Sun Protection Behaviors Research Articles

Facebook Intervention for Young-Onset Melanoma Survivors and Families: Protocol for a Randomized Controlled Trial

Individuals diagnosed with melanoma before the age of 40 years (young-onset melanoma survivors) and their first-degree relatives (FDRs) are a growing population at risk for developing recurrent melanoma or new melanomas. Regular surveillance using clinical skin examination (CSE) and skin self-examination (SSE) and engagement in preventive behaviors including sun protection are recommended. Given the growing population of survivors and their families who are at increased risk, it is surprising that no behavioral interventions have been developed and evaluated to improve risk-reduction behaviors. We describe the rationale and methodology for a randomized controlled trial evaluating the efficacy of a Facebook intervention providing information, goal setting, and peer support to increase CSE, SSE, and sun protection for young-onset melanoma survivors and their FDRs. Overall, 577 survivors and 577 FDRs will be randomly assigned to either the Young Melanoma Family Facebook Group or the Melanoma Family Healthy Lifestyle Facebook Group condition. Participants will complete measures of CSE, SSE, and sun protection, and mediator measures of attitudes and beliefs before and after the intervention. The primary aim is to evaluate the impact of the Young Melanoma Family Facebook intervention versus the Melanoma Family Healthy Lifestyle Facebook intervention on CSE, SSE frequency and comprehensiveness, and sun protection among FDRs. The secondary aims examine the efficacy of the Young Melanoma Family Facebook intervention on survivors' SSE frequency and comprehensiveness and sun protection behaviors and mechanisms of intervention efficacy for intervention impact on FDR and survivor outcomes. The exploratory aim is to evaluate the efficacy of the 2 interventions on perceived stress, physical activity, and healthy eating. This project was funded by the National Institutes of Health (R01CA221854). The project began in May 2018, and recruitment started in January 2019. We anticipate completing enrollment by November 2023. Power calculations recommended a sample size of 577 survivors and 577 FDRs. Multilevel modeling treating family as the upper-level sampling unit and individual as the lower-level sampling unit will be the primary data analytic approach. Fixed effect predictors in these models will include condition, role, sex, all 2- and 3-way interactions, and covariates. The Young Melanoma Family Facebook intervention aims to improve primary and secondary skin cancer prevention for young-onset melanoma survivors and their family members. The intervention's delivery via a popular, freely available social media platform increases its impact because of the potential for dissemination in many contexts. If efficacious, this program could be disseminated by dermatologist practices, public health or nonprofit organizations focused on melanoma, and existing melanoma and skin cancer Facebook groups, thereby expanding its reach. This project will produce a content library of posts and a moderation guide for others. ClinicalTrials.gov NCT03677739; https://clinicaltrials.gov/ct2/show/NCT03677739. DERR1-10.2196/39640.

Serial Cross-Sectional Observations of Sun-Protective Behaviors at an Annual Outdoor Motorsport Event in Tropical Queensland, Australia.

Skin cancer, the most prevalent cancer in Caucasians residing at low latitudes, can primarily be prevented by avoiding overexposure to sunlight. Serial cross-sectional observations were conducted at an outdoor motorsport event held in Townsville, Queensland each July (Southern winter) to determine whether sun-protection habits changed over time. Most (71.1%) of the 1337 attendees observed (97.6% lightly pigmented skin, 64.0% male) wore a hat (any style shading the face), while few (18.5%) wore three-quarter or full-length sleeves. While hat-wearing rates (any style) were similar in 2009 (326, 72.6%) and 2013 (625, 70.4%), the use of sun-protective styles (wide-brimmed/bucket/legionnaires) decreased from 29.2% to 18.6% over the same period, primarily because the use of sun-protective hats halved (from 28.7% to 14.0%) among females, while decreasing from 29.4% to 21.1% in males. Although relatively few individuals wore sun-protective (three-quarter-length or full-length) sleeves regardless of year (OR=0.117, P < 0.0001), encouragingly, the use of sun-protective sleeves more than doubled between 2009 (10.5%) and 2013 (22.5%). Interestingly females, albeit the minority, at this sporting event were less likely to wear a hat (OR=0.473, P < 0.0001) than males. These findings highlight the need for continued momentum toward skin cancer primary prevention through sun protection with a dedicated focus on outdoor sporting settings.

