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Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample.

ABSTRACT: The objective of this study was to develop new scales measuring knowledge and attitude about UVR and sun related behavior, and to examine their association to sun related behavior objectively measured by personal dosimetry. During May-August 2013, 664 Danes wore a personal electronic UV-dosimeter for one week that measured their UVR exposure. Afterwards, they answered a questionnaire on sun-related items. We applied descriptive analysis, linear and logistic regression analysis to evaluate the associations between the questionnaire scales and objective UVR measures. Perceiving protection as routine and important were positively correlated with protective behavior. Knowledge deficit of UV and risk of melanoma, perceived benefits and importance of protection behavior was also correlated with use of protection. 'Knowledge deficit of UV and risk of melanoma and Perceived barrier towards sun avoidance between 12 and 15' were both associated with increased risk of sunburn. Attitude towards tan was associated to both outdoor time and exposure as well as use of protection, but not to sunburn. The results regarding Knowledge deficit of UV and risk of melanoma associated to UVR exposure and Perceived barrier towards sun avoidance between 12 and 15 emphasize the importance of awareness of melanoma risk and the priority of the skin cancer prevention advice. Shifting activities to outside the suns peak-hours could be an approach for structural and campaign preventive measures. Knowledge of items predicting exposure to UVR, use of protection and sunburn are important for planning of preventive interventions and melanoma research.

SUBMITTER: Koster B

PROVIDER: S-EPMC5444774 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample.

Køster Brian B Søndergaard Jens J Nielsen Jesper Bo JB Christensen Karl Bang KB Allen Martin M Olsen Anja A Bentzen Joan J

PloS one 20170525 5

The objective of this study was to develop new scales measuring knowledge and attitude about UVR and sun related behavior, and to examine their association to sun related behavior objectively measured by personal dosimetry. During May-August 2013, 664 Danes wore a personal electronic UV-dosimeter for one week that measured their UVR exposure. Afterwards, they answered a questionnaire on sun-related items. We applied descriptive analysis, linear and logistic regression analysis to evaluate the as ...[more]

PMID: 28542543

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Project description:ImportanceUnderstanding patterns of sun-protective behaviors and their association with sunburn can provide important insight into measurement approaches and intervention targets.ObjectiveTo assess whether decision-based modeling can be used to identify patterns of sun-protective behaviors associated with the likelihood of sunburn and to compare the predictive value of this method with traditional (ie, composite score) measurement approaches.Design, setting, and participantsThis cross-sectional study used a nationally representative sample of 31?162 US adults from the 2015 National Health Interview Survey, consisting of household interviews conducted in person and completed by telephone when necessary. Participants included civilian noninstitutionalized US adults. Data were collected from January 1 through December 31, 2015.Main outcomes and measuresThe associations among sun sensitivity, multiple sun-protective behaviors (ie, using sunscreen, seeking shade, wearing a hat, and wearing protective clothing), and sunburn were examined using a ?2 automatic interaction detection method for decision tree analysis. Results were compared with a composite score approach.ResultsIn our study population of 28?558 respondents with complete data (54.1% women; mean [SD] age, 49.0 [18.0] years), 20 patterns of sun protection were identified. Among 15?992 sun-sensitive individuals, those who used only sunscreen had the highest likelihood of sunburn (62.4%). The group with the lowest likelihood of sunburn did not report using sunscreen but engaged in the other 3 protective behaviors (24.3% likelihood of sunburn). Among 12?566 non-sun-sensitive individuals, those who engaged in all 4 protective behaviors had the lowest likelihood of sunburn (6.6%). The highest likelihood of sunburn was among those who only reported sunscreen use (26.2%). The decision tree model and the composite score approach correctly classified a similar number of cases; however, the decision tree model was superior in classifying cases with sunburn (44.3% correctly classified in the decision tree vs 25.9% with the composite score).Conclusions and relevanceThis innovative application of a decision tree analytic approach demonstrates the interactive and sometimes counterintuitive effects of multiple sun-protective behaviors on likelihood of sunburn. These data show where traditional measurement approaches of behavior may fall short and highlight the importance of linking behavior to a clinically relevant outcome. Given the scope of those affected and enormous associated health care costs, improving efforts in skin cancer prevention has the potential for a significant effect on public health.

