Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample.

Brian Køster,Anja Olsen,Joan Bentzen,Martin Allen,Jens Søndergaard,Jesper Bo Nielsen,Karl Bang Christensen

doi:10.1371/journal.pone.0178190

Brian Køster, Anja Olsen + Show 5 more

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https://doi.org/10.1371/journal.pone.0178190

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Abstract

The objective of this study was to develop new scales measuring knowledge and attitude about UVR and sun related behavior, and to examine their association to sun related behavior objectively measured by personal dosimetry. During May-August 2013, 664 Danes wore a personal electronic UV-dosimeter for one week that measured their UVR exposure. Afterwards, they answered a questionnaire on sun-related items. We applied descriptive analysis, linear and logistic regression analysis to evaluate the associations between the questionnaire scales and objective UVR measures. Perceiving protection as routine and important were positively correlated with protective behavior. Knowledge deficit of UV and risk of melanoma, perceived benefits and importance of protection behavior was also correlated with use of protection. ‘Knowledge deficit of UV and risk of melanoma and Perceived barrier towards sun avoidance between 12 and 15’ were both associated with increased risk of sunburn. Attitude towards tan was associated to both outdoor time and exposure as well as use of protection, but not to sunburn. The results regarding Knowledge deficit of UV and risk of melanoma associated to UVR exposure and Perceived barrier towards sun avoidance between 12 and 15 emphasize the importance of awareness of melanoma risk and the priority of the skin cancer prevention advice. Shifting activities to outside the suns peak-hours could be an approach for structural and campaign preventive measures. Knowledge of items predicting exposure to UVR, use of protection and sunburn are important for planning of preventive interventions and melanoma research.

Highlights

Incidence of both malignant and non-malignant skin cancer have increased for decades in large parts of the western world and especially in Caucasian populations [1]
Exposure to artificial sources of radiation could be prevented by structural prevention if supported politically [12], reducing exposure to natural ultraviolet radiation (UVR) from the sun is dependent on e.g. skin cancer prevention campaigns to influence population behavior
We identified 4 knowledge deficit scales: Uv and risk of melanoma is composed of 6 items on risk of melanoma in relation to sun beds, sunburn as adult, travelling to sunny destinations, staying in the sun between 12pm and 3 pm, sunbathing and outdoor work

Summary

Introduction

Incidence of both malignant and non-malignant skin cancer have increased for decades in large parts of the western world and especially in Caucasian populations [1]. The main risk factor for skin cancer is exposure to ultraviolet radiation (UVR) from the sun and from artificial sources [3]. Ultraviolet radiation is typically divided in UVA (320–400 nm), UVB (280– 320 nm) and UVC (200–280 nm). Exposure to artificial sources of radiation could be prevented by structural prevention if supported politically [12], reducing exposure to natural UVR from the sun is dependent on e.g. skin cancer prevention campaigns to influence population behavior. Campaigns aimed at changing attitudes and behavior towards UV exposure in the general population have been launched in several countries [13,14,15,16]. Sunburn is until now the most common used proxy measure for personal exposure to UVR [6]

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