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Liu RW, Cheng Y, Foerster TA. Modeling the Relationship Between Perceived Descriptive Norms and Willingness to Practice COVID-19 Preventative Behaviors: A Test of the Mediation and Moderation Mechanisms in the Theory of Normative Social Behavior. Health Commun 2024; 39:339-351. [PMID: 36628486 DOI: 10.1080/10410236.2023.2165257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Social norm has been found to impact compliance with COVID-19 preventative behaviors, including handwashing, wearing a face mask, social distancing, and cleaning and disinfecting frequently touched surfaces. There is, however, a limited understanding of the social norm influence mechanisms and its boundary condition in the context of COVID-19. Guided by the theory of normative social behaviors (TNSB), this study conducted an online survey (N = 336) to examine whether perceived injunctive norms (PIN), outcome expectation (OE), group identity (GID), group orientation (GO), and cultural tightness-looseness (CTL) can moderate and/or mediate the relationship between perceived descriptive norms (PDN) and behavioral intentions (BI) to perform COVID-19 preventative behaviors in the United States. Results showed that whereas OE mediated the PDN-BI relationship to enact all four focal behaviors, PIN mediated the PDN-BI relationship for social distancing, wearing a face mask, and cleaning and disinfecting. However, inconsistent with the predictions, all five moderators (i.e. PIN, OE, GO, GID, and CTL) attenuated, instead of strengthening, the PDN-BI relationships for particular preventative behaviors. Theoretical and practical implications were discussed.
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Affiliation(s)
- Rain Wuyu Liu
- Department of Communication, The University of Arizona
| | - Ying Cheng
- Department of Management, California State University, San Bernardino
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2
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Zhang L, Mou Y, Zhang L. Promoting condom negotiation self-efficacy among young women in China: the effects of traditional sexual values and descriptive norms. Health Educ Res 2023; 38:220-229. [PMID: 36852888 DOI: 10.1093/her/cyad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/09/2023] [Accepted: 02/18/2023] [Indexed: 05/24/2023]
Abstract
This study attempts to design effective messages to promote condom negotiation self-efficacy and safer sex intent among young women in China. An online experiment with 2 (descriptive norm: present versus absent) × 2 (traditional sexual value: high versus low) between-subjects factorial design was conducted on a purposive sample of 241 female Chinese college students. The results demonstrated that culturally tailored messages incorporating descriptive norms information on the popularity of condom negotiation can increase participants' self-efficacy (F(1,237) = 9.01, partial η2 = 0.04, P = 0.003) but not safer sex intent (F(1,237) = 2.80, partial η2 = 0.01, P = 0.096). Participants with a lower level of traditional sexual values had similar levels of condom negotiation self-efficacy as those with a higher level of values: F(1,237) = 2.85, partial η2 = 0.01, P = 0.09. There were no significant interaction effects of traditional sexual value and descriptive norm on condom negotiation self-efficacy and safer sex intent. The findings contribute to the cultural sensitivity perspective in health education in an Eastern context and have implications for public health practitioners and policymakers.
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Affiliation(s)
- Lin Zhang
- School of Media and Communication, Shanghai Jiao Tong University, 800 Dongchuan Road, Minhang District, Shanghai 200240, China
| | - Yi Mou
- School of Media and Communication, Shanghai Jiao Tong University, 800 Dongchuan Road, Minhang District, Shanghai 200240, China
| | - Lianshan Zhang
- School of Media and Communication, Shanghai Jiao Tong University, 800 Dongchuan Road, Minhang District, Shanghai 200240, China
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Bae PhD BJ, Heald PhD G. Non-linear effects of absolute risk information on individuals'self-evaluation, affective responses, and behavioral intentionsof precautionary actions against skin cancer. J Am Coll Health 2023; 71:1259-1269. [PMID: 34242548 DOI: 10.1080/07448481.2021.1926266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/01/2021] [Accepted: 04/25/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The current study explores non-linear effects of absolute risk and effects of comparative risk information about skin cancer on individuals' safety ratings, affective responses and behavioral intentions. METHOD An experimental survey was conducted among college students (N = 563) to test the effects of absolute and comparative risk information across a range of risk levels from 3.7% to 60%. RESULTS The non-linear model of absolute risk effect was confirmed by the data. Absolute risk information had detectable effects at low levels of risk, but the effects did not change appreciably at the highest absolute risk levels. Regarding comparative risk, the data did not support its effects on individuals' safety ratings, affective responses and behavioral intentions. CONCLUSION The study found the non-linear model fits well to the skin cancer related feelings and behavioral intentions. It suggests future research apply non-linear models to a variety of health communication areas.
