Abstract
BackgroundNorway has one of the highest incidences of melanoma in the world. It has been suggested that the majority of all skin cancers could be prevented by changes related to sun-tanning behaviour. This study explores the sun-tanning behaviour of the Norwegian population using a modified Health Belief Model (HBM). Increased knowledge about beliefs, attitudes and sun-tanning behaviour can provide information which may be useful for future sun protection interventions.MethodsIn 2017, 1004 members of the Norwegian population completed cross-sectional online surveys. People who seek the sun for tanning purposes was the eligibility criterion for this study, reducing the study population to 569. With the aid of the constructs from the HBM, predictive factors explaining sun-tanning behaviour were determined using multivariate linear regression adjusted for demographics (gender, age, education and income). Furthermore, the predictor variables, empowerment and benefits of tanning, were added to the model.ResultsFive of the constructs in the modified HBM showed significant correlation with sun-tanning behaviour using bivariate analysis. The strongest correlation was perceived barriers of sun protection (0.42), with the next strongest being the benefits of tanning (0.30). The modified model explained 31% of the variation in sun-tanning behaviour using multivariate analysis. Significant predictors from the HBM to sun-tanning behaviour were perceived barriers to sun protection (Beta = 0.36, p < 0.001) and the severity of melanoma (Beta = − 0.20, p < 0.001). In addition, empowerment (Beta = 0.05, p = 0.05) and the benefits of tanning (Beta = 0.28, p < 0.001) proved to be variables with significant effect on sun-tanning behaviour. The demographic factors age, education and income were also associated with sun-tanning behaviour (p < 0.05).ConclusionBased on the results of this study, several factors in the modified HBM had a significant impact on Norwegians’ sun-tanning behaviour. The results indicate that future sun protection interventions should focus on reducing barriers in relation to sun protection behaviour, as well as emphasizing the severity of adverse tanning behaviour and melanoma. Efforts to alter the perceptions of the beneficial factors of tanning behaviour can also be appropriate in health promotion campaigns and interventions. Finally, implementing empowerment strategies could have a positive effect on promoting healthy sun-tanning behaviour.
Highlights
Norway has one of the highest incidences of melanoma in the world
In contrast to other studies which have focused on sun protection behaviour and effects of Ultraviolet radiation (UV)-radiation [4, 11, 28, 29], our study examined the individual’s perceptions of attitudes and behaviour in relation to tanning utilizing a modified Health Belief Model (HBM)
Our results show that individuals with a high degree of perceived empowerment are more likely to engage in sun protective behaviour
Summary
Norway has one of the highest incidences of melanoma in the world. It has been suggested that the majority of all skin cancers could be prevented by changes related to sun-tanning behaviour. The Global Burden of Disease Study shows that Norway is among the top five countries in the world in terms of incidence, mortality, and healthy life years lost due to melanoma [2] It is one of the fastest increasing cancers in Norway and represents a major public health challenge [3, 4]. It has been suggested that the increase in melanoma incidences in Norway may be explained by changes in sunbathing habits, increased trips to warmer countries, men using less sun protection than women, and increased promiscuity amongst elderly people [8] It is important for health communication researchers and practitioners to consider health beliefs and behaviour that can encourage safer sun-tanning behaviour, increase the use of sun protection and instigate early detection of skin cancer. Research aimed at investigating and clarifying sun protection behaviour is essential [9]
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