Effects of appearance-based interventions on sun protection intentions and self-reported behaviors.

Two appearance-based interventions designed to increase sun protection intentions and behaviors were evaluated. Sixty-eight college students in Experiment 1 and 76 beachgoers in Experiment 2 were randomly assigned to receive or not receive a photoaging (premature wrinkling and age spots) information intervention and, separately, to receive or not receive a novel ultraviolet (UV) photo intervention that makes the negative-appearance consequences of UV exposure more salient. Both experiments indicated that the UV photo intervention significantly increased intentions to use sunscreen in the future. A follow-up conducted with the beach sample indicated that UV photo information also produced greater protective behaviors for incidental sun exposure and that the combination of UV photo and photoaging information resulted in substantially lower reported sunbathing.     

Interventions to Promote Sun Protection Behaviors: What Do We Know About the Efficacy of Health‐ and Appearance‐based Messages and the Role of Cognitions and Emotions?

Human behavior has been implicated as a critical component in the development of a number of diseases, including skin cancer. More than 85% of all skin cancers are attributed to over‐exposure to the sun, and two primary types of interventions have been utilized to motivate sun protection practices – those that focus on the health consequences (i.e., skin cancer) and those that highlight the negative appearance consequences (i.e., wrinkles and age spots) of sun exposure. Both health‐based and appearance‐based interventions have been demonstrated to increase awareness of sun exposure dangers and of recommended risk reduction behaviors. Much of the literature examining the efficacy of appearance‐based interventions also contains evidence of behavior change in response to such interventions. The role of consciously accessible attitudes and perceptions as mechanisms of behavior change has been extensively examined, and there is evidence that sun protection interventions may promote behavior change in part by altering various health‐related cognitions (e.g., perceived susceptibility to skin damage). However, the role of nonconscious mechanisms in the efficacy of sun protection interventions has received little empirical attention. A growing body of literature, primarily in other health contexts, has demonstrated that behavior is sometimes more strongly predicted by emotions than cognitions, and that processes outside of conscious awareness may affect behavior change. It is suggested that both future sun protection interventions, and health promotion theories in general, could benefit from a thorough examination of the role that emotions and autonomic reactions may play in intervention efficacy.     

Impact of a facial-ageing intervention versus a health literature intervention on women’s sun protection attitudes and behavioural intentions

This study was designed to investigate the impact of a facial-ageing intervention on women’s sun protection attitudes and behavioural intentions, compared to a health literature intervention where participants viewed literature on the effect of ultraviolet (UV) exposure on health. Seventy women (35 in each condition) completed questionnaires at baseline and immediately post-intervention. The average age of the participants was 23.70 (SD?=?5.03) years. Participants in the facial-ageing intervention condition scored significantly higher on intentions, negative attitudes and perceived sun damage susceptibility after taking part in the intervention, compared to those in the health literature intervention condition. The results are discussed in relation to suggestions for sun protection interventions aimed at women aged from 18 to 34. It is concluded that appearance-based interventions have a role to play in healthcare and educational settings with regard to UV exposure and sun protection intentions.     

Effects of a multicomponent intervention on motivation and sun protection behaviors among midwestern beachgoers.

Skin cancer is the most prevalent of all cancers in the United States. Although avoiding sun exposure and using sun protection reduces skin cancer risk, rates of such behaviors are moderate at best. The present study examined the impact of a multicomponent intervention that aimed to increase the saliency of skin cancer risk while promoting the use of sun protection. Midwestern beachgoers (n = 100) participated in an intervention or questionnaire-only control group. Sun protection, stage of change, and sun exposure were measured at baseline and 2-month follow-up. The intervention group significantly improved in sun protection use and stage of change, but not sun exposure, compared with the control group. Personalizing the risks of unprotected sun exposure combined with providing education about sun protection facilitated healthy changes in behavior and motivation.     

