Measuring nonsolar tanning behavior - Indoor and sunless tanning
ABSTRACT To develop items to measure indoor tanning and sunless tanning that can be used to monitor trends in population surveys or to assess changes in behavior in intervention studies.
A group of experts on indoor tanning convened in December 2005, as part of a national workshop to review the state of the evidence, define measurement issues, and develop items for ever tanned indoors, lifetime frequency, and past-year frequency for both indoor tanning and sunless tanning. Each item was subsequently assessed via in-person interviews for clarity, specificity, recall, and appropriateness of wording.
Universities in Tennessee and Virginia, a medical center in Massachusetts, and a high school in New Hampshire.
The study population comprised 24 adults and 7 adolescents.
Participants understood indoor tanning to represent tanning from beds, booths, and lamps that emit artificial UV radiation, rather than sunless tanning, even though both can be obtained from a booth. Two items were required to distinguish manually applied from booth-applied sunless tanning products. Frequency of use was easier for participants to recall in the past year than for a lifetime.
While indoor tanning items may be recommended with confidence for clarity, sunless tanning items require additional testing. Memory aids may be necessary to facilitate recall of lifetime use of nonsolar tanning. In addition, studies that assess reliability and validity of these measures are needed. Since study participants were primarily young and female, testing in other populations should also be considered.
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ABSTRACT: IMPORTANCE Strong links between indoor tanning behavior and skin cancer have been demonstrated across several studies. Understanding the complex belief systems that underlie indoor tanning in young women is a crucial first step in developing interventions to deter this behavior. OBJECTIVES To develop and validate a comprehensive, multidimensional, theory-based outcome expectations measure to advance an understanding of the sets of beliefs that underlie indoor tanning behavior among young women. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study comprising a web-based survey of 11 sororities at a large university in the southeastern United States. Study participants (n = 706) were aged 18 to 25 years; 45.3% had tanned indoors in their lifetime and 30.3% in the past year. MAIN OUTCOMES AND MEASURES Intention to tan indoors, frequency of indoor tanning behavior in the past year, and indoor tanner type (nontanner, former tanner, or current tanner). RESULTS A comprehensive scale assessing indoor tanning outcome expectations was developed. In total, 6 positive outcome expectations factors and 5 negative outcome expectations factors were identified. These subscales were reliable (coefficient α range, 0.86-0.95) and were significantly (mostly at P < .001) correlated with a set of established measures, including appearance motivation, indoor tanning attitudes and norms, and intention to tan indoors. Examination of subscales across the 3 indoor tanning groups also revealed significant (P < .001) differences on all 11 subscales. Current tanners had the most positive and least negative perceptions about indoor tanning, while nontanners had the most negative and least positive perceptions. Former tanners tended to fall in between these 2 groups. The 2 subscales with the largest differences across the groups were mood enhancement (positive outcome expectation) and psychological/physical discomfort (negative outcome expectation). Multiple linear regression analyses demonstrated several outcome expectations subscales to be significantly associated with intention to tan indoors and frequency of indoor tanning behavior. CONCLUSIONS AND RELEVANCE Results suggest that the Comprehensive Indoor Tanning Expectations (CITE) Scale provides a reliable and valid assessment of the complex sets of beliefs that underlie indoor tanning, including positive (motivational) and negative (deterrent) beliefs. This new scale may further advance research on indoor tanning beliefs and can guide health communications to prevent and deter indoor tanning behavior.02/2014; 150(5). DOI:10.1001/jamadermatol.2013.9086
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ABSTRACT: Background Tanning beds are associated with increased risk of melanoma. Objective We sought to update the evidence of the association of melanoma and indoor tanning focusing on frequency of use and exposure to newer tanning beds. Methods We searched Scopus, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature on August 14, 2013. We included all observational studies that included patients with melanoma who had indoor tanned. Odds ratios (OR) with 95% confidence intervals (CI) were extracted and combined using generic inverse variance methods assuming a random effects model. Results In all, 31 studies were included with data available on 14,956 melanoma cases and 233,106 controls. Compared with never using, the OR for melanoma associated with ever using indoor tanning beds was 1.16 (95% CI 1.05-1.28). Similar findings were identified in recent studies with enrollment occurring in the year 2000 onward (OR 1.22, 95% CI 1.03-1.45) and in subjects attending more than 10 tanning sessions (OR 1.34, 95% CI 1.05-1.71). Limitations The quality of evidence contributing to review results ranges from poor to mediocre. Conclusion Using tanning beds is associated with a subsequent melanoma diagnosis. Exposure from more than 10 tanning sessions is most strongly associated and there was no statistically significant difference in this association before and after 2000, suggesting that newer tanning technology is not safer than older models.Journal of the American Academy of Dermatology 05/2014; 70(5). DOI:10.1016/j.jaad.2013.11.050 · 5.00 Impact Factor
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ABSTRACT: PurposeLittle is known about handheld umbrella use for sun protection in the United States. We sought to determine whether women consider the handheld umbrella a socially acceptable form of sun protection and whether viewing pictures of famous women carrying umbrellas is influential.Methods Cross-sectional survey study of 382 women. Participants viewed a collage of famous women carrying umbrellas to assess effect on social acceptability.ResultsTwelve percent had used a handheld umbrella for sun protection. Participants were more likely to use an umbrella after viewing the collage (P<.001). The majority would consider umbrella use if recommended by a dermatologist. Independent predictors of social acceptability were age, had not lived in another country, sun protective clothing use, and no sunscreen use, while skin color, ethnicity, and education were not. Mean rating of social acceptability was an intermediate score of 5.41 (1 = not acceptable, 10 = totally acceptable) and increased to 5.88 post-collage (P<.001).Conclusion Social acceptability of handheld umbrellas was moderate. Popular media may play a role in whether women view handheld umbrellas as a socially acceptable form of sun protection. Dermatologists may consider recommending handheld umbrellas as an adjunct but not replacement for other methods of sun protection.Photodermatology Photoimmunology and Photomedicine 04/2014; 30(4). DOI:10.1111/phpp.12123 · 1.30 Impact Factor