Skin Cancer Prevention: Sun Protection, Sun Safety, Sunscreen Use

Author(s):  
Karen Glanz
Author(s):  
K. Thoonen ◽  
L. van Osch ◽  
H. de Vries ◽  
S. Jongen ◽  
F. Schneider

Skin cancer, which is increasing exceedingly worldwide, is substantially preventable by reducing unprotected exposure to ultraviolet radiation (UVR). Several comprehensive interventions targeting sun protection behaviors among children and adolescents in various outdoor settings have been developed; however, there is a lack of insight on stand-alone effectiveness of environmental elements. To compose future skin cancer prevention interventions optimally, identification of effective environmental components is necessary. Hence, an extensive systematic literature search was conducted, using four scientific databases and one academic search engine. Seven relevant studies were evaluated based on stand-alone effects of various types of environmental sun safety interventions on socio-cognitive determinants, sun protection behaviors, UVR exposure, and incidence of sunburns and nevi. Free provision of sunscreen was most often the environmental component of interest, however showing inconsistent results in terms of effectiveness. Evidence regarding shade provision on shade-seeking behavior was most apparent. Even though more research is necessary to consolidate the findings, this review accentuates the promising role of environmental components in skin cancer prevention interventions and provides directions for future multi-component sun safety interventions targeted at children and adolescents in various outdoor settings.


Author(s):  
Amy Bleakley ◽  
Amy B Jordan ◽  
Andrew A Strasser ◽  
Deann Lazovich ◽  
Karen Glanz

Abstract Background Recommendations for skin cancer prevention include behaviors such as using sunscreen, seeking shade, and wearing a shirt with sleeves, but the best way to persuasively communicate this information to the public is not clear. Purpose To test whether a messaging strategy using videos that focus on one specific behavior at a time versus a more general or multibehavior sun protection message is effective at changing attitudinal beliefs and intention with regard to sun protection behaviors. Methods Online experiment among non-Hispanic white 18–49 year old adults in the USA. Participants were randomly assigned to one of four conditions, each one with health messages on a different sun protection prevention behavior: “using sunscreen” (Condition 1, n = 259), “seeking shade” (Condition 2, n = 245), or “covering up” (Condition 3, n = 289). Condition 4 (the control, n = 251) is a multibehavior message that equally promotes sunscreen, seeking shade, and covering up and features a general message on sun safety. Results ANOVA and path analysis results suggest that messages which emphasize a single sun protection behavior compared with general sun safety messaging could potentially be a promising approach. The effectiveness of the videos in influencing attitudinal beliefs varied by behavior, with some gender and age moderation. There was an indirect effect on intention to use sunscreen. Conclusions This study advances our understanding of strategies for skin cancer prevention campaigns. Specifically, it suggests that focusing on a single sun protection behavior with targeted beliefs may be valuable as a first step in encouraging sun safety.


2020 ◽  
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rowan Drittij ◽  
Hein de Vries ◽  
Francine Schneider

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. In total, 26 interviews were performed. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d =.84). Comprehensive findings concerning various themes were retrieved. It was found that sunburn was frequently prevalent among children, even though all parents reported using at least one sun protection measure. Parents were often unaware of their child’s sunburn and its severity. Regarding sun protection measures, parents demonstrated an overreliance on sunscreen, often failing to adequately protect their children’s skin. Water-related activities, a lack of shade, and lack of knowledge regarding UV-index were often related to sunburn. Moreover, 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 future 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.


2020 ◽  
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rik Crutzen ◽  
Hein de Vries ◽  
Francine Schneider

Background: Adequate sun safety during childhood is crucial for decreasing skin cancer risk in later life. Although parents are an essential target group in applying sun protection measures for their children, interventions are often not directed at parents. This study identifies the most relevant determinants in predicting parental sun protection intentions and behaviors to provide guidance for future intervention development.Methods: A longitudinal survey study with two measurements was conducted among Dutch parents (N=670) of children (4-12 years old). Twenty-seven socio-cognitive determinants were examined in terms of relevance regarding four parental sun protection behaviors in different sun exposure situations. The CIBER approach was used to visualize room for improvement (sample means) on all determinants and their association strengths (correlations) with sun protection intentions and behaviors.Results: Behavior-specific rather than generic determinants were most relevant in explaining all sun protection behaviors. Of these determinants, attitude, self-efficacy and action planning, and especially parental feelings of difficulty in performing sun protection behaviors, were most relevant. Altogether, the explained variance of all socio-cognitive determinants was highest for shade-seeking behavior (R2= .41 and .43) and lowest for supportive behavior (R2=.19 and .29) in both planned and incidental sun exposure situations respectively.Discussion: This study provides detailed insight into relevant socio-cognitive determinants of parental sun protection behaviors in various sun exposure situations. This insight provides guidance for composing parental skin cancer prevention interventions. Future composition of sun safety interventions should emphasize on enhancing parental feelings of self-efficacy, especially for shade-seeking and clothing behaviors.


