Does Knowledge Influence Melanoma-Prone Behavior? Awareness, Exposure, and Sun Protection Among Five Social Groups
Purpose/Objectives: To examine melanoma-related knowledge, sun exposure, and sun protection to determine whether increased awareness is associated with a reduction in risk.
Design: Quantitative/empiricist study conducted by purpose-designed mailed questionnaire.
Participants: Consultant oncologists at one teaching hospital in London, England; specialist registrars (oncologists in training) contacted through a London-based educational group; oncology-trained nursing staff from oncology departments at two London teaching hospitals; medical students; general (nononcology) nurses; and members of the lay public from one London teaching hospital.
Setting: Two teaching hospitals in London, both registered cancer centers that possess specialist departments of oncology and are staffed by clinical and medical oncologists.
Methods: Anonymous, self-completion, mailed questionnaire.
Research Variables: Sun exposure; use of sun protection and avoidance; knowledge of the biologic effects of sun exposure, moles, and malignant melanoma; melanoma-prone behavior.
Findings: No significant differences were found in sun exposure or melanoma-prone behavior across the five groups studied. No correlation existed between knowledge and melanoma-prone behavior. Differences in knowledge and protection scores were demonstrated across all groups and were statistically significant, but they did not translate into changes in exposure or behavior scores.
Conclusions: Public health policy that seeks to reduce the incidence of melanoma is based on the false premise that increasing awareness of melanoma risk will reduce melanoma-prone behavior. Increasing awareness of the risks of sun exposure may improve the use of sun protection, but it does not reduce melanoma-prone behavior, even among specialist healthcare professionals.
Implications for Nursing: This study provides a new epidemiologic tool for nurses working in the specialty.
Jump to a section
References
Ajzen, I. (1988). Attitudes, personality, and behavior. Milton Keynes, England: Open University Press.
Anonymous. (1998). Our healthier nation (White paper). London: Her Majesty's Stationery Office.
Banks, B.A., Silverman, R.A., Schwartz, R.H., & Tunnessen, W.W., Jr. (1992). Attitudes of teenagers toward sun exposure and sunscreen use. Pediatrics, 89, 40-42.
Berwick, M., & Chen, Y.T. (1995). Reliability of reported sunburn history in a case-control study of cutaneous malignant melanoma. American Journal of Epidemiology, 141, 1033-1037.
Boldeman, C., Jansson, B., Nilsson, B., & Ullen, H. (1997). Sunbed use in Swedish urban adolescents related to behavioral characteristics. Preventive Medicine, 26, 114-119.
Bourke, J.F., Healsmith, M.F., & Graham-Brown, R.A. (1995). Melanoma awareness and sun exposure in Leicester. British Journal of Dermatology, 132, 251-256.
Campbell, H.S., & Birdsell, J.M. (1994). Knowledge, beliefs, and sun protection behaviors of Alberta adults. Preventive Medicine, 23, 160-166.
Cody, R., & Lee, C. (1990). Behaviors, beliefs, and intentions in skin cancer prevention. Journal of Behavioral Medicine, 13, 373-389.
Cohen, R., & Frank-Stromborg, M. (1993). Cancer risk and assessment. In S. Groenwald, M. Frogge, M. Goodman, & C. Yarbro (Eds.)Cancer nursing: Principles and practice (3rd ed., pp. 102-123). Sudbury, MA: Jones and Bartlett.
Douglass, H.M., McGee, R., & Williams, S. (1997). Sun behaviour and perceptions of risk for melanoma among 21-year-old New Zealanders. Australian and New Zealand Journal of Public Health, 21, 329-334.
Fernsler, J., & Miller, M. (1993). Factors affecting health behavior. In S. Groenwald, M. Frogge, M. Goodman, & C. Yarbro (Eds.)Cancer nursing: Principles and practice (3rd ed., pp. 87-101). Sudbury, MA: Jones and Bartlett.
Goldsmith, M.F. (1987). Paler is better, say skin cancer fighters. JAMA, 257, 893-894.
Health Education Authority. (1998a). Factsheet 1. Skin cancer: The facts. London: Her Majesty's Stationery Office.
Health Education Authority. (1998b). Factsheet 4. Sun beds. London: Her Majesty's Stationery Office.
Health Education Authority. (1998c). Factsheet 5. Skin cancer and color. London: Her Majesty's Stationery Office.
Hill, D., White, V., Marks, R., Theobald, T., Borland, R., & Roy, C. (1992). Melanoma prevention: Behavioral and nonbehavioral factors in sunburn among an Australian urban population. Preventive Medicine, 21, 654-669.
Hillhouse, J.J., Stair, A.W., III, & Alder, C.M. (1996). Predictors of sunbathing and sunscreen use in college undergraduates. Journal of Behavioral Medicine, 19, 543-561.
Jerkegren, E., Sandrieser, L., Brandberg, Y., & Rosdahl, I. (1999). Sun-related behaviour and melanoma awareness among Swedish university students. European Journal of Cancer Prevention, 8, 27-34.
Johnson, E.Y., & Lookingbill, D.P. (1984). Sunscreen use and sun exposure. Trends in a white population. Archives of Dermatology, 120, 727-731.
Keesling, B., & Friedman, H.S. (1987). Psychosocial factors in sunbathing and sunscreen use. Health Psychology, 6, 477-493.
Knapp, T. (1998). Quantitative nursing research. London: Sage.
Leary, M.R., & Jones, J.L. (1993). The social psychology of tanning and sunscreen use: Self-presentational motives as a predictor of health risk. Journal of Applied Social Psychology, 23, 1390-1406.
Martin, R.H. (1995). Relationship between risk factors, knowledge and preventive behaviour relevant to skin cancer in general practice patients in south Australia. British Journal of General Practice, 45, 365-367.
Polit, D., & Hungler, B. (1999). Nursing research: Principles and methods (6th ed.). Philadelphia: Lippincott.
Rhodes, A.R. (1995). Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer? Cancer, 75(2 Suppl.), 613-636.
Robinson, J.K., Rademaker, A.W., Sylvester, J.A., & Cook, B. (1997). Summer sun exposure: Knowledge, attitudes, and behaviors of Midwest adolescents. Preventive Medicine, 26, 364-372.
Scheffe, H. (1959). The analysis of variance. New York: Wiley.
Stott, M.A. (1999). Tanning and sunburn: Knowledge, attitudes and behaviour of people in Great Britain. Journal of Public Health Medicine, 21, 377-384.
Sutton, S. (1997). Theory of planned behavior. In A. Baum, S. Newman, J. Weinman, R. West, & C. McManus (Eds.)Cambridge handbook of psychology, health and medicine (pp. 177-180). Cambridge, England: Cambridge University Press.
Vail-Smith, K., & Felts, W.M. (1993). Sunbathing: College students' knowledge, attitudes, and perceptions of risks. Journal of American College Health, 42, 21-26.
Watson, R. (1999). Quantitative research. In M. Treacy & A. Hyde (Eds.)Nursing research, design and practice. Dublin, Ireland: University College Dublin Press.