Factors Associated With Sun Protection Behaviors Among Childhood Cancer Survivors.

Childhood cancer survivors (CCS) are at increased risk of developing skin cancer. Engaging in sun-protective behaviors may ameliorate that risk, but prior work shows that survivors engage in suboptimal levels of sun-protective behaviors. Guided by the Health Belief Model (HBM), this study evaluated factors associated with sun-protective behavior among CCS. This is a secondary analysis of a survey study of 94 adult survivors of childhood cancer recruited from a long-term follow-up clinic. Participants reported their sun protection habits, skin type/sensitivity, barriers to sun protection, and perceived severity and susceptibility of getting skin cancer. Descriptive statistics were used to describe the prevalence of sun protection behaviors and hierarchical linear regression was used to evaluate predictors of sun protection behavior following the HBM. On average, CCS engaged in moderate levels of sun-protective behaviors ( M =2.53; SD=0.59). Hierarchical linear regression indicated that fair skin type ( P =0.02) and higher perceived susceptibility relative to noncancer survivors ( P =0.02) were associated with increased sun protection behaviors. Perceived barriers to sun protection were marginally significant ( P =0.09), whereas other constructs from the HBM did not contribute significantly to the model. Although CCS are at increased risk of developing skin cancer, they engage in suboptimal levels of sun protection behaviors. Findings suggest that interventions to educate survivors about their unique risk of skin cancer and effective prevention behaviors are needed.

Predictors of genetic risk recall among the participants of a randomized controlled precision prevention trial against melanoma

PurposeInherited variation in MC1R imparts low to moderate risk of melanoma. Research on genetic risk recall, factors predicting recall, and whether recall influences adoption of preventive behaviors is limited. MethodsParticipants (n = 447) enrolled in a melanoma precision prevention trial were provided with MC1R risk information (average or higher) and after 6 and 12 months, were asked to recall their genetic risk. Predictors of recall were identified using backward stepwise selection. Intervention effects were reassessed after stratifying by recall. ResultsParticipants at higher risk were 2 to 3 times more likely to misremember or not recall than participants with average risk. Misremembering was almost exclusively observed among participants at higher risk. Among the participants with average risk, lower health numeracy and not completing the telephone follow-up were associated with not recalling or misremembering. Among the participants at higher risk, lower education was associated with not recalling and lower perceived comparative chance of developing melanoma was associated with misremembering. In general, participants at higher risk who correctly recalled had modestly stronger intervention effects on sun protection behaviors than those who misremembered or did not recall. ConclusionFuture studies should examine different strategies to increase genetic risk recall, which may result in improved behavioral outcomes, especially among participants with lower education and health numeracy.

Risk-Factor Assessment and Sun Protection Behaviors of Ohio Farmers

Highlights Most farmers never had a skin cancer assessment by a health professional, but almost 20% had a skin cancer diagnosis. While at risk for skin cancer, Ohio farmers have not widely adopted sun safety protection behaviors. Understanding sun safety practices of farmers may guide development of appropriate resources and interventions. Abstract. The purpose of the study was to identify sun exposure risk factors and sun protection behaviors from a sample of Ohio farmers. A convenience sample of farmers was invited to complete a self-report survey, either online or by paper and pencil at annual pesticide training courses and community-based safety programs. This cross-sectional and descriptive study used public domain survey questions by Glanz et al. and Oh et al. Respondents totaled 505 and self-identified primarily as male, married or with a domestic partner, white, non-Latino, with very fair to fair skin, and worked full-time mostly in field crops. Over 50% of farmers applied or reapplied sunscreen. Between 50% and 70% wore a shirt with sleeves, sunglasses, and/or a hat; a baseball cap was the preferred headwear. Farmers (67%) reported 0-1 sunburns last year, and 83% said they sit in the sun to get a tan. Younger farmers (&amp;lt;44 years old) spent more time in the sun to tan and reported fewer painful sunburns. Most farmers (58%) never had a professional skin cancer assessment, but 17% had a skin cancer diagnosis. While at risk for skin cancer, Ohio farmers have not widely adopted sun safety protection behaviors. Data may direct future multidisciplinary health and safety educational programming by state Extension outreach and healthcare providers. Keywords: Cancer, Farmers, Health risk behavior, Self-report, Sun protection.