Improving the efficacy of appearance-based sun exposure interventions with the terror management health model

The terror management health model (TMHM) suggests that when thoughts of death are accessible people become increasingly motivated to bolster their self-esteem relative to their health, because doing so offers psychological protection against mortality concerns. Two studies examined sun protection intentions as a function of mortality reminders and an appearance-based intervention. In Study 1, participants given a sun protection message that primed mortality and shown a UV-filtered photo of their face reported greater intentions to use sun protection on their face, and took more sunscreen samples than participants shown a regular photo of their face. In Study 2, reminders of mortality increased participants’ intentions to use facial sun protection when the UV photo was specifically framed as revealing appearance consequences of tanning, compared to when the photo was framed as revealing health consequences or when no photo was shown. These findings extend the TMHM, and provide preliminary evidence that appearance-based tanning interventions have a greater influence on sun protection intentions under conditions that prime thoughts of death. We discuss implications of the findings, and highlight the need for additional research examining the applicability to long-term tanning behaviour.     

Illness risk representations and motivations to engage in protective behavior: The case of skin cancer risk

This study evaluates the contents of representations of skin cancer risk and their associations with risk appraisals, worry, and protection intentions and behaviors. The Assessment of Illness Risk Representations (AIRR) was used to measure conceptual and imagery contents of risk representations, as delineated by the Common-Sense Model. University students (N?=?120) completed the AIRR; measures of likelihood and severity appraisals, and worry; and measures of skin self-examination, clinical skin examination, and sun protection intentions and behaviors. Beliefs about identity, causal, and timeline risk were positively associated with likelihood appraisals, whereas consequences and timeline risk beliefs were positively associated with severity appraisals. Identity and timeline risk independently predicted worry. Representational attributes, including imagery vividness and valence, independently predicted intentions and behaviors, whereas likelihood and severity appraisals did not. Symptom imagery interacted with worry to predict detection and prevention intentions: worry predicted greater intentions for participants with symptom imagery but not for those without symptom imagery. The findings support the utility of the AIRR for assessing risk representations and identify ways in which risk representations may guide protective behavior.     

Persuasive Appeals and the Reduction of Skin Cancer Risk: The Roles of Appearance Concern, Perceived Benefits of a Tan, and Efficacy Information

This experiment compared the effectiveness of appearance-based messages focusing on the benefits of tanning and the efficacy of preventive measures on students' intentions to protect themselves against sun-induced skin damage. Subjects who were high or low on a dispositional measure of appearance concern responded to 1 of 4 essays providing either high or low benefits information, and high or low efficacy information. Overall, subjects low in appearance concern expressed greater intentions to take precautionary measures than did those high in appearance concern. Additionally, the low benefits of tanning message produced greater intentions to take precautions than did the high benefits message. The benefits results suggest 1 mechanism through which sun protection behaviors may be encouraged.     

Changing knowledge and attitudes about skin cancer risk factors in adolescents.

We examined knowledge, attitudes, and behaviors related to skin cancer, sun exposure, sunscreen use, and use of tanning booths in 903 female and 800 male adolescents. The effectiveness of a brief, school-based intervention designed to increase teens' knowledge and preventive attitudes about skin cancer was also evaluated. Females, older students, and those with high-risk skin types were most likely to use sunscreen and to take precautions. However, overall level of protection was low. Intentions to take precautions were associated with levels of perceived susceptibility to skin cancer, attitudes about the benefits of sun exposure, skin type, and sex. Beyond intentions, sunscreen use was associated with perceived susceptibility and skin type. The one-session, school-based intervention significantly increased knowledge and perceived susceptibility to skin cancer but not behavioral intentions.     

Evaluation of a multicomponent appearance-based sun-protective intervention for young women: uncovering the mechanisms of program efficacy.

