New Approaches to Melanoma Prevention

Skin cancer is a major public health concern, and tanning remains a modifiable risk factor. Multidimensional influences, including psychosocial, individual, environmental, and policy-related factors, create the milieu for individuals to engage in tanning. Parents and physicians can modify the behavior of teens and young adults using strategies based on harm reduction. Environmental and policy-related factors similar to those used to limit smoking by restricting access of minors to cigarettes in the United States in the 20th century need to be created. Federal regulations can restrict direct advertising and the excise tax can be increased to a prohibitive amount. Social networking may assist with affect regulation

Accuracy of Self-Reported Sun Exposure and Sun Protection Behavior

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures commonly used in the current literature and those recently recommended as standards by a workshop of experts showed evidence of being non-interval and lacking precision for more frequent behavior (e.g., \u3e1 h sun exposure daily). These data indicated that open-ended frequency self-reports of skin cancer risk behaviors that follow procedures designed to increase accuracy were reliable over a summer-long period

Nationwide Analysis on Intentional Indoor and Outdoor Tanning: Prevalence and Correlates

Outdoor and indoor tanning are considered as risk factors for the development of skin cancer. The aims of this nationwide representative study were to quantify both behaviors in a sample with a wide age range, to identify those showing both behaviors and to explore and compare determinants of both behaviors. We used data from the fifth wave (2019) of the National Cancer Aid Monitoring (NCAM). We surveyed the representative sample including 4000 individuals, aged 16-65 years, living in Germany. Data were collected through telephone interviews. In addition to descriptive statistics, we used logistic regression analyses to identify determinants. The one-year-prevalence of tanning bed use was 7.5%, while 31.9% tanned (very) often intentionally outdoors in at least one situation (weekdays, holidays, and weekends). A total of 3.2% reported both risk behaviors. Regression analyses revealed that tanning bed use is associated with employment, an increased number of naevi, and lack of risk awareness. Intentional outdoor tanning was associated with male sex, younger age, past tobacco use, and low risk awareness of UV radiation. Our findings suggest that only a minority of subjects showed both risk behaviors. This implies that individuals seem to perform either one behavior or the other. In addition, the associated determinants differed between both behaviors, implying that specific preventive measures tailored to address to each tanning behavior are needed

Theory-Driven Longitudinal Study Exploring Indoor Tanning Initiation in Teens Using a Person-Centered Approach

Background Younger indoor tanning initiation leads to greater melanoma risk due to more frequent and persistent behavior. Despite this, there are no published studies exploring the predictors of indoor tanning initiation in teen populations. Purpose This longitudinal study uses latent profile analysis to examine indoor tanning initiation in indoor tanning risk subgroups from a national sample of female adolescents. Methods Latent profile analysis used indoor tanning beliefs and perceptions to identify indoor tanning initiation risk subgroups. The teens in each subgroup were reassessed on indoor tanning initiation after a year. Results Three subgroups were identified: a low risk, anti-tanning subgroup (18.6 %) characterized by low scores on positive indoor tanning belief scales and high scores on beliefs about indoor tanning dangers; a moderate risk aware social tanner subgroup (47.2 %) characterized by high scores on positive indoor tanning belief scales but also high scores on beliefs about indoor tanning dangers; and a high risk risky relaxation tanner subgroup (34.2 %) characterized by high scores on positive indoor tanning belief scales and low scores on beliefs about indoor tanning dangers. Teens in the aware social tanner and risky relaxation tanner subgroups were significantly more likely to initiate indoor tanning in the following year. Conclusions These findings highlight the need to identify teens at risk for indoor tanning initiation and develop tailored interventions that will move them to the lowest risk subgroup. Subgroup correlates suggest parent and peer-based interventions may be successful

Characteristics and Practices of Adults Who Use Tanning Beds in Private Residences

Recent research shows that 7.7% of individuals who use indoor tanning beds do so in private homes, but little is known about this group. This study evaluated the tanning practices, reasons for tanning, and association with tanning addiction of adults who use tanning beds in private residences