Sun-protective Behaviours among patients with Cutaneous Hyperpigmentation in Saudi Arabia: A Cross Sectional Study

Background: Hyperpigmentation is a dermatologic disorder, and because dermatologic diseases are visible, they have a profound psychological impact on persons who are affected. Aim: To assess the sun protection practices in Saudi Arabia among patients with cutaneous hyperpigmentation. Method: In October 2022, an online cross-sectional study of patients with cutaneous hyperpigmentation was conducted in Saudi Arabia. Data were collected by questionnaire-based survey, which was designed by the researcher after a thorough literature review. Using binary logistic regression analysis, the factors that influence sunscreen use were identified. Results: A total of 418 people took part in this study. More than half (63.6%) of them reported post-inflammation or acne pigmentation. Almost half (49.0%) reported having this health condition for less than a year. Only about half of the patients (45.0%) said they use sunscreen. Approximately 47.0% of sunscreen users reported using sunscreen with a UV protection factor of 21-50. Almost one-third (35.0%) of the patients reported not reapplying sunscreen during the day. Only 4.8% of patients said they frequently use a hat or sunshade while they are outside, and 40.4% said they frequently stay in the shade when they are outside. Male patients were less likely than female patients to apply sunscreen (Odds ratio: 0.80 (95% CI: 0.64-0.99), (p0.05), Conclusion: Saudi hyperpigmentation patients use sunscreen inadequately. Males used sunscreen less than females. Healthcare authorities should conduct an educational campaign to inform this group of patients about their condition and the necessity of sunscreen. Social media should be utilized to educate the public about different types of sunscreens and improve their use of sunscreens to prevent sun-related skin problems. Keywords: Cutaneous Hyperpigmentation; Saudi Arabia; Sunscreen; Sun-protective

Sun protection and occupation: Current developments and perspectives for prevention of occupational skin cancer.

A substantial proportion of all reported occupational illnesses are constituted by skin cancer, making this disease a serious public health issue. Solar ultra-violet radiation (UVR) exposure is the most significant external factor in the development of skin cancer, for which the broad occupational category of outdoor workers has already been identified as high-risk group. Sun protection by deploying adequate technical, organizational, and person-related measures has to be understood as a functional aspect of workplace safety. To prevent skin cancers brought on by-typically cumulative-solar UVR exposure, outdoor workers must considerably lower their occupationally acquired solar UVR doses. Estimating cumulative sun exposure in outdoor workers requires consideration of the level of solar UVR exposure, the tasks to be done in the sun, and the employees' solar UVR preventive measures. Recent studies have highlighted the necessity for measures to enhance outdoor workers' sun protection behavior. In the coming decades, occupational dermatology is expected to pay increasing attention to sun protection at work. Also, the field of dermato-oncology will likely be concerned with sky-rocketing incidences of occupational skin cancers. The complete range of available alternatives should be utilized in terms of preventive actions, which seems pivotal to handle the present and future challenges in a purposeful manner. This will almost definitely only be possible if politicians' support is effectively combined with communal and individual preventive actions in order to spur long-term transformation.

Skin Cancer Behavioral Risk Factors and Screening Among U.S. Adults in Same-Sex Relationships: A Population-Based Study from 2000 to 2015.

