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Lagacé F, Conte S, Mija LA, Moustaqim-Barrette A, Mahmood F, LeBeau J, McKenna A, Maazi M, Hanna J, Kelly ASV, Rahme E, Hrubeniuk TJ, Peláez S, Litvinov IV. A Comprehensive Analysis of Skin Cancer Concerns and Protective Practices in Manitoba, Canada, Highlights Lack of Skin Cancer Awareness and Predominance of High-Risk Sun Exposure Behaviors. Cancers (Basel) 2024; 16:3093. [PMID: 39272952 PMCID: PMC11394652 DOI: 10.3390/cancers16173093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Santina Conte
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Lorena A Mija
- Faculté de médecine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | | | - Farhan Mahmood
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Jonathan LeBeau
- Faculty of Medicine, McGill University, Montreal, QC H4A3J1, Canada
| | - Alyson McKenna
- Faculté de médecine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Mahan Maazi
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Johnny Hanna
- Faculté de médecine, Université Laval, Québec, QC G1V 0A6, Canada
| | | | - Elham Rahme
- Division of Clinical Epidemiology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Travis J Hrubeniuk
- Population Oncology, Cancer Care Manitoba, Winnipeg, MB R3C 2B1, Canada
- Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3C 2B1, Canada
| | - Sandra Peláez
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Research Centre, Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
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Love B, Ghosh C, Oestman K, Aquino M, Coffman R, Shah M, Dermid G, Rechis R. Understanding the impact of community-based sun safety interventions on a college campus in Texas. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38995616 DOI: 10.1080/07448481.2024.2367989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/09/2024] [Indexed: 07/13/2024]
Abstract
Objective: Examine the impact of a community-based, multi-component sun intervention on the campus of Lee College in Baytown, Texas. Participants: 735 respondents completed the survey as part of a range of campus topics. Methods: Survey data on the program were gathered through an emailed campus-wide survey to better understand the community's perceptions and awareness as well as campaign effectiveness over time. Results: Sun safety self-efficacy and awareness of the importance of sun safety behaviors were high in the community. Students reported a lower level of sun safety self-efficacy than employees. Open-ended responses also offered insight into complex views some community members hold about sun-safety behavior, raising questions about the effectiveness of sunscreen and the need for vitamin D. Conclusions: The paper found high awareness of sun-safe behaviors, high self-efficacy in taking personal action, and appreciation for the institutional effort to care for the community.
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Affiliation(s)
- Brad Love
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA
| | - Charulata Ghosh
- Center for Health Communication, The University of Texas at Austin, Austin, Texas, USA
| | - Katherine Oestman
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mayra Aquino
- Be Well Communities Team, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Mansi Shah
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA
| | - Gerold Dermid
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA
| | - Ruth Rechis
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Hagerman CJ, Stock ML, Jobe MC, Dwyer LA, Houlihan AE, Yeung EW. Ethnic and Gender Differences in Sun-Related Cognitions Among College Students: Implications for Intervention. Int J Behav Med 2024:10.1007/s12529-024-10257-7. [PMID: 38360939 DOI: 10.1007/s12529-024-10257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Skin cancer incidence and prognosis vary by ethnicity and gender, and previous studies demonstrate ethnic and gender differences in sun-related cognitions and behaviors that contribute to this disease. The current study sought to inform skin cancer interventions tailored to specific demographic groups of college students. The study applied the prototype willingness model (PWM) to examine how unique combinations of ethnic and gender identities influence sun-related cognitions. METHOD Using data from a survey of 262 college students, the study tested whether self-reported sun-related cognitions were different for White women, Hispanic women, White men, and Hispanic men. Path modeling was also used to identify which PWM cognitions (e.g., prototypes, norms) were the strongest predictors of risk and protection intentions and willingness in each demographic group. RESULTS Several differences in sun-related cognitions and PWM pathways emerged across groups, emphasizing the need for tailored skin cancer education and interventions. Results suggest that, for White women, interventions should primarily focus on creating less favorable attitudes toward being tan. CONCLUSION Interventions for Hispanic women may instead benefit from manipulating perceived similarity to sun-related prototypes, encouraging closer personal identification with images of women who protect their skin and encouraging less identification with images of women who tan. For White men, skin cancer interventions may focus on creating more favorable images of men who protect their skin from the sun. Lastly, interventions for Hispanic men should increase perceived vulnerability for skin cancer.
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Affiliation(s)
- Charlotte J Hagerman
- Weight, Eating, and Lifestyle Science (WELL) Center, Drexel University, Philadelphia, Pennsylvania, USA
| | - Michelle L Stock
- Department of Brain and Psychological Sciences, The George Washington University, 2013 H St NW, Washington, DC, USA
| | - Mary C Jobe
- Department of Brain and Psychological Sciences, The George Washington University, 2013 H St NW, Washington, DC, USA.
| | - Laura A Dwyer
- Department of Brain and Psychological Sciences, The George Washington University, 2013 H St NW, Washington, DC, USA
| | | | - Ellen W Yeung
- Department of Brain and Psychological Sciences, The George Washington University, 2013 H St NW, Washington, DC, USA
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Seo B, Yang S, Cho E, Qureshi AA, Han J. Association of sun-seeking behaviors with indoor tanning behavior in US white females during high school/college in Nurses' Health Study II. BMC Public Health 2024; 24:162. [PMID: 38212727 PMCID: PMC10785486 DOI: 10.1186/s12889-024-17716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Frequent exposure to ultraviolet light has more detrimental and longer-term effects on the skin in early life than in adulthood. Teenagers with strong sun-seeking behaviors may be more likely to use an indoor tanning bed than those who seek less sun. We aimed to examine associations between sun-seeking behaviors and indoor tanning behavior during high school/college in US females. METHODS In this cross-sectional study, we used data from The Nurses' Health Study II, a large prospective cohort of US female nurses. We included a total of 81,746 white females who provided responses on the average annual frequency of indoor tanning during high school/college. Our study exposures were number of times/week spent outdoors in a swimsuit and percentage of time wearing sunscreen at the pool/beach as a teenager, weekly hours spent outdoors in direct sunlight during the daytime during high school/college, and number of severe sunburns that blistered between ages 15-20 years. The main outcome was annual frequency of indoor tanning bed usage during high school/college. RESULTS In multivariable-adjusted logistic regression, we demonstrated positive associations between sun-seeking behaviors and indoor tanning use. Specifically, teenagers who spent 7 times/week outdoors in a swimsuit (adjusted odds ratio [aOR], 95% confidence interval [CI] for daily vs. <1/week: 2.68, 1.76-4.09) were more likely to use indoor tanning beds ≥ 12 times/year. Teenagers with ≥ 10 sunburns (aOR, 95% CI for ≥ 10 vs. never: 2.18, 1.53-3.10) were more likely to use indoor tanning beds ≥ 12 times/year. Also, teenagers/undergraduates who spent ≥ 5 h/week outdoors in direct sunlight (aOR, 95% CI for ≥ 5 h/week vs. <1 h/week: 2.18, 1.39-3.44) were more likely to use indoor tanning ≥ 12 times/year. However, there was not a significant association between average usage of sunscreen at the pool/beach and average usage of indoor tanning beds. Multivariable-adjusted linear regression models also showed similar results. CONCLUSIONS Teenagers who spent more time outdoors in a swimsuit/direct sunlight or got more sunburns tended to use indoor tanning more frequently. These findings provide evidence that teenagers with stronger sun-seeking behaviors may have more exposure to artificial ultraviolet radiation as well.
