Psychometric assessment of the processes of change scale for sun protection

The fourteen-factor Processes of Change Scale for Sun Protection assesses behavioral and experiential strategies that underlie the process of sun protection acquisition and maintenance. Variations of this measure have been used effectively in several randomized sun protection trials, both for evaluation and as a basis for intervention. However, there are no published studies, to date, that evaluate the psychometric properties of the scale. The present study evaluated factorial invariance and scale reliability in a national sample (N = 1360) of adults involved in a Transtheoretical model tailored intervention for exercise and sun protection, at baseline. Invariance testing ranged from least to most restrictive: Configural Invariance (constraints only factor structure and zero loadings); Pattern Identity Invariance (equal factor loadings across target groups); and Strong Factorial Invariance (equal factor loadings and measurement errors). Multi-sample structural equation modeling tested the invariance of the measurement model across seven subgroups: age, education, ethnicity, gender, race, skin tone, and Stage of Change for Sun Protection. Strong factorial invariance was found across all subgroups. Internal consistency coefficient Alpha and factor rho reliability, respectively, were .83 and .80 for behavioral processes, .91 and .89 for experiential processes, and .93 and .91 for the global scale. These results provide strong empirical evidence that the scale is consistent, has internal validity and can be used in research interventions with population-based adult samples.     

A Qualitative Exploration of Sun Safety Beliefs Among Australian Adults

Informed broadly by the theory of planned behaviour, this study used qualitative methodology to understand Australian adults' sun‐protective decisions. Forty‐two adults participated in focus groups where they discussed behavioural (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs, as well as potential social influences and images of tanned and non‐tanned people. Responses were analysed using the consensual qualitative research approach to determine the dominant themes. Themes of fashion and comfort were prominent, the important role of friends and family in sun safe decision‐making was highlighted, as was the availability of sun‐protective measures (e.g., in an accessible place or in the environment). Additional themes included the need to model sound sun‐protective behaviours to (current and future) children, the emphasis on personal choice and personal responsibility to be sun safe, and the influence of Australian identity and culture on tanning and socially acceptable forms of sun protection. These beliefs can be used to inform interventions and public health campaigns targeting sun safety among Australians, a population with the highest skin cancer incidence in the world.     

Predicting sun-protective intentions and behaviours using the theory of planned behaviour: a systematic review and meta-analysis

Objective: To synthesise theory of planned behaviour (TPB) relationships, using meta-analysis, and test the predictive utility of the model for sun protection behaviour.

Design: Thirty-eight samples were identified via database/manual searches and academic society posts based on the criteria: measuring sun-protective intentions and/or prospective behaviour; using the TPB/theory of reasoned action as a basis of measurement; and providing bivariate correlations for at least one relevant TPB association.

Main outcome measures: Sun-protective intentions and behaviours.

Results: The sample-weighted average effects were moderate-to-strong with attitudes showing the strongest association with intention (r+ = 0.494), followed by perceived behavioural control (PBC; r+ = 0.451), and subjective norm (r+ = 0.419). Intentions showed a stronger association with prospective behaviour (r+ = 0.486) compared to PBC (r+ = 0.314). A total of 39% of variance in intentions and 25% of variance in behaviour were explained. Publication bias was not evident. Moderator analyses showed that TPB associations were stronger when measures specified the Target, Action, Context and Time; in non-student samples; and when follow-up exceeded two weeks.

Conclusion: Despite recent criticism, this review shows that the TPB explains a large amount of variance in sun protection and that TPB associations are robust across different populations.     

The relationship between skin tone dissatisfaction and sun tanning behaviour

Understanding the factors that contribute to sun exposure is vital for skin cancer prevention. The present study aimed to examine the utility of a new measure for cancer prevention research, the Skin Tone Rating Scale. Australian undergraduate women (N = 156) completed an online questionnaire measuring skin tone dissatisfaction, peer and media norms surrounding tanning, internalisation of a tanned ideal, appearance reasons for tanning, and self‐reported tanning behaviour. The two‐item Skin Tone Rating Scale provided a short and easy‐to‐administer measure of skin tone dissatisfaction that correlated with self‐reported tanning behaviour. The Skin Tone Rating Scale was also moderately related to appearance reasons for tanning and internalisation of a tanned ideal, demonstrating concurrent validity. Socio‐cultural influences (from peers and media) were positively correlated with skin tone dissatisfaction, and this relationship was partially mediated by internalisation of a tanned ideal. Although more research is needed to establish causation, this study provides an important addition to sun tanning literature; it provides a new measure to predict self‐reported tanning behaviour, the Skin Tone Rating Scale, which highlights the importance of appearance concerns in relation to tanning and sun exposure.     

Closing the intention–behaviour gap for sunscreen use and sun protection behaviours

Objective

Two studies were conducted with the aim of closing the intention–behaviour gap for sunscreen use and sun protection behaviours by examining the influence of self-regulatory capacity on the prediction of sunscreen use (Study 1) and self-regulatory capacity and habit on sun protection behaviours (Study 2).

Design

Studies were conducted online. Participants completed questionnaires and cognitive measures and then reported behaviour one week later.

Main Outcome Measures

Questionnaires measuring intention and cognitive tasks measuring self-regulatory capacity were administered to 209 university students. One week later, participants reported behaviour. In Study 2, questionnaires measuring intentions, and habit and cognitive tasks measuring self-regulatory capacity were administered to 178 university students who reported behaviour one week later.

Results

Intention accounted for 7.1% of variance in sunscreen use, no measures of self-regulation accounted for variance in behaviour or moderated the intention–behaviour gap (Study 1). Intention, self-regulatory capacity and habit accounted for 56.1% of variance in sun protection behaviours (Study 2). Intention, self-regulatory ability and habit predicted behaviour, while habit moderated the intention–behaviour gap.

Conclusion

Interventions aimed at increasing sun protection behaviours should take into account level of intention, self-regulatory capacity and habit. Individuals may benefit from habit formation strategies and self-regulation training.     

Native American Spirituality

ABSTRACT

Followers of the New Age movement and others have been exploiting and commercializing “Native American” spirituality. This exploitation is being fought by many Native people. Native American spirituality may be studied and appreciated, but use of Native American religious forms outside of Native American communities is considered misappropriation and cultural theft. Native spiritualities address the needs of present-day Native communities. A Native spirituality that ignores that need is no longer a religion of and for the community. Disconnected from a Native community, religious beliefs, ceremonies, and religious art forms lose their primary significance.     

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.     

Health Behaviors of Childhood Cancer Survivors: What We’ve Learned

There has been a dramatic increase in the number of childhood cancer survivors due to improved cancer treatments. However, these survivors are at risk for numerous late-effects as a result of their cancer therapy. Engaging in health-protective behaviors and limiting risky health behaviors are vitally important for survivors given their increased risks and physical late-effects. For this paper, we systematically reviewed the literature on childhood cancer survivors’ health behaviors by searching for published data and conference proceedings using computerized databases and references, and summarized these results. We examined the literature describing the prevalence of a variety of health behaviors among survivors, identifying significant covariates, and describing health behavior interventions. Finally, we provided research recommendations and discussed an ongoing study designed to address some of the limitations in the existing literature. The research to date is limited and recommendations for future studies are outlined.