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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review.Am J Prev Med. 2004; 27: 422-466
- United States Cancer Statistics: 1999–2014 Incidence and Mortality Web-based Report.(Published 2017. Accessed November 1,)
- Cancer Facts and Figures.American Cancer Society, Atlanta, GA2017
- SEER Cancer Statistics Review, 1975–2014.National Cancer Institute, Bethesda, MD2017
- Skin cancer.www.cdc.gov/cancer/skin/index.htm(Published 2017. Accessed November 1,)Date: 2017
- Prevention guidelines.(Accessed July 6,)
- Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states.J Am Acad Dermatol. 2011; 65: S114.e1-S114.e11
- Sun protection.www.who.int/uv/sun_protection/en/(Published 2017. Accessed December 11,)Date: 2017
- How Do I Protect Myself from UV Rays?.(Published 2017. Accessed December 11,)
American Academy of Dermatology. Prevent Skin Cancer. www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent.Published 2017. Accessed December 11, 2017.
- Skin cancer-related prevention and screening behaviors: a review of the literature.J Behav Med. 2009; 32: 406-428
- Predictors of sun protection in Canadian adults.Can J Public Health. 2002; 93: 470-474
- Compensation strategies in sun protection behaviors by a population with nonmelanoma skin cancer.Prev Med. 1992; 21: 754-765
Passantino L, Costa M, Matsui M. Skin cancer prevention strategies. In: Vereecken P, editor. Highlights in Skin Cancer. In Tech; 2013.https://doi.org/10.5772/55241.
- Current status of the sunscreen regulation in the United States: 2011 Food and Drug Administration's final rule on labeling and effectiveness testing.J Am Acad Dermatol. 2011; 65: 863-869
- Labeling and effectiveness testing; sunscreen drug products for over-the-counter human use. Final rule.Fed Regist. 2011; 2011;76: 35620
- Strategies for skin cancer prevention.Int J Dermatol. 2004; 43: 243-251
- The eternal quest for optimal balance between maximizing pleasure and minimizing harm: the compensatory health beliefs model.Br J Health Psychol. 2006; 11: 139-153
- A Theory of Cognitive Dissonance.Row, Peterson, Evanston. IL1957: :1
- Compensatory health beliefs: scale development and psychometric properties.Psychol Health. 2004; 19: 607-624
- Health-promoting and health-risk behaviors: theory-driven analyses of multiple health behavior change in three international samples.Int J Behav Med. 2012; 19: 1-13
- Gateway health behaviors in college students: investigating transfer and compensation effects.J Am Coll Health. 2009; 58: 39-44
- Effects of exercise on gut peptides, energy intake and appetite.J Endocrinol. 2007; 193: 251-258
- Just thinking about exercise makes me serve more food. Physical activity and calorie compensation.Appetite. 2011; 56: 332-335
- Smoking behaviour and compensation: a review of the literature.Psychopharmacology (Berl). 1999; 145: 1-20
- Smoking behaviour and compensation: a review of the literature with meta-analysis.Regul Toxicol Pharmacol. 2014; 70: 615-628
- When and where do we apply what we learn?: A taxonomy for far transfer.Psychol Bull. 2002; 128: 612.
- A longitudinal quasi-experiment on the effects of posttraining transfer interventions.Hum Resour Dev Q. 2004; 15: 57-76
- Predicting and Changing Behavior: The Reasoned Action Approach.Taylor & Francis, Abingdon, UK2010
- Measures of sun exposure and sun protection practices for behavioral and epidemiologic research.Arch Dermatol. 2008; 144: 217-222
- Validity of self-reported sunscreen use by parents, children, and lifeguards.Am J Prev Med. 2009; 36: 63-69
- Validity of self-reported solar UVR exposure compared to objectively measured UVR exposure.Cancer Epidemiol Biomarkers Prev. 2010; 19: 3005-3012
- Validity of covering-up sun-protection habits: association of observations and self-report.J Am Acad Dermatol. 2009; 60: 739-744
- Development and reliability of a brief skin cancer risk assessment tool.Cancer Detect Prev. 2003; 27: 311-315
- Intentional outdoor tanning in the United States: results from the 2015 Summer ConsumerStyles survey.Prev Med. 2017; 101: 137-141
- Melanoma etiology: where are we.Oncogene. 2003; 22: 3042-3052
- An efficient method of estimating seemingly unrelated regressions and tests for aggregation bias.J Am Stat Assoc. 1962; 57: 348-368
- Tanning behaviour among young frequent tanners is related to attitudes and not lack of knowledge about the dangers.Health Educ J. 2009; 68: 232-243
Article Info
Publication History
Published online: October 18, 2018
Identification
Copyright
© 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