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Affiliation(s)
- Bojung Seo
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd, Health Sciences Building, RG 6124, Indianapolis, IN, 46202, USA
| | - Sheng Yang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd, Health Sciences Building, RG 6124, Indianapolis, IN, 46202, USA
| | - Eunyoung Cho
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA
| | - Abrar A Qureshi
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd, Health Sciences Building, RG 6124, Indianapolis, IN, 46202, USA.
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, USA.
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Raymond-Lezman JR, Riskin S. Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults. Cureus 2023; 15:e34934. [PMID: 36938200 PMCID: PMC10016731 DOI: 10.7759/cureus.34934] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/16/2023] Open
Abstract
Skin cancer is the most common cancer diagnosis worldwide. Many factors are involved in the development of skin cancers, but ultraviolet (UV) light exposure is the most modifiable. Our lifetime cumulative UV exposure may be a result of poor sun protection practices in childhood and adolescence. Modifying the attitudes and behaviors of children can be done in the classroom, at recreational activities, and at home. A review of the literature was conducted using Embase and PubMed to examine the relationship between attitudes and behaviors as they relate to sun protection strategies. Well-developed, standardized sun protection educational programs are needed to instruct children and adolescents. Individualized counseling from physicians or online programs is needed to help parents increase sun-safe standards for their children. Many young women utilize indoor tanning beds frequently, but many instructional programs increased their tanning bed usage. Time should be allotted at schools, sports practices, camps, and other outdoor activities for sunscreen reapplication. Many parents and children report the media is their primary source of information about sun safety. Media outlets may positively change attitudes and behaviors when reporting about sun safety. Parents and children need individualized programs or counseling to reduce ultraviolet (UV) exposure and increase sun protection. At-risk populations need tailored instruction, but few strategies have worked to decrease UV exposure.
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Affiliation(s)
- Jonathan R Raymond-Lezman
- Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Suzanne Riskin
- Department of Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Association of Sun Safety Behaviors and Barriers with Sunburn History in College Students in a Region with High UV Exposure. Curr Oncol 2022; 29:9671-9680. [PMID: 36547173 PMCID: PMC9776479 DOI: 10.3390/curroncol29120759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Over five million cases of skin cancer are diagnosed each year in the United States with melanoma the third most common cancer in young adults. While publications have shown that sunburns increase the risk of developing melanoma throughout the lifetime including in adolescence and adulthood showing the importance of altering sun exposing behaviors throughout the lifetime, use of sun protection in college students remails low. In Fall 2019, an online survey of undergraduate students living on campus at a large southwestern university was conducted to determine the frequency of recent sunburns as well as sun protective behaviors and perceived knowledge of and barriers to sun protection. Associations between knowledge, behaviors, and barriers with self-reported sunburn were evaluated using logistic regression. Over 46% of 458 students reported at least one sunburn in the past three months and 21% reported having multiple sunburns in that period. Furthermore, 53% reported that they intentionally tanned their skin outdoors occasionally or more frequently, while 6.4% reported using an indoor tanning bed occasionally or more. Adjusted for skin sensitivity, recent sunburn history was associated with higher tanning activity scores and with high agreement that tanning was attractive (p < 0.01). This information can inform a more targeted series of intervention programming on the university campus.
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7
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Cole SE, Hawkins M, Miller KA, Allen MW, Cockburn M. Correlation Between Objective Measures of Sun Exposure and Self‐reported Sun Protective Behavior and Attitudes in Predominantly Hispanic Youth. Photochem Photobiol 2022; 99:1037-1046. [DOI: 10.1111/php.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah E. Cole
- Department of Population and Public Health Sciences Keck School of Medicine of the University of Southern California Los Angeles CA United States
| | - Makenzie Hawkins
- Department of Pediatrics University of Utah Salt Lake City UT United States
| | - Kimberly A. Miller
- Department of Population and Public Health Sciences Keck School of Medicine of the University of Southern California Los Angeles CA United States
- Department of Dermatology Keck School of Medicine of the University of Southern California Los Angeles CA United States
| | - Martin W. Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology, Department of Electrical and Computer Engineering University of Canterbury Christchurch New Zealand
| | - Myles Cockburn
- Department of Population and Public Health Sciences Keck School of Medicine of the University of Southern California Los Angeles CA United States
- Department of Dermatology Keck School of Medicine of the University of Southern California Los Angeles CA United States
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Stockfleth E, Revol O. Encouraging sun protection early in life: from a successful prevention programme in children to the identification of psychological barriers in adolescents. J Eur Acad Dermatol Venereol 2022; 36 Suppl 6:12-21. [PMID: 35738808 DOI: 10.1111/jdv.18194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
Children and adolescents have high rates of sunburn and high levels of ultraviolet radiation (UVR) exposure and are therefore at risk of developing skin cancer in later life. Minimizing UVR exposure in childhood and adolescence may be the most important component of skin cancer prevention efforts. Thus, age-adapted prevention campaigns, targeting children, adolescents and caregivers, are needed to change sun protection behaviour among individuals in these age groups. In the first part of this review, we describe the 'SunPass' programme, which was initiated in Germany in 2010 as the first nationwide educational intervention for sun safety designed to teach kindergarten children and their caregivers how to protect themselves from overexposure to the sun. Implemented in 55 kindergartens, this programme has been shown to be effective at improving sun protection behaviour (P < 0.001) and hat use (P = 0.029) among kindergarten children, as well as at improving shade practices and increasing demand for protective clothing (P < 0.001). Up to 40 000 children, 50 000 parents/grandparents and 2500 kindergarten caregivers took part in the SunPass programme in Germany from 2019 to June 2021. The programme has also been adapted and implemented in several other European countries and could be readily adapted for use elsewhere. In the second part of this review, we discuss the specific challenges faced by adolescents and consider how these issues may impact their sun protection behaviour. Adolescents have difficulties suppressing responses to reward-related cues and projecting themselves into the future. They also place a lot of importance on social acceptance and cosmetic appearance, and their higher risk of depression, addiction and impulsivity make them vulnerable to tanning addiction. These specificities need to be acknowledged by dermatologists, so they can adapt their therapeutic relationship and develop effective sun protection interventions for this generation.
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Affiliation(s)
- E Stockfleth
- Klinik für Dermatologie und Ruhr-Universität Bochum, Gudrunstrasse 52, Bochum, Germany
| | - O Revol
- Child Development Unit, Hospices Civils de Lyon, Bron, France
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Bonilla C, Mejia-Lancheros C. The Skin We Live in: Pigmentation Traits and Tanning Behaviour in British Young Adults, an Observational and Genetically-Informed Study. Genes (Basel) 2022; 13:896. [PMID: 35627282 PMCID: PMC9140533 DOI: 10.3390/genes13050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023] Open
Abstract
Skin cancer incidence has been increasing worldwide, representing a particularly high burden for populations of European ancestry. Outdoor and indoor tanning using ultraviolet (UV) radiation devices are major risk factors for skin cancer. While tanning behaviours can be modified by targeted interventions to reduce skin cancer rates, there is insufficient evidence on the motivations for tanning preferences and their relationship with pigmentation phenotypes. The present observational and genetically-informed study investigates motives for tanning and the role that pigmentation phenotypes play on outdoor and indoor tanning behaviour in British young adults. This study included 3722 participants from the Avon Longitudinal Study of Parents and Children in South West England, with data on pigmentation features, tanning ability and preferences, and SNP genotypes. Liking to tan and outdoor tanning were strongly influenced by pigmentary traits and tanning ability. However, the association of these phenotypes with UV indoor tanning was weaker. Our results provide evidence to support the implementation of skin cancer preventative interventions that consider individual biological characteristics and motives for undergoing outdoor and indoor tanning.