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Affiliation(s)
- Beom Jun Bae PhD
- Communication Arts Department, Georgia Southern University, Statesboro, Georgia, USA
| | - Gary Heald PhD
- School of Communication, Florida State University, Tallahassee, Florida, USA
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Pagoto SL, Waring ME, Groshon LC, Rosen AO, Schroeder MW, Goetz JM. Proof-of-Concept Feasibility Trial of a Dissonance-Based Sun Safety Intervention for Young Adult Tanners. Ann Behav Med 2022; 56:830-841. [PMID: 35179176 PMCID: PMC9345184 DOI: 10.1093/abm/kaab116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Melanoma is the second most common cancer in young adults. Social media may be a means to conduct interventions to increase sun safety in young adults. PURPOSE We conducted a randomized proof-of-concept pilot trial to evaluate the feasibility and acceptability of a dissonance-based social media intervention designed to promote sun safety in young adult tanners. METHODS Young adult tanners (N = 66) were randomized into two 4-week interventions in which participants were incentivized to create content for a social media campaign on healthy skin or healthy lifestyle. Feasibility outcomes included retention, participation, acceptability, and contamination. We also examined the impact of participation on motivation to engage in the target health behaviors and outdoor tanning intentions. RESULTS Retention was 100%. Most Healthy Skin (88%) and Healthy Lifestyle participants (91%) created ≥1 post. Acceptability was high with 94% and 97% of participants in Healthy Skin and Healthy Lifestyle conditions, respectively, agreeing they would recommend the campaign to a friend. At 4 weeks, Healthy Skin participants reported greater declines in motivation to tan indoors (p = .0017) and outdoors (p = .0003), and greater increases in motivation to wear sunscreen (p = .0009) and protective clothing (p = .0342). Healthy Skin participants reported greater declines in intentions to tan outdoors in the next year (p = .0286). CONCLUSIONS A dissonance-based, social media sun safety intervention was feasible and acceptable. Future research should examine the efficacy and longer-term effects of this intervention in young adults at elevated risk for skin cancer. TRIAL REGISTRATION Clinicaltrials.gov NCT03834974 https://clinicaltrials.gov/ct2/show/NCT03834974.
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Affiliation(s)
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
| | - Laurie C Groshon
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
| | - Aviana O Rosen
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
| | - Matthew W Schroeder
- Department of Allied Health Sciences, University of Connecticut, 2006 Hillside Road, Unit 1248, Room 22, Storrs, CT 06268, USA
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Bowers JM, Hamilton JG, Wu YP, Moyer A, Hay JL. Acculturation, Sun Tanning Behavior, and Tanning Attitudes Among Asian College Students in the Northeastern USA. Int J Behav Med 2022; 29:25-35. [PMID: 33942255 PMCID: PMC9272584 DOI: 10.1007/s12529-021-09993-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND College students participate in high levels of tanning, a skin cancer risk behavior due to ultraviolet radiation exposure, yet little is known about Asian college students' behavior. This study examined the relationship between tanning attitudes, acculturation to the USA (cultural assimilation), and tanning behavior. METHOD An online survey was used to recruit 211 Asian college students in the northeastern USA (47.4% born outside of the USA) to respond to questions about recent tanning behavior, sun protection strategies, attitudes about tanning, and acculturation to the USA. RESULTS Attitudes about tanning, particularly desire for a darker skin tone and social norms, along with acculturation to the USA, were predictive of intentional tanning. The sample reported high levels of sun protection, which was associated with low acculturation. CONCLUSION The significant role of acculturation in this study indicates that it may be a useful factor to include in future tanning intervention studies of relevant populations.