Results of a Social Media Campaign to Prevent Indoor Tanning by Teens: A Randomized Controlled Trial

Indoor tanning (IT) increases risk of developing skin cancer. A social media campaign to reduce mother\u27s permissiveness toward their teenage daughters IT was evaluated. Mothers (N = 869) of daughters aged 14–17 in 34 states without bans on IT by minors were enrolled in a randomized trial with assessments at baseline and 12-months follow-up in 2017–19. A year-long adolescent health campaign was delivered to all mothers. The intervention group received posts on preventing IT and the control group, posts about preventing prescription drug misuse. Daughters (n = 469; 54.0%) completed the assessments at baseline and 12 months. At 12-month follow-up, intervention-group mothers were less permissive of IT by daughters (unadjusted means = 1.70 [95% CI: 1.59, 1.80] v. 1.85 [1.73, 1.97] [5-point Likert scale], b = -0.152), reported more communication about avoiding IT with daughters (4.09 [3.84, 4.35] v. 3.42 [3.16, 3.68] [sum of 7 yes/no items], b = 0.213), and had lower intentions to indoor tan (1.41 [1.28, 1.55] v. 1.60 [1.43, 1.76] [7-point likelihood scale], b = -0.221) than control-group mothers. Daughters confirmed intervention-group mothers communicated about IT (3.81 [3.49, 4.14] v. 3.20 [2.87, 3.53] [sum of 7 yes/no items], b = 0.237) and shared IT posts (unadjusted percentages = 52.4% v. 36.4%, b = 0.438) more than control-group mothers. No differences were found in IT behavior, self-efficacy to refuse permission, and negative attitudes toward IT. A social media campaign may be an effective strategy to convince mothers to withhold permission for IT, which may help increase the effectiveness of state laws designed to reduce IT by minors by requiring parental permission

Gender Differences in Indoor Tanning Habits and Location

To the Editor, In 2013, 1.9 million US men reported tanning indoors. Existing research largely target teen and young adult female tanners, and less is known about male tanning behavior. Using Survey Sampling International, we recruited a nationally representative sample of 773 adults who intend to use or used an indoor tanning bed. Participants reporting a lifetime history of tanning indoors (n=636; 33.5% male) were included...

Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial

BACKGROUND: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. OBJECTIVE: This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers\u27 permissiveness regarding their teenage daughters\u27 use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. METHODS: The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers\u27 permissiveness regarding their teenage daughters\u27 use of indoor tanning, teenage daughters\u27 perception of their mothers\u27 permissiveness, and indoor tanning by both mothers and daughters. RESULTS: The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. CONCLUSIONS: This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. CLINICALTRIAL: Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE)

Interdisciplinary Perspectives on Sun Safety and Skin Cancer Risk: achieving consensus

Overexposure to the sun is associated with an increased risk of melanoma and nonmelanoma skin cancer, but indications of improvements in sun protection behavior are poor. Attempts to identify emerging themes in skin cancer control have largely been driven by groups of experts from a single field. In December 2016, 19 experts from various disciplines convened for Interdisciplinary Perspectives on Skin Cancer, a 2-day meeting hosted by the National Academy of Sciences. The group discussed knowledge gaps, perspectives on sun exposure, implications for skin cancer risk and other health outcomes, and new directions. Five themes emerged from the discussion: (1) The definition of risk must be expanded, and categories for skin physiology must be refined to incorporate population diversities. (2) Risky sun exposure often co-occurs with other health-related behaviors. (3) Messages must be nuanced to target at-risk populations. (4) Persons at risk for tanning disorder must be recognized and treated. (5) Sun safety interventions must be scalable. Efficient use of technologies will be required to sharpen messages to specific populations and to integrate them within multilevel interventions. Further interdisciplinary research should address these emerging themes to build effective and sustainable approaches to large-scale behavior change