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Affiliation(s)
- Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo CEP 01246-903, Brazil
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada;
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Rocholl M, Hannappel J, Ludewig M, John SM. UV-Induced Skin Cancer Knowledge, Sun Exposure, and Tanning Behavior among University Students: Investigation of an Opportunity Sample of German University Students. J Skin Cancer 2021; 2021:5558694. [PMID: 35003809 PMCID: PMC8731302 DOI: 10.1155/2021/5558694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/04/2021] [Accepted: 12/15/2021] [Indexed: 12/03/2022] Open
Abstract
Ultraviolet radiation (UVR) is the most important risk factor for developing skin cancer. University students can be considered as a particularly high-risk group for long- and short-term adverse effects of UVR due to intensive solar UVR exposure and high rates of sunburn. While validated questionnaires for assessing solar UVR exposure and sun protection behavior are available in German, a questionnaire for assessing the level of knowledge about this topic is still missing. We conducted a literature search for cross-sectional studies assessing skin cancer and sun protection knowledge among university students in Medline (via PubMed) and analyzed existing questionnaires and topics contained therein. We chose to translate the "Skin Cancer and Sun Knowledge Scale" referring to the TRAPD method into the German language and pilot-tested the translation with an opportunity sample of German students. The literature search revealed 36 eligible studies. Four major topics were identified within the studies: knowledge on skin cancer, risk factors, UVR, and sun protection measures. One hundred and seven German university students (86.0% female) with a mean age of 26.25 years (SD ± 4.58; range: 19-46) participated in our pilot study. The internal reliability of the scale was KR-20 = 0.624. We discovered an improvable level of knowledge in terms of skin cancer among the study population. Statistical analyses revealed no significant associations between the level of knowledge and UVR exposure or tanning behavior, respectively. The skin cancer and sun protection knowledge of German university students should be examined thoroughly. While the psychometric properties of the SCSK require further thorough investigation, first empirical experiences indicate the suitability of the tool to assess the level of knowledge regarding skin cancer and sun protection.
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Affiliation(s)
- Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
| | - Julia Hannappel
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
| | - Michaela Ludewig
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, Osnabrück 49076, Germany
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Tang E, Fung K, Chan AW. Incidence and mortality rates of keratinocyte carcinoma from 1998-2017: a population-based study of sex differences in Ontario, Canada. CMAJ 2021; 193:E1516-E1524. [PMID: 34607845 PMCID: PMC8568084 DOI: 10.1503/cmaj.210595] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Keratinocyte carcinoma is the most common malignant disease, but it is not captured in major registries. We aimed to describe differences by sex in the incidence and mortality rates of keratinocyte carcinoma in Ontario, Canada. Methods: We conducted a population-based retrospective study of adults residing in Ontario between Jan. 1, 1998, and Dec. 31, 2017, using linked health administrative databases. We identified the first diagnosis of keratinocyte carcinoma using a validated algorithm of health insurance claims, and deaths related to keratinocyte carcinoma from death certificates. We calculated the incidence and mortality rates of keratinocyte carcinoma, stratified by sex, age and income quintile. We evaluated trends using the average annual percentage change (AAPC) based on joinpoint regression. Results: After decreasing from 1998 to 2003, the incidence rate of keratinocyte carcinoma increased by 30% to 369 per 100 000 males and 345 per 100 000 females in 2017 (AAPC 1.9%, 95% confidence interval [CI] 1.7 to 2.1 from 2003 to 2017). The incidence rate was higher in females younger than 55 years, but higher in males aged 55 years or older. Between 2008 and 2017, the incidence rate rose faster in females than males aged 45–54 years (AAPC 1.2% v. 0.5%, p = 0.01) and 55–64 years (1.2% v. 0.1%, p < 0.01). The incidence was higher in males than females in the higher income quintiles. Between 1998 and 2017, the mortality rate of keratinocyte carcinoma was 1.8 times higher in males than females, on average, and rose 4.8-fold overall (AAPC 8.9%, 95% CI 6.4 to 11.4 in males; 8.0%, 95% CI 5.3–10.8 in females). Interpretation: The population burden of keratinocyte carcinoma is growing, and the incidence and mortality rates rose disproportionately among certain sex- and age-specific groups. This warrants further investigation into causal factors and renewed preventive public health measures.
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Affiliation(s)
- Evan Tang
- Faculty of Medicine (Tang), University of Toronto; ICES (Fung, Chan); Division of Dermatology, Department of Medicine (Tang, Chan), Women's College Research Institute, Women's College Hospital, Toronto, Ont
| | - Kinwah Fung
- Faculty of Medicine (Tang), University of Toronto; ICES (Fung, Chan); Division of Dermatology, Department of Medicine (Tang, Chan), Women's College Research Institute, Women's College Hospital, Toronto, Ont
| | - An-Wen Chan
- Faculty of Medicine (Tang), University of Toronto; ICES (Fung, Chan); Division of Dermatology, Department of Medicine (Tang, Chan), Women's College Research Institute, Women's College Hospital, Toronto, Ont.
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12
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Age and Cohort Trends of Malignant Melanoma in the United States. Cancers (Basel) 2021; 13:cancers13153866. [PMID: 34359766 PMCID: PMC8345588 DOI: 10.3390/cancers13153866] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The occurrence of melanoma in the United States is increasing over time. We examined trends in melanoma by birth year and age groups to determine if individuals born more recently experience higher rates of melanoma as they age. We examined these trends separately among men and women and by the location on the body that the melanoma occurred. Melanoma incidence has continued to increase across more recent birth years and varies by body site and sex. Melanoma incidence will likely continue to increase as younger individuals age. While these are mostly thin melanomas, treatment to prevent cancer progression is still costly, both economically and emotionally, for patients. Abstract The incidence of malignant melanoma in the United States is increasing, possibly due to changes in ultraviolet radiation (UVR) exposure due to lifestyle or increased awareness and diagnosis of melanoma. To determine if more recent birth cohorts experience higher rates of melanoma as they age, we examined age and birth cohort trends in the United States stratified by anatomic site and cancer type (in situ vs. malignant) of the melanoma diagnosed from 1975–2017. Poisson regression of cutaneous melanoma cases per population for 1975–2017 from the Surveillance, Epidemiology, and End Results (SEER) cancer registries was used to estimate age adjusted incidence for five-year birth cohorts restricted to Whites, ages 15–84. The rate of melanoma incidence across birth cohorts varies by anatomic site and sex. Melanomas at all anatomic sites continue to increase, except for head and neck melanomas in men. Much of the increase in malignant melanoma is driven by cases of thin (<1.5 mm) lesions. While increased skin exams may contribute to the increased incidence of in situ and thin melanoma observed across birth cohorts, the shifts in anatomic site of highest melanoma incidence across birth cohorts suggest changes in UVR exposure may also play a role.