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Affiliation(s)
- Jennifer M. Bowers
- Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY 11794-2500, USA,Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Jada G. Hamilton
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah, Salt Lake City, UT 84132, USA
| | - Anne Moyer
- Department of Psychology, Stony Brook University, 100 Nichols Road, Stony Brook, NY 11794-2500, USA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
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Buller DB, Pagoto S, Henry KL, Baker K, Walkosz BJ, Hillhouse J, Berteletti J, Bibeau J, Kinsey A. Persisting Effects of a Social Media Campaign to Prevent Indoor Tanning: A Randomized Trial. Cancer Epidemiol Biomarkers Prev. [DOI: 10.1158/1055-9965.epi-21-0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/10/2021] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
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Cheng Y, Liu RW, Foerster TA. Predicting intentions to practice COVID-19 preventative behaviors in the United States: A test of the risk perception attitude framework and the theory of normative social behavior. J Health Psychol 2021; 27:2744-2762. [PMID: 34933582 DOI: 10.1177/13591053211057382] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined risk perceptions, efficacy beliefs, social norms, and their interactions as predictors of people's intention to practice four COVID-19 preventative behaviors among a U.S. sample with quotas on age, sex, ethnicity, and region (N = 336). This online survey found that perceived injunctive norms predicted intentions to clean and disinfect (β = 0.20), practice social distancing (β = 0.14), and wear a face mask (β = 0.24). Additionally, efficacy beliefs were found to attenuate the association between descriptive norm perceptions and intention to wash hands (B = -0.15) and wear a face mask(B = -0.12). The results revealed the importance of considering both psychological and social factors to promote COVID-19 preventative behaviors.
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Affiliation(s)
- Ying Cheng
- California State University San Bernardino, USA
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Willoughby JF, Myrick JG, Li J. Appearance, Friends, and Feelings: A Two-Study Exploration of Young Women's Emotional Associations and Indoor Tanning Frequency. Int J Behav Med 2021; 28:705-714. [PMID: 33825154 DOI: 10.1007/s12529-021-09968-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Knowledge of its potential cancer risk is often not enough to motivate individuals to avoid indoor tanning. Previous research has found that emotions toward indoor tanning and appearance motivations may prompt people to continue despite the risks. METHODS We conducted two online surveys of US young adult women. Study one included a convenience sample of female undergraduates (N = 502) at a university in the northwestern USA. Study two included young women from a nationwide US online panel (N = 270). RESULTS Results suggest that emotional associations, both positive and negative, with indoor tanning explain greater variances in indoor tanning behavior than demographics and previously established psychosocial predictors of tanning alone. Appearance motivations were also positively associated with indoor tanning in both samples. CONCLUSIONS This research has implications for health care providers and health communicators, as indoor tanning prevention messages and campaigns should consider the association between both positive and negative emotions on tanning behaviors as well as appearance motivations.
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Affiliation(s)
- Jessica Fitts Willoughby
- The Edward R. Murrow College of Communication, Washington State University, Pullman, Washington, USA.