Purpose: Skin cancer is prevalent in sexual minority men but little is known about risk factors and screening specifically among couples in same-sex relationships (SSR). We aimed to compare sunburns, sun-protective behaviors, indoor tanning, and total body skin examinations (TBSEs) between people in SSR with those in opposite-sex relationships (OSR). Methods: We conducted a pooled cross-sectional analysis of 2000-2015 data from the National Health Interview Survey, a nationally representative survey of the United States civilian population. Results: Of 102,365 adults with a spouse or married partner, 448 (0.4%) were men in SSR, 48,312 (48.1%) men in OSR, 497 (0.5%) women in SSR, and 53,108 women in OSR (51.9%). Men in SSR were more likely than men in OSR to seek shade (adjusted odds ratio [aOR] = 1.41; 95% confidence interval [CI] = 1.07-1.85), tan indoors (aOR = 3.71; 95% CI = 2.38-5.78), and receive any TBSE (aOR = 2.45; 95% CI = 1.69-3.54) after adjusting for sociodemographic factors, health insurance status, and health behaviors. Men in SSR were less likely than men in OSR to wear long pants (aOR = 0.63; 95% CI = 0.46-0.85) and caps or visors (aOR = 0.50; 95% CI = 0.36-0.69). No differences in sunburns, sun-protective behaviors, indoor tanning, and TBSE between women in SSR and OSR were observed after multivariable adjustment. Conclusion: Patterns of sun-protective behaviors and indoor tanning among men in SSR, compared with men in OSR, demonstrate modifiable behaviors that may mitigate skin cancer risk. Dyadic counseling and public health interventions geared toward men in SSR may promote sun-protective behaviors and reduce indoor tanning.

Association of Sun Safety Behaviors and Barriers with Sunburn History in College Students in a Region with High UV Exposure.

Over five million cases of skin cancer are diagnosed each year in the United States with melanoma the third most common cancer in young adults. While publications have shown that sunburns increase the risk of developing melanoma throughout the lifetime including in adolescence and adulthood showing the importance of altering sun exposing behaviors throughout the lifetime, use of sun protection in college students remails low. In Fall 2019, an online survey of undergraduate students living on campus at a large southwestern university was conducted to determine the frequency of recent sunburns as well as sun protective behaviors and perceived knowledge of and barriers to sun protection. Associations between knowledge, behaviors, and barriers with self-reported sunburn were evaluated using logistic regression. Over 46% of 458 students reported at least one sunburn in the past three months and 21% reported having multiple sunburns in that period. Furthermore, 53% reported that they intentionally tanned their skin outdoors occasionally or more frequently, while 6.4% reported using an indoor tanning bed occasionally or more. Adjusted for skin sensitivity, recent sunburn history was associated with higher tanning activity scores and with high agreement that tanning was attractive (p &lt; 0.01). This information can inform a more targeted series of intervention programming on the university campus.

Sun exposure and protection practices among Florida college marching band members and alumni: a cross-sectional study.

In the USA, skin cancer is the most common cancer, more than all other cancers combined. Skin cancer may be prevented by using sun protection. This is particularly important in 18-29-year-olds who, compared to older individuals, experience sunburns more frequently. Moreover, in locations close to the equator, such as Florida, people are at an increased risk of developing melanoma. College marching band members spend a significant amount of time in the sun, as much as 25h weekly practicing and performing at games, yet little is known about this population. We examined and compared sun exposure and protection practices among Florida college marching band members and alumni. In 2020, anonymouscross-sectional web-based surveys were distributed via email and private Facebook groups. A total of 859 members and alumni of five Florida university marching bands participated. Questionnaires assessed demographic characteristics, sun protection behaviors, as well as history of sunburn and skin cancer. Analyses of variance and multiple linear regression analyses were employed to compare sun protection practices between band members and alumni. During sunny day practices, only 16.1% (63/391) of alumni and 27.1% (127/468) of current band members always wore sunscreen. In the multiple linear regression, after adjusting for gender, race/ethnicity, and family history of skin cancer, alumni, who participated in marching band practices within the past 50years, were significantly less likely to wear sunscreen or hats compared to current band members. Overall, men were less likely to wear sunscreen but were more likely to wear hats and shirts with sleeves that cover their shoulders compared to women. Compared to the general US population in 2017 (0.38%), alumni of Florida college marching bands in 2020 (2.04%) have a self-reported increase in melanoma prevalence of 1.66%. Of note, melanoma diagnoses were only reported by alumni who self-identified as non-Hispanic white; none of the non-Hispanic black, Hispanic, or other alumni reported a melanoma diagnosis. As skin cancer incidence continues to rise, it is critical that leaders in the marching band community continually address unprotected sun exposure, by promoting protective practices, as well as modifying attitudes and behaviors regarding sun exposure and protection.