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Thoonen K, van Osch L, Drittij R, de Vries H, Schneider F. A Qualitative Exploration of Parental Perceptions Regarding Children's Sun Exposure, Sun Protection, and Sunburn. Front Public Health 2021; 9:596253. [PMID: 33681123 PMCID: PMC7930008 DOI: 10.3389/fpubh.2021.596253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/21/2021] [Indexed: 11/13/2022] Open
Abstract
Sun protection among children is of utmost importance since sunburn in early life is a major risk factor for skin cancer development. Because parents play a vital role in enhancing sun safety among children, this study explored parental perceptions concerning sun exposure, sun protection behaviors, and sunburn in children. Additionally, the context in which children experience sunburn in order to assist the development, optimization, and targeting of sun safety interventions for parents is revealed. A qualitative study design, using a semi-structured interview guide addressing several themes (e.g., sun exposure, sun protection, and sunburn experiences), was used. Data were collected in the Netherlands in the fall of 2019. Parents were recruited via purposive sampling at schools, youth services centers, and social media. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d = 0.84). In total, 26 interviews were performed (n = 17 mothers, n = 17 daughters, aged between 4 and 11 years). Parental perceptions and recall of their child's lifetime sunburn were frequent, even though all parents reported using at least one sun protection measure during sun exposure situations and parents seemed often unaware of their child's sunburn. Moreover, parents reported an overreliance on sunscreen, often failing to adequately protect their children's skin. Water-related activities, a lack of shade, and misconceptions regarding UV-index were often related to sunburn. In addition, unexpected sun exposure or longer exposure duration than initially planned were reported as challenging situations. The majority of parents had positive perceptions regarding tanned skin for both themselves as for children. This study provides directions for skin cancer prevention efforts targeted at both parents and their children. Since a lack of knowledge regarding sufficient sun protection measures and sunburn occurrence in various situations was reported, educational efforts are warranted. Additionally, focusing on clothing, shade-seeking, and adequate sunscreen use is recommended to increase children's sun safety. By intervening in the physical environment as well (e.g., providing shady areas), sun protection barriers can be reduced. Lastly, the general positive attitude toward tanned skin evident in this study is certainly worthy of attention in future interventions.
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Affiliation(s)
- Karlijn Thoonen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Liesbeth van Osch
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Rowan Drittij
- Faculty of Health, Medicine and Life Sciences, Health Sciences Master, Health Education and Promotion, Maastricht University, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Francine Schneider
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Willoughby JF, Myrick JG, Gibbons S, Kogan C. Associations Between Emotions, Social Media Use, and Sun Exposure Among Young Women: Ecological Momentary Assessment Study. JMIR DERMATOLOGY 2020. [DOI: 10.2196/18371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background
Research has pointed to a connection between social media use, emotions, and tanning behaviors. However, less is known about the role specific emotions may play in influencing social media use and how emotions and social media use may each be associated with outdoor tanning.
Objective
This paper aims to examine the connection between emotions, social media use, and outdoor tanning behaviors among young women, a group particularly important for skin cancer prevention efforts.
Methods
We used ecological momentary assessment to collect data from 197 women aged 18 to 25 years 3 times a day for 7 days in July 2018. We collected data from women in 2 states.
Results
We found that boredom was associated with increased time spent on social media and that increased time spent on social media was associated with increased time spent outdoors without sun protection.
Conclusions
Our results highlight that social media may be a particularly important channel for skin cancer prevention efforts targeting young women, as more social media use was associated with increased time spent outdoors with skin exposed. Researchers should consider the role of emotions in motivating social media use and subsequent tanning behaviors. Additionally, as boredom was associated with social media use, intervention developers would benefit from developing digital and social media interventions that entertain as well as educate.
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Murray J, Williams B. The Role of Images on Illness Behaviour: Interdisciplinary Theory, Evidence, and Ideas. Psychol Rep 2020; 124:2453-2475. [PMID: 32757718 PMCID: PMC8647478 DOI: 10.1177/0033294120945602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
If illness behaviour is to be fully understood, the social and behavioural sciences must
work together to understand the wider forms in which illness is experienced and
communicated with individuals and society. The current paper synthesised literature across
social and behavioural sciences exploring illness experience and communication through
physical and mental images. It argues that images may have the capacity to embody and
influence beliefs, emotions, and health outcomes. While four commonalities exist,
facilitating understandings of illness behaviour across the fields (i.e., understanding
the importance of the patient perspective; perception of the cause, sense of identity with
the illness, consequences, and level of control; health beliefs influencing illness
experience, behaviours, and outcomes; and understanding illness beliefs and experiences
through an almost exclusive focus on the written or spoken word), we will focus on
exploring the fourth commonality. The choice to focus on the role of images on illness
behaviour is due to the proliferation of interventions using image-based approaches. While
these novel approaches show merit, there is a scarcity of theoretical underpinnings and
explorations into the ways in which these are developed and into how people perceive and
understand their own illnesses using image representations. The current paper identified
that the use of images can elucidate patient and practitioner understandings of illness,
facilitate communication, and potentially influence illness behaviours. It further
identified commonalities across the social and behavioural sciences to facilitate theory
informed understandings of illness behaviour which could be applied to visual intervention
development to improve health outcomes.
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Affiliation(s)
- Jennifer Murray
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Brian Williams
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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Basch CH, Hillyer GC, Kecojevic A, Ku CS, Basch CE. Indoor tanning and poor mental health among adolescents in New York City (2015). J Health Psychol 2019; 26:870-879. [DOI: 10.1177/1359105319852668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored relationships between mental health and indoor tanning among high school students in New York City using 2015 data from the Youth Risk Behavior Surveillance System. Those more likely to use indoor tanning were females (odds ratio = 6.26, 95% confidence interval = 6.08–6.45) and non-Hispanic White (odds ratio = 1.10, 95% confidence interval = 1.06–1.14). Being bullied on school property (odds ratio = 1.30, 95% confidence interval = 1.25–1.34), having attempted suicide (odds ratio = 2.08, 95% confidence interval = 1.99–2.18), and having sought counseling (odds ratio = 1.22, 95% confidence interval = 1.18–1.26) were significantly associated with indoor tanning. This study indicates that engaging in indoor tanning is associated with a number of mental health factors.
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Basch CH, Hillyer GC, Romero RA, MacLean SA, Ethan D. College Students’ Attitudes and Behaviors Related to Sun Safety and Appearance in Relation to Health Information-Seeking Behavior and Social Media Use: Cross-Sectional Study. JMIR DERMATOLOGY 2018. [DOI: 10.2196/10984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bleakley A, Lazovich D, B Jordan A, Glanz K. Compensation Behaviors and Skin Cancer Prevention. Am J Prev Med 2018; 55:848-855. [PMID: 30344038 DOI: 10.1016/j.amepre.2018.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/16/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Skin cancer prevention guidelines recommend practicing multiple behaviors to protect against harmful ultraviolet rays, yet few adults report practicing more than one recommended behavior. This study examines the extent to which skin cancer prevention behaviors are combined and may follow a pattern of compensation in which an individual's performance of one behavior (e.g., wearing sunscreen) precludes performing other protective behaviors (e.g., wearing a hat). METHODS Data from qualitative semi-structured interviews (n=80) in 2015 and a quantitative online national survey (n=940) in 2016 with non-Hispanic white adults aged 18-49 years from the U.S. were used to examine combinations of skin cancer prevention behaviors. Data were analyzed in 2017. RESULTS Protective behaviors like wearing sunglasses and sunscreen were a common approach to prevention, but protective, avoidant (i.e., seeking shade, avoiding outdoor tanning), and covering-up (i.e., wearing a hat, shirt) strategies were rarely used in combination. Regression analyses to determine correlates of protection, avoidance, and covering-up showed that age was positively associated with practicing each strategy; positive attitudes about tanning were negatively associated with avoidance and covering-up; and positive body image was positively associated with protection and negatively associated with avoidance. Demographics such as education, employment, and gender, but not skin cancer risk, were also related to the various strategies. CONCLUSIONS Although a full evaluation of compensation theory and skin cancer prevention was limited by the available data, the results suggest that application of the theory may yield clues for how to improve sun protection behaviors.