| | - Jessica Gall Myrick
- Donald P. Bellisario College of Communications, Pennsylvania State University, State College, PA, USA
| | - Jiayu Li
- The Edward R. Murrow College of Communication, Washington State University, Pullman, Washington, USA
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Yilma H, Sedlander E, Rimal RN, Pant I, Munjral A, Mohanty S. The reduction in anemia through normative innovations (RANI) project: study protocol for a cluster randomized controlled trial in Odisha, India. BMC Public Health 2020; 20:203. [PMID: 32033546 PMCID: PMC7007687 DOI: 10.1186/s12889-020-8271-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than half of women in India are anemic. Anemia can result in fatigue, poor work productivity, higher risk of pre-term delivery, and maternal mortality. The Indian government has promoted the use of iron-folic acid supplements (IFA) for the prevention and treatment of anemia for the past five decades, but uptake remains low and anemia prevalence high. Current programs target individual-level barriers among pregnant women and adolescents, but a more comprehensive approach that targets multiple levels among all women of reproductive age is needed to increase uptake of IFA and iron-rich foods. METHODS The Reduction in Anemia through Normative Innovations (RANI) project is a norms-based intervention to reduce anemia among women of reproductive age. We will evaluate the intervention through a clustered randomized controlled trial in Odisha, India. We will collect data at three time points (baseline, midline, and end line). For the study, we selected 89 clusters of villages, which we randomized into treatment and control on a 1:1 basis. The treatment arm will receive the RANI project components while the control arm will receive usual care. Fifteen clusters (40-41 villages) were selected and 4000 women (2000 in each arm) living in the selected clusters will be randomly selected to take part in data collection. Women in both study arms will have their hemoglobin concentrations measured. They will also complete in-person surveys about their knowledge, attitudes, perceptions of iron folic acid supplements, and nutritional intake. We will also select a smaller cohort of 300 non-pregnant women (150 in each arm) from this cohort for additional physical activity and cognitive testing. We will conduct both within- and between-group comparisons (treatment and control) at baseline, midline and end line using t-tests. We will also conduct structural equation modeling to examine how much each factor accounts for IFA use and hemoglobin levels. DISCUSSION This RCT will enable us to examine whether a social norms-based intervention can increase uptake of iron folic acid supplements and iron rich foods to reduce anemia. TRIAL REGISTRATION This trial was registered with Clinical Trial Registry- India (CTRI) (CTRI/2018/10/016186) on 29 October 2018.
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Affiliation(s)
- Hagere Yilma
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA.
| | - Erica Sedlander
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Rajiv N Rimal
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ichhya Pant
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Ashita Munjral
- Department of Social and Economic Empowerment, IPE Global Limited, New Delhi, Delhi, India
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Carcioppolo N, Orrego Dunleavy V, Myrick JG. A Closer Look at Descriptive Norms and Indoor Tanning: Investigating the Intermediary Role of Positive and Negative Outcome Expectations. Health Commun 2019; 34:1619-1627. [PMID: 30198759 DOI: 10.1080/10410236.2018.1517632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Indoor tanning is a risky behavior that dramatically increases skin cancer risk. Researchers from multiple disciplines aim to better understand this behavior to develop interventions and messages to curtail it. As such, we investigated the role of social norms and outcome expectations as predictors of tanning behavior as part of a larger test of constructs included in the Theory of Normative Social Behavior. In addition to offering additional empirical results to support theoretical claims for the importance of social norms and outcome expectations in predicting health behaviors, we offer indoor tanning-specific operationalizations in a conditional process model with the aim of assessing how content-specific measurements predict indoor tanning intentions. Results of a survey of adult indoor tanners from across the U.S. (N = 262) highlight when and how descriptive norms influence tanning intentions through the mediating roles of anticipatory socialization, injunctive norms, and health threat, and through the moderating role of mood-based tanning motivations. Implications for theory building as well as for intervention and message design are discussed.
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Affiliation(s)
- Nick Carcioppolo
- Department of Communication Studies and Affiliate Faculty at the Sylvester Comprehensive Cancer Center, University of Miami
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Basaran AMB, Christensen JL, Miller LC, Appleby PR, Read SJ. The relationship between social norms and sexual risk-reduction intentions and behavior among men who have sex with men: Findings from an eHealth intervention. Psychol Addict Behav 2019; 33:382-391. [PMID: 31070388 DOI: 10.1037/adb0000467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Normative-based research has found that norms are significant predictors of safe sex behavioral intentions and behavior. Research shows that group identity moderates the relationship between norms and intentions/behavior. The present study used the theory of normative social behavior to evaluate whether identification with characters in an HIV-prevention interactive video moderated the relationship between sexual risk-taking norms and risk reduction intentions/behavior. Participants included 540 men between the ages 18 and 30 enrolled in a randomized controlled trial with a 3-month follow-up. We found support for the hypothesized interaction. At low levels of character identification, the negative relationship between sexual risk-taking norms and risk reduction intentions was strong. However, as character identification increased, the link between norms and intentions became weaker. The mean intentions score of high-risk norm participants was elevated to the level reported by low risk norm participants, demonstrating the favorable effect of character identification on narrative persuasion in entertainment-education. The utility of a social norms approach to health behavior change is discussed in the context of eHealth interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Carcioppolo N, Peng W, Lun D, Occa A. Can a Social Norms Appeal Reduce Indoor Tanning? Preliminary Findings From a Tailored Messaging Intervention. Health Educ Behav 2019; 46:818-823. [PMID: 30938186 DOI: 10.1177/1090198119839105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perceived social norms are routinely observed as positive predictors of indoor tanning. Past research has suggested that messaging interventions target normative perceptions to reduce indoor tanning behavior. Despite this call, little empirical research has investigated the utility of taking a social norms approach in behavioral interventions. The present study addresses this gap by conducting a quasi-experiment (N = 206) assessing the effect of an intervention message correcting normative misperceptions on indoor tanning intentions at different levels of tanning frequency. Results suggest that tailored normative intervention messages can successfully reduce tanning intentions among high-frequency tanners, those who scored at the 75th and 90th percentile of tanning frequency (f2 for interaction = .015). These results provide preliminary empirical evidence to support previous theorizing on the efficacy of social norms interventions among high-frequency indoor tanners.