An appearance-based sun-protection intervention program was developed, implemented, and evaluated in a sample of 211 Caucasian women (ages 18-25) randomly assigned to the sun-protection program or to a stress management (control) program. The sun-protection program incorporated a novel construct of image norms of aspirational peers (i.e., female media figures, fashion models) approving paleness. The authors targeted these image norms as well as the advantages of tanning, health beliefs about photoaging and skin cancer, and self-efficacy for sun protection. The intervention produced significant differences across conditions favoring sun protection on all constructs but severity of skin cancer and barriers to sun protection. At follow-up, treatment participants exceeded controls both in intention to sun protect and sun-protective behavior and reported lower intention to sunbathe and fewer hours of sunbathing. A mediational model of intervention outcomes revealed distinct mediators for sun protection versus sunbathing.     

Changing teachers' beliefs regarding autonomy support and structure: The role of experienced psychological need satisfaction in teacher training

ObjectivesGrounded in Self-Determination Theory, this study examined whether physical education (PE) teachers' psychological need satisfaction experienced during continuous professional development (CPD) on need-supportive teaching predicted changes in their effectiveness and feasibility beliefs regarding the proposed teaching approach, as well as their intentions to apply this approach and subsequent changes in their self-reported in-class behaviors.MethodsPrior to the training, a sample of 80 PE teachers (57.5% men, Mage = 42.70 ± 10.15 years) reported on their effectiveness and feasibility beliefs regarding autonomy-supportive and structuring teaching strategies and their in-class application of these strategies. Immediately following the training, these beliefs were assessed again and participants reported on their psychological need satisfaction experienced during the training and their intentions to apply the proposed strategies. Finally, two weeks after the training, participants' self-reported in-class application of the teaching strategies was measured for the second time.ResultsPsychological need satisfaction experienced during the training related to a change in effectiveness and feasibility beliefs regarding autonomy support and structure, and to teachers' intentions to apply the proposed strategies as reported immediately after receiving the training. In addition, teachers' intentions related to a change in their self-reported in-class application of structuring, but not autonomy-supportive, teaching strategies.ConclusionsExperiences of psychological need satisfaction during CPD can help to increase the likelihood that teachers become more convinced about the effectiveness and feasibility of the proposed change and can produce greater intentions toward change, which may relate to actual (albeit) self-reported behavior change.     

Behavior change after context disruption: Opportunities and pitfalls

Many behaviors are performed automatically in response to contextual cues rather than conscious intentions, which can make behavior change challenging. The combined discontinuity and self-activation hypotheses predict that disruption to a context that cues behaviors can provide opportunity for behavior change guided by intentions rather than contextual cues. In this study, we asked an online sample of participants (N = 452) to report on desired change in the frequency of new, unwanted, or potentially habitual behaviors following a contextual disruption due to the COVID-19 pandemic. We find a distinction between new ‘start’ behaviors and unwanted ‘stop’ behaviors where new behaviors appear more personally meaningful (i.e. higher in autonomous motivation and positive affective attitude) than unwanted or potentially habitual behaviors. Our results suggest that behavior change theory and interventions that acknowledge differential processes between starting new behaviors and stopping old unwanted behaviors would provide greater insights for behavior science.     

Sun protection behaviour of children and their parents at the beach

Abstract

The present study observed the sun protection behaviour of 8–12 year old children and their parents on the beach. Interviews with children and parents were then conducted to examine possible influences on sun protection and the relationship between observed and self reported behaviour.

The sample consisted of 50 children and 68 parents. All 50 children were observed and interviewed. All the parents were observed and 33 were interviewed. Indices of sun protection cover were computed as a sum of clothing and sunscreen cover. Most parents and children were inadequately covered against the sun. Factors related to children's sun protection included parent's cover and the child's tan level. The relationship between attitude to sun protection and observed behaviour could not be examined as all children and parents indicated they thought it was important to protect their skin against the sun.

Inconsistencies between observed and self-reported sun protection were found for children who were not protecting themselves. The possibility that self-report may overestimate actual protective behaviour is discussed.     

Beyond cognition: predicting health risk behaviors from instrumental and affective beliefs.