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Affiliation(s)
- Amy Bleakley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Amy B Jordan
- School of Communication and Information, Rutgers the State University of New Jersey, New Brunswick, New Jersey
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Iacopetta K, Collins-Praino LE, Buisman-Pijlman FTA, Hutchinson MR. Can neuroimmune mechanisms explain the link between ultraviolet light (UV) exposure and addictive behavior? Brain Behav Immun 2018; 73:125-132. [PMID: 30009997 DOI: 10.1016/j.bbi.2018.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/03/2018] [Accepted: 07/12/2018] [Indexed: 12/22/2022] Open
Abstract
High ultraviolet (UV) light exposure on the skin acts as a reinforcing stimulus, increasing sun-seeking behavior and even addiction-like sun seeking behavior. However, the physiological mechanisms that underlie this process remain to be defined. Here, we propose a novel hypothesis that neuroimmune signaling, arising from inflammatory responses in UV-damaged skin cells, causes potentiated signaling within the cortico-mesolimbic pathway, leading to increased sun-seeking behaviors. This hypothesized UV-induced, skin-to-brain signaling depends upon cell stress signals, termed alarmins, reaching the circulation, thereby triggering the activation of innate immune receptors, such as toll-like receptors (TLRs). This innate immune response is hypothesized to occur both peripherally and centrally, with the downstream signaling from TLR activation affecting both the endogenous opioid system and the mesolimbic dopamine pathway. As both neurotransmitter systems play a key role in the development of addiction behaviors through their actions at key brain regions, such as the nucleus accumbens (NAc), we hypothesize a novel connection between UV-induced inflammation and the activation of pathways that contribute to the development of addiction. This paper is a review of the existing literature to examine the evidence which suggests that chronic sun tanning resembles a behavioral addiction and proposes a novel pathway by which persistent sun-seeking behavior could affect brain neurochemistry in a manner similar to that of repeated drug use.
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Affiliation(s)
- Krystal Iacopetta
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, SA, Australia
| | - Lyndsey E Collins-Praino
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, SA, Australia
| | - Femke T A Buisman-Pijlman
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, SA, Australia
| | - Mark R Hutchinson
- Adelaide Centre for Neuroscience Research, Adelaide Medical School, University of Adelaide, SA, Australia; Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, University of Adelaide, Adelaide, SA, Australia.
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Sun-related knowledge and attitudes of primary and secondary schoolchildren in western Switzerland. Eur J Cancer Prev 2018; 26:411-417. [PMID: 27749495 DOI: 10.1097/cej.0000000000000279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Switzerland, particularly its western region, has the highest incidence of melanoma in Europe. Although the risk of melanoma increases with sun overexposure during childhood, sun-related knowledge and attitudes of Swiss children are scarcely documented. We report the first investigation of the knowledge of the danger of ultraviolet radiation, attitudes towards a suntan and parental influence of schoolchildren in western Switzerland. All fifth, eighth and eleventh graders (average ages of 9, 12 and 15, respectively) in the 18 primary (fifth grade, n=431) and secondary (eighth and eleventh grades, n=837) public schools of La Chaux-de-Fonds were surveyed during regular school classes. The response rate was 91% (1154/1268). Sun-related knowledge was high overall. Eight out of 10 children knew about the risk of skin cancer and recognized the most susceptible phototype. Knowledge increased significantly with age. Girls, older children, fair-skinned participants and those who preferred a tanned skin obtained the highest knowledge score. The main source of information on ultraviolet radiation and sun protection was their parents (76%), followed by the school (11%) and the media (9%). Multivariate logistic regression analyses identified higher sun-related knowledge, lower familial socioprofessional status and skin phototypes III-IV to be associated with a tan-seeking attitude. Parental sensitization (56%) and encouragement (61%) towards sun protection were more common among fair-skinned children and those of higher familial socioprofessional status. The high awareness of the risk of skin cancer among Swiss schoolchildren does not translate into appropriate attitudes. Community-wide intervention programmes involving parents, teachers, peers and primary care clinicians could be considered for Swiss prevention campaigns to improve children's sun behaviour and change their current pro-tan attitude.
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Littlewood Z, Greenfield S. Parents' knowledge, attitudes and beliefs regarding sun protection in children: a qualitative study. BMC Public Health 2018; 18:207. [PMID: 29391005 PMCID: PMC5796497 DOI: 10.1186/s12889-018-5091-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/17/2018] [Indexed: 11/25/2022] Open
Abstract
Background Childhood is a critical period for sun protection, when the skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Children are dependent upon parents to implement sun protective measures. Existing qualitative research exploring parents’ attitudes and beliefs underpinning children’s sun protection is from Australia, which has the highest melanoma incidence rates globally, and thus benefits from widespread sun protection awareness campaigns. Parents’ sun protective behaviour may, therefore, differ between Australia and the UK. This study investigates the topic in a UK context, using qualitative methodology to gain detailed insights into a relatively under-researched area. The aim of the study was to explore parents’ knowledge and understanding of sun protection in children, and factors that motivate and challenge them in this area. Finally, it aimed to determine if and how ethnicity and skin type influence these attitudes and beliefs. Methods Twenty-two semi-structured individual interviews were carried out with parents of children aged 5 years or younger, recruited from local nurseries. Transcripts were analysed using thematic analysis. Results Four overarching themes emerged, each incorporating two to three sub-themes. ‘Attitudes towards children’s sun protection’ refers to the fact that parents considered sun protection to be important for children, a finding which was consistent between different skin types. ‘Sun protection practices’ brings together several protective behaviours adopted in children and, to a lesser degree, in parents, and their associated disadvantages. ‘Sun safety knowledge’ refers to parents’ awareness of the risks of sun exposure and the need for protection, and illustrates where gaps in knowledge exist, such as regarding the need for vitamin D, and the importance of vigilant sun protection even in the UK. Finally, ‘motivating and facilitating factors’ highlights motivations for sun protection in children, and factors that facilitate it in practice. Conclusion This study found parents to be motivated and concerned about children’s sun protection, irrespective of children’s ethnicity, and aware of appropriate protective behaviours. It indicates key challenges which could be targeted in future campaigns in order to improve sun protection in children and reduce uncertainty and anxiety regarding sun safety amongst parents. Electronic supplementary material The online version of this article (10.1186/s12889-018-5091-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zoe Littlewood
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, Murray Learning Centre, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Cho H, Yu B, Cannon J, Zhu YM. Efficacy of a Media Literacy Intervention for Indoor Tanning Prevention. JOURNAL OF HEALTH COMMUNICATION 2018; 23:643-651. [PMID: 30058942 PMCID: PMC6605049 DOI: 10.1080/10810730.2018.1500659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Indoor tanning leads to melanoma, the fifth most common cancer in the USA. The highest rate of indoor tanning is among young women whose exposure to tanned images in the media is linked to protanning attitudes. This study evaluated the efficacy of a media literacy intervention for reducing young women's indoor tanning. Intervention participants analyzed the content and functions of the media influencing protanning attitudes and produced counter-messages to help themselves and peers resist harmful media effects. The message production was of two types: digital argument production or digital story production. The control group received assessments only. This three-group randomized design involved 26 sorority chapters and 247 members in five Midwestern states where indoor tanning is prevalent. At 2- and 6-month follow-up assessments, those in the two intervention conditions were less likely to be indoor tanners (p = .033) and reported lower indoor tanning intentions (p = .002) compared to those in the control condition. No difference between the two intervention groups was found for behavior. Although the argument group exhibited slightly weaker indoor tanning intentions than the story group, the difference was not significant. The results provide the first evidence of the efficacy of a media literacy intervention for indoor tanning reduction. Implications for participative engagement interventions are discussed.
