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Compensation Behaviors and Skin Cancer Prevention

Published:October 18, 2018DOI:https://doi.org/10.1016/j.amepre.2018.06.019

      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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      REFERENCES

        • Saraiya M
        • Glanz K
        • Briss PA
        • et al.
        Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review.
        Am J Prev Med. 2004; 27: 422-466
        • U.S. Cancer Statistics Working Group
        United States Cancer Statistics: 1999–2014 Incidence and Mortality Web-based Report.
        (Published 2017. Accessed November 1,)
        • American Cancer Society
        Cancer Facts and Figures.
        American Cancer Society, Atlanta, GA2017
        • National Cancer Institute
        SEER Cancer Statistics Review, 1975–2014.
        National Cancer Institute, Bethesda, MD2017
        • CDC
        Skin cancer.
        (Published 2017. Accessed November 1,)
        • Skin Cancer Foundation
        Prevention guidelines.
        (Accessed July 6,)
        • Buller DB
        • Cokkinides V
        • Hall HI
        • et al.
        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
        • WHO
        Sun protection.
        (Published 2017. Accessed December 11,)
        • American Cancer Society
        How Do I Protect Myself from UV Rays?.
        (Published 2017. Accessed December 11,)
      1. 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.

        • Kasparian NA
        • McLoone JK
        • Meiser B
        Skin cancer-related prevention and screening behaviors: a review of the literature.
        J Behav Med. 2009; 32: 406-428
        • Purdue MP
        Predictors of sun protection in Canadian adults.
        Can J Public Health. 2002; 93: 470-474
        • Robinson JK
        Compensation strategies in sun protection behaviors by a population with nonmelanoma skin cancer.
        Prev Med. 1992; 21: 754-765
      2. 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.

        • Wang SQ
        • Lim HW
        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
        • Food Drug Administration
        Labeling and effectiveness testing; sunscreen drug products for over-the-counter human use. Final rule.
        Fed Regist. 2011; 2011;76: 35620
        • Harris RB
        • Alberts DS
        Strategies for skin cancer prevention.
        Int J Dermatol. 2004; 43: 243-251
        • Rabia M
        • Knäuper B
        • Miquelon P
        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
        • Festinger L.
        A Theory of Cognitive Dissonance.
        Row, Peterson, Evanston. IL1957: :1
        • Knäuper B
        • Rabiau M
        • Cohen O
        • Patriciu N
        Compensatory health beliefs: scale development and psychometric properties.
        Psychol Health. 2004; 19: 607-624
        • Lippke S
        • Nigg CR
        • Maddock JE
        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
        • Nigg CR
        • Lee H-R
        • Hubbard AE
        • Min-Sun K
        Gateway health behaviors in college students: investigating transfer and compensation effects.
        J Am Coll Health. 2009; 58: 39-44
        • Martins C
        • Morgan LM
        • Bloom SR
        • Robertson MD
        Effects of exercise on gut peptides, energy intake and appetite.
        J Endocrinol. 2007; 193: 251-258
        • Werle CO
        • Wansink B
        • Payne CR
        Just thinking about exercise makes me serve more food. Physical activity and calorie compensation.
        Appetite. 2011; 56: 332-335
        • Scherer G.
        Smoking behaviour and compensation: a review of the literature.
        Psychopharmacology (Berl). 1999; 145: 1-20
        • Scherer G
        • Lee PN
        Smoking behaviour and compensation: a review of the literature with meta-analysis.
        Regul Toxicol Pharmacol. 2014; 70: 615-628
        • Barnett SM
        • Ceci SJ
        When and where do we apply what we learn?: A taxonomy for far transfer.
        Psychol Bull. 2002; 128: 612.
        • Gaudine AP
        • Saks AM
        A longitudinal quasi-experiment on the effects of posttraining transfer interventions.
        Hum Resour Dev Q. 2004; 15: 57-76
        • Fishbein M
        • Ajzen I
        Predicting and Changing Behavior: The Reasoned Action Approach.
        Taylor & Francis, Abingdon, UK2010
        • Glanz K
        • Yaroch AL
        • Dancel M
        • et al.
        Measures of sun exposure and sun protection practices for behavioral and epidemiologic research.
        Arch Dermatol. 2008; 144: 217-222
        • Glanz K
        • McCarty F
        • Nehl EJ
        • et al.
        Validity of self-reported sunscreen use by parents, children, and lifeguards.
        Am J Prev Med. 2009; 36: 63-69
        • Glanz KL
        • Gies P
        • O'Riordan DL
        • et al.
        Validity of self-reported solar UVR exposure compared to objectively measured UVR exposure.
        Cancer Epidemiol Biomarkers Prev. 2010; 19: 3005-3012
        • O'Riordan DL
        • Nehl E
        • Gies P
        • et al.
        Validity of covering-up sun-protection habits: association of observations and self-report.
        J Am Acad Dermatol. 2009; 60: 739-744
        • Glanz K
        • Schoenfeld E
        • Weinstock MA
        • Layi G
        • Kidd J
        • Shigaki DM
        Development and reliability of a brief skin cancer risk assessment tool.
        Cancer Detect Prev. 2003; 27: 311-315
        • Shoemaker M
        • Berkowitz Z
        • Watson M
        Intentional outdoor tanning in the United States: results from the 2015 Summer ConsumerStyles survey.
        Prev Med. 2017; 101: 137-141
        • Tucker MA
        • Goldstein AM
        Melanoma etiology: where are we.
        Oncogene. 2003; 22: 3042-3052
        • Zellner A
        An efficient method of estimating seemingly unrelated regressions and tests for aggregation bias.
        J Am Stat Assoc. 1962; 57: 348-368
        • Dennis LK
        • Lowe JB
        • Snetselaar LG
        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