2021 ◽  
pp. 109019812110104
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rik Crutzen ◽  
Hein de Vries ◽  
Francine Schneider

Background Adequate sun safety during childhood is crucial for decreasing skin cancer risk in later life. Although parents are an essential target group in applying sun protection measures for their children, insight into the determinants associated with their sun protection behaviors is limited. Aims This study aims to identify the most relevant determinants in predicting multiple parental sun protection intentions and behaviors in different sun exposure situations. Method A longitudinal survey study with two measurements was conducted among Dutch parents ( N = 670) of children (4–12 years old). Twenty-seven sociocognitive determinants were examined in terms of relevance regarding four parental sun protection behaviors in different sun exposure situations. The Confidence Interval-Based Estimation of Relevance approach was used to visualize room for improvement (sample means) on all determinants and their association strengths (correlations) with sun protection intentions and behaviors. Results Behavior-specific rather than generic determinants were most relevant in explaining all sun protection behaviors. Of these determinants, attitude, self-efficacy and action planning, and especially parental feelings of difficulty in performing sun protection behaviors, were most relevant. Altogether, the explained variance of all sociocognitive determinants was highest for shade-seeking behavior ( R2 = .41 and .43) and lowest for supportive behavior ( R2 = .19 and .29) in both planned and incidental sun exposure situations, respectively. Discussion This study provides detailed insight into relevant sociocognitive determinants of parental sun protection behaviors in various sun exposure situations and directions for composing parental skin cancer prevention interventions. Conclusions Future composition of sun safety interventions should emphasize on enhancing parental feelings of self-efficacy, especially for shade-seeking and clothing behaviors.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e018299 ◽  
Author(s):  
Titus Josef Brinker ◽  
Bianca Lisa Faria ◽  
Martina Gatzka ◽  
Olber Moreira de Faria ◽  
Markus V Heppt ◽  
...  

IntroductionThe incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. The Southeast of Brazil has especially high incidences of melanoma, and early detection is low. Exposure to UV radiation represents a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation for adolescents for tanning. A medical student-delivered intervention that harnesses the broad availability of mobile phones as well as adolescents’ interest in their appearance may represent a novel method to improve skin cancer prevention.Methods and analysisWe developed a free mobile app (Sunface), which will be implemented in at least 30 secondary school classes, each with 21 students (at least 30 classes with 21 students for control) in February 2018 in Southeast Brazil via a novel method called mirroring. In a 45 min classroom seminar, the students’ altered three-dimensional selfies on tablets are ‘mirrored’ via a projector in front of their entire class, showing the effects of unprotected UV exposure on their future faces. External block randomisation via computer is performed on the class level with a 1:1 allocation. Sociodemographic data, as well as skin type, ancestry, UV protection behaviour and its predictors are measured via a paper–pencil questionnaire before as well as at 3 and 6 months postintervention. The primary end point is the group difference in the 30-day prevalence of daily sunscreen use at a 6-month follow-up. Secondary end points include (1) the difference in daily sunscreen use at a 3-month follow-up, (2) if a self-skin examination in accordance with the ABCDE rule was performed within the 6-month follow-up and (3) the number of tanning sessions.Ethics and disseminationEthical approval was obtained from the ethics committee of the University of Itauna. Results will be disseminated at conferences and in peer-reviewed journals.Trial registration numberNCT03178240; Pre-results.


2009 ◽  
Vol 129 (12) ◽  
pp. 2766-2771 ◽  
Author(s):  
Louisa G. Gordon ◽  
Paul A. Scuffham ◽  
Jolieke C. van der Pols ◽  
Penelope McBride ◽  
Gail M. Williams ◽  
...  

1999 ◽  
Vol 26 (3) ◽  
pp. 317-343 ◽  
Author(s):  
David B. Buller ◽  
Ron Borland

Increasing sun protection for children may reduce their risk for skin cancer, so many health authorities recommend comprehensive sun safety for children. Sun protection of children in North America and Europe is generally lower than desired and lower than in Australia. This article provides a critical reviewof evaluations on the effects of 24 sun protection programs for children under age 14. Programs are classified based on the target population, setting, and features. Most programs improved sun safety knowledge, but changes in sun protection attitude and behaviors were smaller. Multiunit presentations were more effective than short-duration presentations. Peer education was effective but needs further evaluation. Some programs for parents have been shown to increase sun protection for children. Strategies to improve sun safety policies need further study. A few community-wide programs have effectively improved sun protection. Future research should address innovative strategies and issues of design and measurement. There is no gold standard for measuring sun protection behavior, but self-report, prospective diaries, and observational techniques show small positive correlations.


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