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Affiliation(s)
- Hyunyi Cho
- Corresponding author Hyunyi Cho, School of Communication, The Ohio State University 154 N. Oval Mall Columbus, OH 43210 Phone: 614-247-1691,
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Taylor J, Lamont A, Murray M. Talking about sunbed tanning in online discussion forums: Assertions and arguments. Psychol Health 2017; 33:518-536. [PMID: 28911238 DOI: 10.1080/08870446.2017.1375496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE There is increasing evidence of both health and appearance risks associated with sunbed use. At the same time, the sunbed industry promotes the benefits of using sunbeds, and the image of a tanned skin as attractive and healthy arguably remains embedded within contemporary western culture. These tensions are played out in everyday conversations, and this paper reports a study which explored how sunbed users manage them within online discussion forums. DESIGN A total of 556 posts from 13 sunbed-related threads, taken from six different UK-based online forums, were analysed thematically followed by techniques from discourse analysis. MAIN OUTCOME MEASURES Informed by social representations theory and discursive-rhetorical psychology, the way social representations of sunbed use are constructed, debated and disputed in online discussion forums were explored. RESULTS Sunbed users drew upon numerous representations to distance and protect themselves from negativity they were confronted with in the forums, utilising a range of rhetorical, discursive strategies to help them. CONCLUSION Theoretical contributions and potential practical implications of the findings are discussed. Findings indicate, for example, that those working on campaigns and interventions in this area need to consider the wider negativity and argumentative orientation of sunbed users' responses.
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Affiliation(s)
- Jennifer Taylor
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
| | - Alexandra Lamont
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
| | - Michael Murray
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
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Falzone AE, Brindis CD, Chren MM, Junn A, Pagoto S, Wehner M, Linos E. Teens, Tweets, and Tanning Beds: Rethinking the Use of Social Media for Skin Cancer Prevention. Am J Prev Med 2017; 53:S86-S94. [PMID: 28818251 PMCID: PMC5886032 DOI: 10.1016/j.amepre.2017.04.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/22/2017] [Accepted: 04/20/2017] [Indexed: 12/14/2022]
Abstract
The incidence of skin cancer is rising in the U.S., and melanoma, the deadliest form, is increasing disproportionately among young white women. Indoor tanning is a modifiable risk factor for all skin cancers and continues to be used at the highest rates in young white women. Adolescents and young adults report personal appearance-based reasons for using indoor tanning. Previous research has explored the influences on tanning bed use, including individual factors as well as relationships with peers, family, schools, media influences, legislation, and societal beauty norms. Adolescents and young adults also have high rates of social media usage, and research is emerging on how best to utilize these platforms for prevention. Social media has the potential to be a cost-effective way to reach large numbers of young people and target messages at characteristics of specific audiences. Recent prevention efforts have shown that comprehensive prevention campaigns that include technology and social media are promising in reducing rates of indoor tanning among young adults. This review examines the literature on psychosocial influences on indoor tanning among adolescents and young adults, and highlights ways in which technology and social media can be used for prevention efforts.
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Affiliation(s)
- Ashley E Falzone
- School of Medicine, the Program for Clinical Research, Department of Dermatology, University of California, San Francisco, San Francisco, California
| | - Claire D Brindis
- Philip R. Lee Institute for Health Policy Studies and the Adolescent and Young Adult Health National Resource Center at the University of California, San Francisco, San Francisco, California
| | - Mary-Margaret Chren
- School of Medicine, the Program for Clinical Research, Department of Dermatology, University of California, San Francisco, San Francisco, California; Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Alexandra Junn
- School of Medicine, the Program for Clinical Research, Department of Dermatology, University of California, San Francisco, San Francisco, California
| | - Sherry Pagoto
- Department of Medicine, University of Massachusetts Medical School, Worchester, Massachusetts
| | - Mackenzie Wehner
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Eleni Linos
- School of Medicine, the Program for Clinical Research, Department of Dermatology, University of California, San Francisco, San Francisco, California.
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Rodrigues AM, Sniehotta FF, Birch-Machin MA, Araujo-Soares V. Aware, motivated and striving for a 'safe tan': an exploratory mixed-method study of sun-protection during holidays. Health Psychol Behav Med 2017; 5:276-298. [PMID: 28670503 PMCID: PMC5470104 DOI: 10.1080/21642850.2017.1335205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/23/2017] [Indexed: 10/30/2022] Open
Abstract
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.
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Affiliation(s)
- Angela M Rodrigues
- Institute of Health and Society, Medical Faculty, Newcastle University, Newcastle upon Tyne, UK
| | - Falko F Sniehotta
- Institute of Health and Society, Medical Faculty, Newcastle University, Newcastle upon Tyne, UK
| | - Mark A Birch-Machin
- Institute of Cellular Medicine, Medical Faculty, Newcastle University, Newcastle upon Tyne, UK
| | - Vera Araujo-Soares
- Institute of Health and Society, Medical Faculty, Newcastle University, Newcastle upon Tyne, UK
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Kirk L, Greenfield S. Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study. BMJ Open 2017; 7:e014388. [PMID: 28289050 PMCID: PMC5353347 DOI: 10.1136/bmjopen-2016-014388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/23/2017] [Accepted: 02/13/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To explore whether knowledge about the harms of ultraviolet radiation (UVR) influences UK university students' sun-related behaviours and examine in depth their attitudes towards: sun protection, natural and artificial tanning behaviours. DESIGN Qualitative methodology with 15 semistructured, individual interviews. Thematic analysis using the Framework Method with analyst triangulation and member validation. SETTING One university in the West Midlands, UK. PARTICIPANTS 15 Caucasian male (n=4) and female (n=11) students, aged 18-22 years, from a UK university. Participants were recruited using convenience sampling from the university's main campus followed by purposive sampling for: gender, course and sun-related behaviours. RESULTS Five main themes emerged: (1) knowledge of UVR; (2) sun-protection practices; (3) attitudes towards tanning; (4) external influences and (5) internal influences. All students knew the associated skin cancer risks from the sun and sunbed use, but this did not appear an important influence in their sun-related behaviours. Body image strongly motivated sun-protection practices and the desire to tan naturally or artificially, across both genders. However, participants' final decision-making appeared to be influenced by their beliefs that practising known harmful sun-related behaviours would not affect them or the perceived susceptibility to sunburn. Beliefs about sunbathing and sunscreen use prompted improper use of sun protection and inadvertently caused more harmful practices. Participants' peers, family and the media had dual roles influencing the development of attitudes towards sun protection and tanning, which contributed to how participants behaved in the sun and their engagement in tanning methods. CONCLUSIONS Knowledge about the risk of skin cancer associated with UVR did not strongly influence sun-related behaviours, whereas body image appeared as a key motivator. Attitudes towards sun protection and tanning stemmed from the media, peers and family, and particularly from childhood habits. Public health strategies may benefit from appearance-related skin cancer prevention campaigns, encouraging safer parental sun-related habits and correcting sun-related misconceptions.