Project description:Sun protection among children is of utmost importance since sunburn in early life is a major risk factor for skin cancer development. Because parents play a vital role in enhancing sun safety among children, this study explored parental perceptions concerning sun exposure, sun protection behaviors, and sunburn in children. Additionally, the context in which children experience sunburn in order to assist the development, optimization, and targeting of sun safety interventions for parents is revealed. A qualitative study design, using a semi-structured interview guide addressing several themes (e.g., sun exposure, sun protection, and sunburn experiences), was used. Data were collected in the Netherlands in the fall of 2019. Parents were recruited via purposive sampling at schools, youth services centers, and social media. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d = 0.84). In total, 26 interviews were performed (n = 17 mothers, n = 17 daughters, aged between 4 and 11 years). Parental perceptions and recall of their child's lifetime sunburn were frequent, even though all parents reported using at least one sun protection measure during sun exposure situations and parents seemed often unaware of their child's sunburn. Moreover, parents reported an overreliance on sunscreen, often failing to adequately protect their children's skin. Water-related activities, a lack of shade, and misconceptions regarding UV-index were often related to sunburn. In addition, unexpected sun exposure or longer exposure duration than initially planned were reported as challenging situations. The majority of parents had positive perceptions regarding tanned skin for both themselves as for children. This study provides directions for skin cancer prevention efforts targeted at both parents and their children. Since a lack of knowledge regarding sufficient sun protection measures and sunburn occurrence in various situations was reported, educational efforts are warranted. Additionally, focusing on clothing, shade-seeking, and adequate sunscreen use is recommended to increase children's sun safety. By intervening in the physical environment as well (e.g., providing shady areas), sun protection barriers can be reduced. Lastly, the general positive attitude toward tanned skin evident in this study is certainly worthy of attention in future interventions.

Project description:In the context of climate change, yield and quality losses from sunburn necrosis are challenging grape growers around the world. In a previous review, we identified the role of wind speed, duration of heat exposure, drought stress and adaptation as major knowledge gaps that prevent a better predictability of sunburn events. In this paper we present results of targeted experiments aiming to close these knowledge gaps. The effects of drought stress and adaptation on sunburn susceptibility were investigated in a combined drought stress/ defoliation experiment. Riesling grapevines growing in an arid climate were fully irrigated or drought stressed, and clusters were exposed to sunlight by fruit-zone leaf removal (defoliation) at two developmental stages. Sunburn symptoms were induced using infrared heaters while fruit surface temperature was measured using thermal imaging enabling the establishment of threshold temperatures. The influence of the duration of heat exposure of berries was examined by heating grape clusters to a stable temperature and monitoring the evolution of sunburn symptoms over time. To examine the effects of wind speed on the appearance of sunburn necrosis symptoms, fruit surface temperatures and sunburn severity were measured along an artificially induced wind speed gradient in two cultivars using thermal imaging and visual inspection. Longer durations of heat exposure required lower fruit surface temperatures to induce damage, while the differences in temperature after 60 min and 90 min of exposure were marginal (47.82 ± 0.25 °C and 47.06 ± 0.26 °C). Clusters of vines grown under water deficit were less susceptible to sunburn compared to those of well-irrigated plants following defoliation. The lethal temperature of clusters exposed to sunlight for seven days did not differ from those exposed to sunlight for 28 days, indicating that a full adaptation ocurred within this period. Higher wind speeds led to lower cluster temperatures and reduced sunburn severity. First evidence of a drought priming induced heat tolerance of grapevine berries was found, while adaptation had a more pronounced effect on the susceptibility to sunburn compared to water stress.

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Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample.

Publications

Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample.

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