OBJECTIVE: Two studies assessed the relative contribution of affective and instrumental beliefs to the prediction of 2 risk behaviors: driving above the speed limit and smoking. DESIGN: Both studies took the form of large-scale questionnaire surveys (Study 1, N=292; Study 2, N=500) measuring instrumental and affective beliefs and self-reported behavior. In both cases, behavior was also measured objectively. OUTCOME MEASURES: In Study 1, speeding behavior was measured via infrared camera along sections of road with 30 mph, 40 mph, and 60 mph speed limits. Self-reports of speeding in these same contexts represented a 2nd dependent variable. In Study 2, level of smoking was measured via a carbon monoxide monitor, and participants were asked to indicate the number of cigarettes they smoked in a week. RESULTS: In Study 1, positive and negative instrumental and affective beliefs were significant predictors of self-reported speed. The most powerful predictor was negative affective beliefs. Observed speed was predicted by negative affective beliefs only. In Study 2, the significant predictors of self-reported smoking and objective measures of smoking were positive and negative affective beliefs. CONCLUSION: The findings indicate the importance of affective beliefs across 2 health risk behaviors. Implications for social cognition models and interventions are discussed.     

How optimists face skin cancer information: Risk assessment,attention, memory,and behavior

The purpose of the present study was to investigate how optimists process health-related information. Sixty-five young adults (ages 18–35) reported skin cancer-related knowledge and behaviors, and read slides of information on skin and skin cancer. Visual attention to the slides was recorded using eye tracking, and their memory for the information was measured. Additionally, participants’ self-reported skin cancer-relevant behavior was assessed prospectively in the months following the lab component of the study. Results show that individuals low in dispositional optimism or high in health-related optimism paid more attention when they were at high objective risk of developing skin cancer; and individuals high in dispositional optimism or high in health-related optimism were more likely to perform adaptive, health-promoting behaviors. In addition, optimistic beliefs were found not to be related with unrealistic optimism. Dispositional and health-related optimism therefore appear to predict health-related cognition and behavior in distinct ways.     

Sun protective behaviour,optimism bias,and the transtheoretical model of behaviour change

This study investigated the relationship between sun protective behaviours and three psychological variables influencing health behaviour: decisional balance, optimism bias, and the transtheoretical model of behaviour change. Two hundred participants completed the ‘Readiness to Alter Sun Protective Behaviour’ questionnaire, and a short questionnaire investigating optimism bias, decisional balance, attitudes, and experiences of sun protection and skin cancer. Participants were evenly distributed between the precontemplation, contemplation, and action stages. Participants in the action stage were significantly more likely to endorse the perceived advantages associated with sun protective behaviour than participants in the precontemplation and contemplation stages. They also reported sunbathing significantly less—and being more concerned about contracting skin cancer—than participants in the earlier stages. Decisional balance and optimism bias scores varied systematically across the stages of change; however, decisional balance was the only significant psychological predictor of sun protective behaviours. Optimism bias was greatest in the precontemplation stage, whereas the action stage was characterised by more positive attitudes to sun protection. This suggests that knowledge of the real risks of skin cancer might be a precursor to behaviour change, but only a change in attitudes results in a move to the action stage and measurable behaviour change.     

Interventions to prevent skin cancer: Experimental evaluation of informational and fear appeals

Abstract

Reports experimental and correlational analyses of intentional sunbathing in 82 female and 54 male suntanned adults at high-risk of skin cancer. Random assignment to high or low information conditions allowed evaluation of a widely-distributed American Cancer Society pamphlet. A crossed manipulation assigned subjects to a cancer fear/no fear condition. Personality variables served as correlational predictors of sunbathing attitudes, intentions, and information-seeking behaviors; skin cancer knowledge served as both a predictor and a dependent variable. Skin cancer knowledge, but not fear, emerged as a significant predictor of attitudes, intentions, and behaviors; and simple provision of information affected relevant knowledge. Contrary to the limits often encountered with health behaviors, specific cancer education appears to be somewhat effective in this domain, though indirectly. High risk-taking personalities were less likely to have or seek relevant information, suggesting the need to take into account individual predispositions and routes of knowledge acquisition when designing interventions.