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Affiliation(s)
- Lucy Kirk
- College of Medical and Dental Sciences, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Cheetham I, Ogden J. Enhancing sun safety in young women: The relative impact of format and temporal framing on beliefs and behaviour. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1210069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Indiana Cheetham
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Jane Ogden
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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Heckman CJ, Darlow SD, Ritterband LM, Handorf EA, Manne SL. Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults. Am J Prev Med 2016; 51:1-11. [PMID: 26810358 PMCID: PMC4914462 DOI: 10.1016/j.amepre.2015.11.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 10/22/2015] [Accepted: 11/11/2015] [Indexed: 11/28/2022]
Abstract
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. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02147080.
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Affiliation(s)
- Carolyn J Heckman
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
| | - Susan D Darlow
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Lee M Ritterband
- BeHealth Solutions, LLC, Charlottesville, Virginia; University of Virginia Health System, Charlottesville, Virginia
| | | | - Sharon L Manne
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
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Perez D, Kite J, Dunlop SM, Cust AE, Goumas C, Cotter T, Walsberger SC, Dessaix A, Bauman A. Exposure to the 'Dark Side of Tanning' skin cancer prevention mass media campaign and its association with tanning attitudes in New South Wales, Australia. HEALTH EDUCATION RESEARCH 2015; 30:336-346. [PMID: 25697580 DOI: 10.1093/her/cyv002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Melanoma is the most common cancer among 15- to 29-year-olds in Australia, with rates increasing with age. The 'Dark Side of Tanning' (DSOT) mass media campaign was developed in 2007 to influence attitudes related to tanning. This study aimed to assess recall and impact of the DSOT campaign. Data were collected using online surveys of 13- to 44-year-olds living in New South Wales in the summer months of 2007-2010 (n = 7490). Regression models were used to determine predictors of recall of DSOT and to investigate associations between exposure to the campaign and tanning attitudes. The campaign achieved consistently high recall (unprompted recall 42-53% during campaign periods; prompted recall 76-84%). Those who recalled DSOT advertisements had a higher likelihood of reporting negative tanning attitudes compared with those who reported no recall, after adjusting for other factors (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.01-1.27 for unprompted recall; OR 1.19, 95% CI 1.03-1.36 for prompted recall). Being interviewed in later campaign years was also a significant predictor of negative tanning attitudes (e.g. fourth year of campaign versus first year: OR 1.24, 95% CI 1.01-1.53). These results suggest that mass media campaigns have potential to influence tanning-related attitudes and could play an important role in skin cancer prevention.
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Affiliation(s)
- Donna Perez
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - James Kite
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Sally M Dunlop
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Anne E Cust
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Chris Goumas
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Trish Cotter
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Scott C Walsberger
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Anita Dessaix
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
| | - Adrian Bauman
- Cancer Institute NSW - Cancer Screening and Prevention, Sydney, NSW, Australia, University of Sydney - School of Public Health, Sydney, NSW, Australia, Victorian Comprehensive Cancer Center, Melbourne, VIC, Australia and Cancer Council NSW, Sydney, NSW, Australia
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Garone M, Howard J, Fabrikant J. A review of common tanning methods. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2015; 8:43-47. [PMID: 25741402 PMCID: PMC4345932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Tanning in the United States has become an increasingly popular activity in our culture. Tanning methods have evolved through the years to become more readily accessible and easier to use for all consumers, regardless of geographic location. With the rising incidence of skin cancer, the demand for safe and efficient tanning methods remains high. There are currently many different tanning methods being utilized, and still more are being researched. This article serves to summarize some of the most common tarining methods used in the United States today as well as some potential methods currently under study.
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Affiliation(s)
| | - John Howard
- Broward Health Medical Center, Ft. Lauderdale, Florida
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Hay JL, Geller AC, Schoenhammer M, Gordon M, Bishop M, Shuk E, Oliveria S, Halpern AC. Tanning and beauty: Mother and teenage daughters in discussion. J Health Psychol 2014; 21:1261-70. [PMID: 25318997 DOI: 10.1177/1359105314551621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tanning increases dramatically through the teenage years, but the family context of this health risk behavior is relatively unstudied. We conducted videotaped conversations between teenage girls (10th and 11th grade) and their mothers. We developed a coding system for discussion content and highlight findings including inadequate knowledge concerning the harms of tanning and positive views of outdoor tanning over indoor tanning, yet agreement that all tans are attractive. Many teens believed that indoor tanning is sometimes necessary to achieve the tanned look. These findings can usefully guide intervention development regarding the harms of all tanning, rather than indoor or outdoor tanning specifically.
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Affiliation(s)
| | | | | | | | | | - Elyse Shuk
- Memorial Sloan Kettering Cancer Center, USA
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Abstract
This study investigated the attitudes of body-tanning behaviors: suntanning, tanning bed, tanning spray, and sunless tanning product use. Data collected from 208 female college students (M age = 19.8 yr., SD = 2.0; M weight = 63.3 kg, SD = 2.0; M height = 165.9 cm, SD = 8.1) online. The questionnaire comprised four constructs: appearance-based, health-based, and emotion-based tanning attitudes, and body-tanning behaviors. Both appearance-based and emotion-based pro-tanning attitudes were associated with significantly higher body-tanning behaviors. However, health-based pro-tanning attitudes did not significantly affect body-tanning behaviors. The results from both UV- and non-UV exposure-related tanning behaviors provide future intervention strategies, such as establishing a positive body image without a tan and identifying negative emotional consequences as a result of tanning.
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Basch CH, Hillyer GC, Ethan D, Berdnik A, Basch CE. Tanning Shade Gradations of Models in Mainstream Fitness and Muscle Enthusiast Magazines. Am J Mens Health 2014; 9:301-6. [DOI: 10.1177/1557988314543511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tanned skin has been associated with perceptions of fitness and social desirability. Portrayal of models in magazines may reflect and perpetuate these perceptions. Limited research has investigated tanning shade gradations of models in men’s versus women’s fitness and muscle enthusiast magazines. Such findings are relevant in light of increased incidence and prevalence of melanoma in the United States. This study evaluated and compared tanning shade gradations of adult Caucasian male and female model images in mainstream fitness and muscle enthusiast magazines. Sixty-nine U.S. magazine issues (spring and summer, 2013) were utilized. Two independent reviewers rated tanning shade gradations of adult Caucasian male and female model images on magazines’ covers, advertisements, and feature articles. Shade gradations were assessed using stock photographs of Caucasian models with varying levels of tanned skin on an 8-shade scale. A total of 4,683 images were evaluated. Darkest tanning shades were found among males in muscle enthusiast magazines and lightest among females in women’s mainstream fitness magazines. By gender, male model images were 54% more likely to portray a darker tanning shade. In this study, images in men’s (vs. women’s) fitness and muscle enthusiast magazines portrayed Caucasian models with darker skin shades. Despite these magazines’ fitness-related messages, protanning images may promote attitudes and behaviors associated with higher skin cancer risk. To date, this is the first study to explore tanning shades in men’s magazines of these genres. Further research is necessary to identify effects of exposure to these images among male readers.