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Affiliation(s)
| | - Wei Peng
- University of Miami, Coral Gables, FL, USA
| | - Di Lun
- University of Miami, Coral Gables, FL, USA
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14
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Abstract
This study of 312 female undergraduates investigated the association of recently, formerly, or never indoor tanning with self-perceptions and social influence, and examined reasons to tan and not to tan. Previous research on indoor tanning has focused on recent or current tanners, and few studies have examined former indoor tanners. By examining self-perceptions and social influence, this study aimed to understand how these common tanning correlates, measured in former indoor tanners, compared to those who have never tanned indoors (i.e., never tanners) and those who have recently tanned indoors. Appearance and global self-perceptions were more positive in former indoor tanners compared to never tanners and recent tanners. Recent indoor tanning was positively associated with both higher outdoor tanning frequency and having a higher number of friends performing skin cancer risk behaviors, and formerly indoor tanning was also associated with both, but to a lesser extent. Appearance and social influence were commonly described as reasons for indoor tanning, and perceived health risk, appearance, and social influence were described as prominent reasons for tanning cessation. This study improves what is known about former indoor tanners, which may be useful for behavior change maintenance efforts and developing approaches for skin cancer screening interventions.
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Affiliation(s)
- Jennifer M Bowers
- a Department of Psychology , Stony Brook University , Stony Brook , NY , USA
| | - Anne Moyer
- a Department of Psychology , Stony Brook University , Stony Brook , NY , USA
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Abstract
PURPOSE Indoor tanning is associated with an increased risk of developing skin cancer. In the United States, nearly 1 in 5 white women aged 18 to 25 are indoor tanners. This study elicited beliefs about tanning indoors and quitting/cutting back on indoor tanning. DESIGN Semi-structured interviews. PARTICIPANTS AND SETTING Forty 18- to 25-year-old white females who engaged in frequent indoor tanning participated in either in-person or telephone interviews. Most were college students from southeastern Pennsylvania and Delaware. METHOD A semi-structured interview was used to elicit beliefs about indoor tanning and quitting or cutting back. Data analyses using NVivo and multiple coders identified key themes about going and quitting/cutting back on indoor tanning. RESULTS Key themes stated as reasons for indoor tanning included improving physical appearance, social acceptance, increased confidence, and happiness. The main themes identified as advantages of quitting/cutting back on indoor tanning were to decrease skin cancer risk and save money. Perceived disadvantages of quitting/cutting back included themes of concerns about being pale and a decline in self-confidence. The prospect of saving money and warm weather were seen as facilitating quitting/cutting back. CONCLUSION Findings suggest the necessity of addressing appearance concerns, psychological benefits associated with feeling more attractive, and short-term gains such as saving money. These findings provide a foundation for developing effective anti-indoor tanning communication.