The effect of patient characteristics on illness perception and sun protection behaviors in melasma.

Melasma, a significant cosmetic problem, has been accepted by some authors as a photoaging illness in recent times. There is no published study evaluating the effects of the clinical and sociodemographic findings on illness perception and sun protection behaviors (SPBs) in patients with melasma. Sociodemographic data, personal characteristics, and clinical features of 150 patients with melasma were recorded in this cross-sectional study. They were analyzed for their SPBs in three groups as "never," "rarely/sometimes," and "often/always." Patients completed the Melasma Quality of Life (QoL) Scale and Revised-Illness Perception Questionnaire. Melasma patients with higher clinical severity and Qol scores, lower education level, concomitant chronic illness, and a history of previous melasma treatment thought more frequently that melasma had negative serious consequences. Majority of the patients blamed sun exposure as the cause of the melasma. However, SPBs were more frequent only in patients with higher socioeconomic and educational levels, a previous history of melasma treatment, and evaluating their disease as a chronic condition. Neither Qol nor clinical severity score had a significant effect on sun exposure causal attribution or SPBs. No significant effect of patients' perception of melasma was determined on the use of sunscreen or protective hat. Being aware of the factors affecting the perception of melasma and QoL of patients might be helpful in making persistent individual recommendations for the regulation of SPBs.

Sun protection behavior: health impact, prevalence, correlates and interventions

Sun protection behavior can reduce skin cancer risk. This paper provides an overview of skin cancer risk and the complex behavioral options for sun protection, along with a narrative review of research on determinants of, and interventions to promote, sun protection. Gaps and opportunities for future research are also outlined. Evidence supports the effectiveness of sunscreen use, ultraviolet (UV) protection clothing, and shade seeking. However, these behaviors are complex and are often performed in ways that are inadequate for sun protection. Most research examining and targeting determinants of sun protection behavior has focused on sunscreen use, to the exclusion of other strategies, and has largely ignored the complexity of even sunscreen use. Most research and interventions are theory- driven, drawing on social cognitive constructs, but also considering self and social identity and emotion. Multilevel perspectives considering context, environment, policies, and other structural contexts have also been applied to sun protection behavior, but there is a need to combine psychological constructs with factors at other levels to optimize predictive models and intervention effectiveness. Effective sun protection effectively involves complex behaviors and perceived and actual tradeoffs that should be considered, in combination with multilevel determinants, in research predicting and promoting sun safety.

An integrated skin cancer education program in renal transplant recipients and patients with glomerular disease

Sun-protective strategies focusing on skin cancer awareness are needed in immunosuppressed patients at risk of skin cancers. The study aims to determine the effect of an integrated skin cancer education program on skin cancer awareness and sun-protective behaviours in renal transplant recipients (RTRs) and patients with glomerular disease (GD) treated with long-term immunosuppressants. A pilot prospective cohort study in Central Queensland, Australia was undertaken among adult RTRs and patients with GD, who completed survey questionaries on skin cancer and sun-health knowledge (SCSK), sun-protection practices and skin examination pre- and post-education. Fifty patients (25 RTRs, 25 patients with GD) participated in the study. All of them completed questionnaires at pre-, 3-month post-education and 92%(n = 46) at 6-month post-education. There was a significant increase in SCSK scores from baseline at 3-months (p < 0.001) and 6-months post-intervention (p < 0.01). Improved knowledge was retained for 6 months after education. There were changes in 2 of 8 photoprotective behaviours at 6 months. Interventional education enhanced regular self-skin examination rate (p < 0.001) as well as the frequency of full skin checks by general practitioners (GPs) (p < 0.001). Overall, RTRs had better compliance with sun-protective methods and higher skin examination rates by themselves and/ or GPs before and after the intervention of education compared to patients with GD. To conclude, an integrated skin cancer education program improved knowledge of skin cancer and skin health as well as the frequency of self-skin examination and formal skin assessments. However, improvement in patient compliance did not extend to other sun-protective practices.

