Abstract
Ultraviolet radiation (UVR) is the most important risk factor for developing skin cancer. University students can be considered as a particularly high-risk group for long- and short-term adverse effects of UVR due to intensive solar UVR exposure and high rates of sunburn. While validated questionnaires for assessing solar UVR exposure and sun protection behavior are available in German, a questionnaire for assessing the level of knowledge about this topic is still missing. We conducted a literature search for cross-sectional studies assessing skin cancer and sun protection knowledge among university students in Medline (via PubMed) and analyzed existing questionnaires and topics contained therein. We chose to translate the “Skin Cancer and Sun Knowledge Scale” referring to the TRAPD method into the German language and pilot-tested the translation with an opportunity sample of German students. The literature search revealed 36 eligible studies. Four major topics were identified within the studies: knowledge on skin cancer, risk factors, UVR, and sun protection measures. One hundred and seven German university students (86.0% female) with a mean age of 26.25 years (SD ± 4.58; range: 19–46) participated in our pilot study. The internal reliability of the scale was KR-20 = 0.624. We discovered an improvable level of knowledge in terms of skin cancer among the study population. Statistical analyses revealed no significant associations between the level of knowledge and UVR exposure or tanning behavior, respectively. The skin cancer and sun protection knowledge of German university students should be examined thoroughly. While the psychometric properties of the SCSK require further thorough investigation, first empirical experiences indicate the suitability of the tool to assess the level of knowledge regarding skin cancer and sun protection.
Highlights
Skin cancer is one of the most common types of cancer worldwide within the Caucasian population and a significant public health issue [1,2,3,4]
The students’ sun exposure was assessed according to Glanz et al [41] by means of two items which capture the average frequency of hours participants spent outdoors per day on weekdays (Monday till Friday) and on weekends (Saturday and Sunday) between 10 a.m. and 4 p.m. in summertime
Most studies fail to report on a systematic approach to question selection or questionnaire development, as knowledge was not always the primary outcome of the study. Based on these results and a discussion within the research group of this work, we found the “Skin Cancer and Sun Knowledge Scale” (SCSK) to be the most appropriate instrument to capture the level of knowledge and that translation and pilot testing of the instrument might be worthwhile. erefore, the SCSK was translated into German and used subsequently
Summary
Skin cancer is one of the most common types of cancer worldwide within the Caucasian population and a significant public health issue [1,2,3,4]. As various studies (among others [18,19,20,21,22,23]) point out, university students can be considered as a high-risk group for long- and short-term adverse effects of UVR—due to a high solar UVR exposure, insufficient application of sun-protective measures, and positive attitudes toward tanning—and should receive particular attention. While the importance of knowledge in predicting behavior has been widely discussed in various health contexts [24], the body of evidence regarding sun-protective behavior is still inconclusive In this regard, Nahar et al [25] highlight deficiencies in terms of sunscreen and UVR knowledge, a moderate-to-high level of skin cancer knowledge, and an insufficient use of sun-protective measures among medical students from Australia, Brazil, Peru, Albania, Canada, England, France, Hungary, Malaysia, Pakistan, Poland, Romania, Sweden, Turkey, and the USA. We aimed for (3) assessing students’ sun exposure and outdoor tanning behavior
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