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Basch CH, Ethan D, Hillyer GC, Berdnik A. Skin cancer prevention coverage in popular US women's health and fitness magazines: an analysis of advertisements and articles. Glob J Health Sci 2014; 6:42-8. [PMID: 24999136 PMCID: PMC4825453 DOI: 10.5539/gjhs.v6n4p42] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/26/2014] [Indexed: 12/16/2022] Open
Abstract
The desire to be tan is a phenomenon that public health researchers have investigated, as exposure to UV radiation increases the chances of developing skin cancer. Media messages in women’s magazines have been shown to contribute to this problem. Much less is known about the prevalence of skin cancer prevention messages in these magazines. This study’s aim was to identify the number and type of articles and advertised products devoted to skin health (sun protection and skin cancer prevention in particular) within five popular U.S. greater than women’s health and fitness magazines. We analyzed articles and advertisements over seven months of issues of the following popular women’s health and fitness magazines: Fitness, Health, Self, Shape, and Women’s Health, March 2013 through September 2013. Overall, 31 issues of the five magazines with a total of 780 articles and 1,986 advertisements were analyzed. Of the 780 articles, a mere 2.9% (n=23) were devoted to skin. Of the 258 skin product advertisements, less than 20% of the products contained sun protection factor (SPF). These findings suggest that women’s health and fitness magazines can improve their efforts in informing women of skin cancer risks and preventive measures to minimize these risks. The role of these magazines in building health literacy among their readers is also discussed.
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O’Leary RE, Diehl J, Levins PC. Update on tanning: More risks, fewer benefits. J Am Acad Dermatol 2014; 70:562-8. [DOI: 10.1016/j.jaad.2013.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/05/2013] [Accepted: 11/10/2013] [Indexed: 01/14/2023]
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Dennis LK, Lowe JB. Does artificial UV use prior to spring break protect students from sunburns during spring break? PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2013; 29:140-8. [PMID: 23651274 DOI: 10.1111/phpp.12040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dark-skinned individuals are less likely than light-skinned individuals to become sunburned or develop skin cancer. Some have extrapolated this relationship and surmised that developing and maintaining a tan will reduce the risk of sunburns and melanoma. In order to examine whether this strategy indeed protects against sunburns, we surveyed college students about both their tanning habits prior to spring break and their spring break activities. METHODS Sorority and fraternity students were recruited after spring break. Analyses examined associations between potential risk factors and the development of one or more sunburns during spring break. RESULTS As expected, the risk of obtaining a sunburn increased with: time spent in the sun during spring break; light complexion, as assessed by various sun-sensitivity factors; and lack of sunscreen use. We also found that tanning using an artificial UV source during the 10 weeks prior to spring break was not associated with reduced risk of sunburns during spring-break, but rather with a marginal increase in this risk. CONCLUSIONS These data provide evidence that maintaining a tan may not provide protection from sunburns. Public health messages need to address this misconception, stating clearly that a tan does not protect against or reduce the chances of developing a sunburn.
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Affiliation(s)
- Leslie K Dennis
- Division of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
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Lowe JB. Traveling sun smart starts before your patient leaves. J Travel Med 2013; 20:67-8. [PMID: 23464710 DOI: 10.1111/jtm.12004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/12/2012] [Accepted: 11/19/2012] [Indexed: 11/29/2022]
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Craciun C, Schüz N, Lippke S, Schwarzer R. Translating intentions into sunscreen use: An interaction of self-efficacy and appearance norms. PSYCHOL HEALTH MED 2012; 17:447-56. [PMID: 22292908 DOI: 10.1080/13548506.2011.613941] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Estaville L, Trad M, Martinez G. University student understanding of cancer: analysis of ethnic group variances. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:580-584. [PMID: 22477236 DOI: 10.1007/s13187-012-0356-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Traditional university and college students ages 18-24 are traversing an important period in their lives in which behavioral intervention is critical in reducing their risk of cancer in later years. The study's purpose was to determine the perceptions and level of knowledge about cancer of white, Hispanic, and black university students (n=958). Sources of student information about cancer were also identified. The survey results showed all students know very little about cancer and their perceptions of cancer are bad with many students thinking that cancer and death are synonymous. We also discovered university students do not discuss cancer often in their classrooms nor with their family or friends. Moreover, university students are unlikely to perform monthly or even yearly self-examinations for breast or testicular cancers; black students have the lowest rate of self-examinations.
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Basch CH, Hillyer GC, Basch CE, Neugut AI. Improving understanding about tanning behaviors in college students: a pilot study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:250-256. [PMID: 22420703 DOI: 10.1080/07448481.2011.596872] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Melanoma is the second most common cancer diagnosed among 15- to 29-year-olds. This pilot study assessed behaviors, barriers, and beliefs relevant to sun exposure and protective behaviors. PARTICIPANTS The sample comprised 153 undergraduate students at a large state university in western New York. METHODS Participants completed an online survey about sun safety habits, barriers to using sunblock, and beliefs about tanning and sun exposure. RESULTS Response rate was 90.8% (n = 139). Most students (87.8%) reportedly spent ≥ 3 hours per day outside in the summer, but only 17.3% reported always using sunblock during this time. Sixty percent reported recent indoor tanning and 41% reported more than 10 lifetime sunburns. The greatest barrier to using sunblock was forgetting (84.2%). CONCLUSIONS Demographics coupled with inconsistent and low levels of sunblock use, high annual prevalence of indoor tanning, and multiple lifetime sunburns indicate that this sample is at high risk for skin cancer.
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Affiliation(s)
- Corey Hannah Basch
- Department of Public Health, William Paterson University, Wayne, NJ 07470, USA.
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Brouse CH, Hillyer GC, Basch CE, Neugut AI. Geography, facilities, and promotional strategies used to encourage indoor tanning in New York City. J Community Health 2011; 36:635-9. [PMID: 21222021 DOI: 10.1007/s10900-010-9354-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is emerging evidence for the relationship between indoor tanning and melanoma. Eighty-five indoor tanning facilities in New York City were observed to determine number of tanning machines, pricing, promotions, products, and hours. Census data by zip code was used to determine population density, gender, race, age, percent living in poverty, percent unemployed, and percent college educated of areas in which tanning facilities were located. Pricing varied by the type of machine, number of sessions purchased, and single versus bundled sessions. Facilities were located in areas that had greater population density and slightly greater median age. Compared with the zip code areas with no facilities, those with tanning facilities had a higher proportion of white residents; a lower proportion of residents living in poverty and unemployed; and a higher proportion of residents with a college education. Our data suggest that the strategic location of facilities and promotions used in NYC seek to maximize patronage by those with comparatively high levels of income and education and who may be more influenced by the social desirability of artificial tanning. Long-term interventions aimed at changing social norms regarding tan skin are needed.
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Affiliation(s)
- Corey H Brouse
- Columbia University, 722 W. 168th Street 7th Floor, New York, NY 10032, USA.
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Dennis LK, Kancherla V, Snetselaar LG. Adolescent attitudes towards tanning: does age matter? PEDIATRIC HEALTH 2009; 3:565-578. [PMID: 22707979 PMCID: PMC3374604 DOI: 10.2217/phe.09.55] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Adolescents seem to be obsessed with tanning. One third of both adolescents and adults report sunbathing. On average, about 20% of adolescents report ever-using of artificial UV tanning devices with 15% currently using them. Tanning attitudes appear similar for adolescents and adults. The top three reasons for tanning included beliefs that a tan makes them more comfortable socializing with friends, looks better and is attractive. The top reason for using artificial UV tanning devices is also aesthetics, followed by relaxation. Other reasons for using artificial UV tanning devices include vacation preparation and to gain a protective base. Attitudes related to appearance that result in more frequent tanning may be difficult to change.
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Affiliation(s)
- Leslie K Dennis
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
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