Sun protective behaviors in sun-sensitive individuals: a cross-sectional study examining for ethnic and racial differences.

The rates of non-melanoma skin cancer continue to rise in the United States. We investigated if differences exist in skin cancer preventive behaviors among sun-sensitive non-Hispanic whites and other racial and ethnic groups. The National Health Information Survey was used to perform the cross-sectional study. Outcomes of interest included multiple sun-protective methods. Individuals were determined to be sun-sensitive if Fitzpatrick skin phototype (SPT) I/II. Multivariable logistic regression was used to examine the associations between the use of sun-protective practices and race and ethnicity, SPT, and survey year. The study included 67,471 individuals. Adjusted prevalences of skin cancer preventive behaviors revealed that across all SPTs, non-Hispanic whites were more likely to use sunscreen, undergo physician-administered FBSE, and have multiple sunburns or tan indoors in the past year compared to corresponding SPT other racial and ethnic groups. In contrast, other racial and ethnic groups with any SPT were more likely to practice sun avoidance than corresponding SPT non-Hispanic whites. Additionally, other racial and ethnic groups with SPT III+ were more likely to wear sun-protective clothing than non-Hispanic white individuals with similar SPTs. For all SPT and racial and ethnic groups, there were significant increases in sunscreen use and decreases in past-year indoor tanning. Full body skin examination prevalence, regardless of sun sensitivity, increased for all non-Hispanic whites, but remained unchanged for sun-sensitive other racial and ethnic groups. Adjusted prevalence of multiple sunburns and use of protective clothing remained unchanged for all racial and ethnic groups across all SPT categories. There are differences in sun-protective behaviors among sun-sensitive individuals by race and ethnicity with the magnitude of some of these differences increasing. Future research and public health campaigns are needed on photosensitive individuals and the relationship between skin protective behaviors and race/ethnicity. When discussing sun protection, care providers should not only consider the influence of sun-sensitivity, but also race and ethnicity, and its impact on sun prevention behaviors.

Sun-Protective Behaviors in Patients with Melasma

Melasma is an acquired, chronic hyperpigmentation disorder exacerbated by hormone fluctuations, heat, inflammation, and sun exposure. Sun exposure is the greatest triggering and exacerbating factor, yet few studies investigate how patients with melasma practice sun-protective behaviors (SPBs). This mixed-methods project explored barriers to SPBs in patients with melasma. The demographic questionnaire and Sun Exposure and Protection Index (SEPI) survey were completed by 21 participants, and 13 participants were interviewed. Only 5 participants (23%) reapplied sunscreen every 2 hours as recommended. Interviews revealed a lack of knowledge and perceived risk regarding incidental sun exposures and proper sunscreen use.

Assessing sun protection practices for children: knowledge and behaviours of parents