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Affiliation(s)
- Karen Glanz
- 1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- 2 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Jordan
- 3 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - DeAnn Lazovich
- 4 School of Public Health, University of Minnesota, MN, USA
| | - Amy Bleakley
- 3 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
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Daniel CL, Gassman NR, Fernandez AM, Bae S, Tan MCB. Intentional tanning behaviors among undergraduates on the United States' Gulf Coast. BMC Public Health 2018; 18:441. [PMID: 29615031 PMCID: PMC5883533 DOI: 10.1186/s12889-018-5345-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 03/21/2018] [Indexed: 12/03/2022] Open
Abstract
Background Rates of melanoma have dramatically increased among adolescents and young adults in recent years, particularly among young women. Exposure to ultraviolet radiation from intentional tanning practices is likely a major contributor to this epidemic. Southern and coastal regions have higher melanoma mortality rates among non-Hispanic whites in other parts of the U.S., yet little is known about tanning practices of adolescents and young adults in these regions. This study determines the prevalence and methods of intentional tanning utilized by an undergraduate population located on the United States’ Gulf Coast. Methods Undergraduate students enrolled at a university on the Gulf Coast completed an online survey from March–April 2016, self-reporting their engagement, knowledge, and attitudes regarding outdoor tanning (OT), indoor tanning (IT) and spray tanning (ST). Univariate and multivariate analyses were performed to identify factors associated with tanning behaviors. Results 2668 undergraduates completed the survey. Of these, 64.9% reported OT tanning, 50.7% reported ever IT, and 21.2% reported ever ST. Conclusions In the largest study to date of intentional tanning behaviors of adolescents and young adults from coastal regions, we found high rates of intentional tanning behaviors. There was also significant engagement in spray tanning by this population, not previously reported for adolescents and young adults in a sample of this size. We also identified a high association between different tanning methods, indicating this population engages in multiple tanning behaviors, a phenomenon whose health consequences are not yet known.
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Affiliation(s)
- Casey L Daniel
- Division of Oncological Sciences, University of South Alabama Mitchell Cancer Institute, 1660 Springhill Avenue, Mobile, AL, 36604, USA.
| | - Natalie R Gassman
- Division of Oncological Sciences, University of South Alabama Mitchell Cancer Institute, 1660 Springhill Avenue, Mobile, AL, 36604, USA
| | - Alyssa M Fernandez
- Division of Oncological Sciences, University of South Alabama Mitchell Cancer Institute, 1660 Springhill Avenue, Mobile, AL, 36604, USA
| | - Sejong Bae
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL, 35205, USA.,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcus C B Tan
- Department of Surgery, University of South Alabama College of Medicine, 2451 Fillingim Street, Mobile, AL, 36617, USA
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Abstract
Many studies to date have examined how media influence health-related behavior through social norms. However, most studies focused on traditional media. In the era of traditional and social media integration, our study advances health and mass communication scholarship by examining the influence of both traditional and social media mediated through social norms. Also, we examined a boundary condition for the norms-mediated media influence process. Namely, in the context of college binge drinking, we predict that exposure to TV and social media prodrinking messages can influence college students' binge drinking intentions through perceived peer descriptive and injunctive norms. We also predict that group identification will moderate this indirect effect. Our moderated mediation models were tested via structural equation modeling (N = 609). We found that college students' exposure to social media prodrinking messages indirectly influenced their binge drinking intentions via perceived injunctive norms, and students' identification with their peers moderated this indirect effect. However, neither descriptive nor injunctive norms mediated the influence of students' exposure to TV prodrinking messages on their binge drinking intentions. Theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Bo Yang
- a Tobacco Center of Regulatory Science , School of Public Health , Georgia State University , Atlanta , USA
| | - Xinyan Zhao
- b School of Communication , Hong Kong Baptist University , Hong Kong , China
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Gambla WC, Fernandez AM, Gassman NR, Tan MCB, Daniel CL. College tanning behaviors, attitudes, beliefs, and intentions: A systematic review of the literature. Prev Med 2017; 105:77-87. [PMID: 28867504 DOI: 10.1016/j.ypmed.2017.08.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 08/18/2017] [Accepted: 08/27/2017] [Indexed: 01/30/2023]
Abstract
Despite well-established links between exposure to ultraviolet radiation (UVR) and skin cancer, UVR-based tanning behaviors persist among college students. Understanding tanning motivations, perceptions, barriers, and demographic characteristics of this population is critical to modifying these behaviors, but is limited by variability in study design, sample size, and outcomes measured in the current literature. To help clarify the tanning behaviors of this population and provide a concise reference for future studies, this review examines existing reports to determine the comparability of tanning behaviors across multiple U.S. college populations. A systematic review of the literature was performed in July 2016 to identify studies investigating tanning behaviors among U.S. college students. Twenty-three studies met inclusion criteria. High rates of indoor tanning (IT) and outdoor tanning (OT) were found among college students. Key motivators included appearance, emotion, health perceptions, and the influence of parents, peers, and the media. Misconceptions regarding skin protection, low rates of sun protective behaviors, and tanning dependence were barriers against safe UVR exposure. Understudied demographic factors may account for variance in observed tanning behaviors, emphasizing the need for standardization efforts to consistently identify trends associated with geographical region, age, year in college, and sex. The findings presented in this review reaffirm that college students are at high risk for tanning-associated skin cancer, emphasizing the critical need for effective, targeted interventions. Improved interventions will reduce the burden of skin cancer within this group, ultimately contributing to longer, healthier lives.
