempting beliefs are still widespread within the general opinion, it is essential to continue public health information campaigns dedicated to cancer prevention, so as to induce better prevention practices within the general population and to reduce stigmatisation and isolation experienced by cancer patients. If risk denial is not systematically a consequence of a lack of information, it is generally associated to a cognitive construction that gives coherence to behaviours.

[Behaviors related to sunlight exposure versus protection in a random population sample from 15 Brazilian State capitals and the Federal District, 2002-2003]

This article examines region-specific relations between prevalence of protection against sunlight and socio-demographic and behavioral variables in Brazil. Data were derived from a cross-sectional population-based random sample. Information on sunlight exposure was available for a total of 16,999 individuals 15 years and older. Comparing the North and South of Brazil, crude differences between women and men in the use of "sunscreen" and "protective headwear" were +10.9% (95%CI: 7.1; 14.6) and -11.6% (95%CI: -17.0; -6.3) in the North and +21.3% (95%CI: 17.7; 24.9) and -16.0% (95%CI: -20.2; -12.5) in the South. Adjusted differences by selected variables confirmed that women use more sunscreen protection and less headwear protection as compared to men in both the North and South, but the difference was not homogeneous by region (interaction term p value < 0.05).

Skin phototypes of a Maltese sample population

BACKGROUND AND AIM

Skin phototyping is a clinical classification system based on a patient's historical reporting of the acute skin response to sunlight. We carried out a simple study to estimate the skin phototypes of the Maltese people in order to acquire more information on the relative risk of the general Maltese population to sun burning and to the more chronic effects of sun exposure, including photoaging and skin cancers.

METHOD

A consultant dermatologist and dermatology trainees determined the skin phototype of patients seen with skin infections or skin tags at dermatology outpatients in Malta by carrying out a short interview.

RESULTS

Data were collected on 756 patients. The commonest reported skin phototype in both sexes was type III (48.0% overall; 52.4% in males, 43.8% in females); this was followed by type IV in males (30.4%) and type II in females (32.3%). Only 1.2% of the total was of skin type I.

CONCLUSION

Approximately one half of the Maltese population is at moderate risk of sun damage; about one quarter is at low risk; and the other quarter is at high risk, the latter group needing more thorough sun avoidance and better surveillance for skin tumours. Social desirability can influence responses to such questionnaires and might have contributed to the difference between males and females noted in our study.

Australian adolescents' sun protection behavior: who are we kidding?

PURPOSE

To examine the influence of tan preference and skin type on sun protection behaviors of Australian adolescents.

METHODS

The Australian Secondary School Alcohol and Drug Questionnaires were conducted in 1993, 1996, 1999 and 2002 among randomly selected students aged 12--17. Schools were randomly selected from each education sector in each state. The self-administered questionnaire contained questions about tan preferences, skin type and usual SunSmart behavior (use of sunscreen, hats and covering clothing).

RESULTS

The routine use of SunSmart behavior was low in all survey years. There was a significant decrease over time in the proportion of students who practiced SunSmart behavior, with prevalence rates lower in 2002 than in any other survey year (males: p<0.01 and females: p<0.01). As desire for a tan increased, routine practice of SunSmart behaviors decreased. Across the four survey periods, male (p<0.01) and female (p<0.01) students who preferred no tan were significantly more likely to practice SunSmart behavior than students who preferred any sort of tan. Across the four survey years, male (p<0.01) and female (p<0.01) students with skin that 'just burns' were most likely to routinely practice SunSmart behavior.

CONCLUSIONS

Sun protection practices among adolescents have continued to decline significantly over time. Future educational programs require an innovative approach to modify adolescent behaviors in relation to sun exposure and sun protection.