Abstract Background The development of melanoma in adulthood is strongly associated with sunburns during childhood. Parental knowledge and behaviours play a key role in sun protection behaviour from which children can acquire general and integrated learning patterns. With this being known, numerous positive preventive health behaviours can be initially shaped in the family, with children having parents as a model. Methods A cross-sectional approach (web-based questionnaire) was conducted to gather information regarding parents’ knowledge and behaviours of children’s sun protection, alongside the predictors that might influence the adoption of these behaviours, between April and May 2021. The survey was disseminated to 53 primary school teachers from 9 schools in Cluj-Napoca Romania, and the data set included 355 valid surveys (parents with at least one child aged between 0 to 12 years old) out of 476 total surveys. Descriptive statistics, Chi-square tests of association and logistic regressions were computed. Results The study showed differences in children’s sun exposure patterns, their sunburn and parental sun protection behaviour. Overall, parents reported fair sun protection behaviours and children’s sunburn frequency was overall moderate among all children in the previous summer season. However, an increase in children’s age generates an increase in parents’ sunscreen application for their children in both planned and incidental situations. There were statistically significant associations between parents’ sex and their knowledge about the fatal consequences of skin cancer or their level of education and the damage produced by tanning bed usage or sunscreen efficiency measures. Conclusions These results are a starting point for various program interventions that can be done for parents in order to increase their knowledge on sun protection practices for their children. Key messages • Skin cancer is substantially preventable if unprotected exposure to ultraviolet radiation is reduced during the first years of a child’s life. • Parental knowledge and behaviors play a key role in sun protection behavior from whom children can acquire general and integrated learning patterns.

Ultraviolet exposure of competitors during a Tokyo Olympic Sailing Regatta Test Event.

Overexposure to sunlight is the main cause of skin cancer. Photoprotection practices and sunburn play a crucial role in skin cancer prevention. This study aimed to quantify the risk of sun exposure and to evaluate photoprotection practices in Spanish sailors during Olympic competitions. Solar daily ultraviolet (UV) radiation cycle, personal UV dosimetry, photoprotection practices and sunburn checking were followed during three consecutive days of competition among sailors from the Spanish Olympic Sailing Team during a Tokyo Olympic Regatta Test Event. A total of 13 sailors (7 women), with mean age of 27.6 ± 4.7 years and sports experience of 17.7 ± 5.4 years, were studied. The most common phototypes were type III (53.8%) and type II (38.5%). The rate of sunburn checked was high (46.2%). The mean daily personal UV exposure received was 761.0 ± 263.6J/m2 , 3.0 ± 1.1 minimal erythemal dose and 7.6 ± 2.6 standard erythemal dose, seven times greater than the maximum permissible UV light exposure values for an 8 h working day. The use of a T-shirt was the most common practice (94.2%), followed by the use of shade (50.2%), hat/cap (44.0%), sunglasses (26.1%) and sunscreen (11.8%). Olympic sailor's studies presented high levels of UV radiation received, high rate of sunburn and insufficient adherence to sun-protective behaviours (especially, to use of sunscreen) to prevent sunburn, the main cause of skin cancer. Sport Federations should develop educational campaigns addressing sun-related exposure habits and photoprotection behaviours to reduce the risk of skin cancer among these athletes.

'I had a bigger cancer risk than I thought…': The experience of receiving personalized risk information as part of a skin cancer prevention intervention in the college setting.

Diagnoses of both melanoma and nonmelanoma skin cancers are becoming increasingly common among young adults. Interventions in this population are a priority because they do not consistently follow skin cancer prevention recommendations. The goal of the current study was to examine college students' perspectives on and experience with receiving a skin cancer prevention intervention that provided personalized skin cancer risk feedback in the form of an ultraviolet (UV) photograph, the results of genetic testing for common skin cancer risk variants, and/or general skin cancer prevention education. Qualitative interviews were conducted with 38 college students who received a skin cancer prevention intervention. The interview covered students' feelings about their personal skin cancer risk information, the impact of the intervention on their skin cancer risk perceptions, actions or intentions to act with regard to their sun protection practicesand feedback for improvement of the intervention content or delivery. Participants reported that different intervention components contributed to increased awareness of their sun protection behaviours, shifts in cognitions about and motivation to implement sun protection strategiesand reported changes to their skin cancer prevention strategies. Our findings indicate that college students are interested in and responsive to these types of multicomponent skin cancer preventive interventions. Further, students demonstrate some motivation and intentionality toward changing their skin cancer risk behaviour in the short term. Participants involved in this study were members of the public (undergraduate students) who were involved in a skin cancer prevention intervention, then participated in semistructured interviews, which provided the data analysed for this study.