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Affiliation(s)
- William C Gambla
- College of Medicine, University of South Alabama, Mobile, AL, United States
| | - Alyssa M Fernandez
- Division of Oncological Sciences, University of South Alabama Mitchell Cancer Institute, Mobile, AL, United States
| | - Natalie R Gassman
- Division of Oncological Sciences, University of South Alabama Mitchell Cancer Institute, Mobile, AL, United States
| | - Marcus C B Tan
- College of Medicine, University of South Alabama, Mobile, AL, United States
| | - Casey L Daniel
- Division of Oncological Sciences, University of South Alabama Mitchell Cancer Institute, Mobile, AL, United States.
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Rodríguez VM, Daniel CL, Welles BF, Geller AC, Hay JL. Friendly tanning: young adults' engagement with friends around indoor tanning. J Behav Med 2017; 40:631-40. [PMID: 28181003 DOI: 10.1007/s10865-017-9832-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/29/2017] [Indexed: 01/20/2023]
Abstract
Indoor tanning (IT), particularly during early adulthood, increases risk for melanoma and is exceedingly common among youth. Social influence, including social norms, promotes IT but little is known about young adults' engagement with friends around tanning. We examined IT behaviors and tanning-related communication with friends at three universities. Of 837 participants, 261 (31%) reported ever tanning (90% female, 85% White). Of those, 113 (43%) were former tanners and 148 (57%) current tanners. Current tanners reported more social tanning and discussions with friends about tanning, more frequent outdoor tanning, high propensity to tan, and greater lifetime IT exposure than former tanners. Risks-to-benefits discussion ratios were greater for former tanners. In adjusted analyses, current tanners were more likely to make plans to tan and to talk about tanning benefits with friends. Findings confirm IT is a social experience. Future work should examine social tanning's role in the promotion and reduction of IT among youth.
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Carcioppolo N. When Does Perceived Susceptibility to Skin Cancer Influence Indoor Tanning? The Moderating Role of Two Risk Perception Beliefs. J Health Commun 2016; 21:1170-1178. [PMID: 27786607 DOI: 10.1080/10810730.2016.1237593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Previous research has demonstrated an inconsistent relationship between perceived susceptibility to skin cancer and indoor tanning. The current study explored potential moderators of this relationship to better understand how risk perceptions can impact indoor tanning intentions and behavior. A national online survey (N = 267) was administered in the United States to establish the relationship between perceived susceptibility to skin cancer, cancer fatalism, and external risk attribution beliefs on indoor tanning intentions and behavior. Results revealed significant 3-way interactions among these risk perceptions on both intentions and behavior that run contrary to much of the published research on perceived susceptibility and health behavior. These findings suggest that the relationship between perceived susceptibility to skin cancer and indoor tanning is conditional on other risk perceptions. These results are discussed in terms of their theoretical and practical implications.
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Affiliation(s)
- Nick Carcioppolo
- a Department of Communication Studies , University of Miami , Coral Gables , Florida , USA
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