The Association of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, and Sun-Protective Behaviors in a Navy Population.

U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention perceptions, benefits, threats, barriers, and sun-protective behavior self-efficacy) and sun-protective behaviors (e.g., wearing long sleeve shirts and using sunscreen and not deliberately exposing skin for a tan) in a Navy population. A cross-sectional, descriptive, correlational design was utilized, and the study approval was obtained by the Naval Medical Center Portsmouth Institutional Review Board. Two-hundred twenty-nine active duty Navy service members aged 18-30 years who presented to primary care for their periodic health assessment completed the Brief Skin Cancer Risk Assessment and the Skin Cancer Survey. Descriptive statistics were utilized to assess service members' perceptions and knowledge regarding skin cancer prevention along with sociodemographic characteristics. The Spearman rank-order correlation and the Mann-Whitney U test were used to assess associations. P-values <.05 were used to determine statistical significance. Skin cancer prevention knowledge was significantly related to sun-protective behavior self-efficacy (r = 0.218, P = .001), benefits (r = 0.271, P ≤ .001), sun protection behaviors (r = 0.152, P = .024), skin cancer risk (r = 0.256, P = .001), current frequency of high-risk sun behavior (r = 0.183, P = .006), past frequency of high-risk sun behavior (r = 0.219, P = .001), sun exposure (U = 4,813.50, P = .005), tanning bed use (U = 3,154.50, P = .031), and training (U = 4,099.50, P = .005). Integrating skin cancer education into primary care visits (i.e., periodic health assessments) may improve Navy service members' modifiable sun-protective attitudes and behaviors and may contribute to lowering future skin cancer rates.

Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001-2018.

BackgroundThe National Health and Nutrition Examination Surveys (NHANES) collect and release data to the public every 2 years. The latest NHANES study on the vitamin D status of Americans was based on data from 2001 to 2014, and the latest data (2015–2016 and 2017–2018) have not been studied yet. Thus, we extracted all the available data from NHANES (2001–2018), aiming to analyze the prevalence and trends of vitamin D deficiency (VDD) in the US population to bridge the research gap.MethodsAccording to previous studies and nutritional guidelines for vitamin D, severe VDD was defined as serum 25(OH)D levels of <25 nmol/L, moderate deficiency as 25–50 nmol/L, insufficiency as 50–75 nmol/L, and sufficiency as >75 nmol/L. We comprehensively estimated the prevalence of serum 25(OH)D levels of <25, 25–50, 50–75, and >75 nmol/L in Americans and described trends in vitamin D status from 2001 to 2018. Weighted multivariate linear regression models were used to explore the predictors of VDD. All analyses and the data were adjusted for the complex sampling design of NHANES using Mobile Examination Center (MEC) weights.ResultsBased on the most recent data of 71,685 participants, our study showed that the weighted prevalence of severe and moderate VDD was 2.6% and 22.0%, and the prevalence of vitamin D insufficiency (VDI) and sufficiency was 40.9% and 34.5%. The prevalence of severe and moderate VDD was higher in women, non-Hispanic black Americans, people aged 20–29 years, and during the season of winter. From 2001 to 2018, we found a slight linear decrease in the prevalence of moderate VDD (coefficient = −0.847; P = 0.009) and VDI (coefficient = −0.810; P = 0.014). We also found a slight linear increase in vitamin D sufficient (coefficient = 1.693; P = 0.004). However, no trend change was observed in severe VDD (coefficient = −0.037; P = 0.698). Age, sex, ethnicity, season, sun-protective behaviors, lower BMI, lower socioeconomic status (SES), drinking, and lower milk consumption were predictors of severe VDD.ConclusionVitamin D deficiency is still prevalent in the United States, especially in non-Hispanic black Americans, women, individuals aged 20–29, and during winter. Therefore, individuals, healthcare providers, and policymakers should take public health measures to develop and implement prevention strategies to deal with VDD.