Factors Influencing Sun Protection Behaviors among Patients with Skin Cancer: An Application of the Information-Motivation-Behavioral Skills Model

© 2019 by the Dermatology Nurses\u27 Association. This study aimed to assess predictors of sun protection behaviors based on the information-motivation-behavioral skills (IMB) model among people diagnosed with nonmelanoma skin cancer (NMSC). For this descriptive, cross-sectional study, a convenience sample of 311 patients with NMSC was recruited at a medical center in Mississippi. Patients were invited to complete a face- A nd content-valid, IMB-model-based questionnaire. The average age of the participants was 64.12 (±12.02) years, and most (58.8%) were male. Most participants indicated not using sun protection behaviors while outdoors. Findings showed that sun protection behaviors were directly predicted by self-efficacy (standardized path coefficient = 0.504, p \u3c.001) and social support (standardized path coefficient = 0.199, p =.010). In addition, sun protection behavior was indirectly predicted (through self-efficacy) by social support (standardized indirect effect = 0.160, p \u3c.001) and attitudes (standardized indirect effect = 0.192, p =.001). The explained variances for self-efficacy and sun protection behaviors were 43% and 35.4%, respectively. In conclusion, the IMB model appears to be a useful theoretical framework for predicting sun protection behaviors among patients with NMSC. Sun safety intervention programs should be developed based on this theoretical model for patients with NMSC

Skin Cancer Knowledge, Attitudes, and Behaviors in Collegiate Athletes

Outdoor athletes represent an important group at risk for skin cancer because they are routinely exposed to high levels of ultraviolet radiation. The purpose of this study was to assess current skin cancer knowledge, attitudes, and behaviors among collegiate athletes. A modified version of the Melanoma Risk Behavior Survey was completed by 343 athletes attending a Southern University in the USA, generating an 87% response rate. Survey results demonstrated that the majority of the athletes do not limit their sun exposure and reported low levels of sun protective behaviors. In addition, athletes lacked knowledge about skin cancer and sun protection. Eighty-three percent of the athletes stated that tanning beds improve one's overall health. Race was significantly associated with skin cancer knowledge, whereas, gender was found to be significantly associated with knowledge, attitudes, and behaviors towards skin cancer. Additionally, there was a significant relationship between knowledge and behavior, but not between attitude and behavior. This study highlights the need to educate athletes about the hazards of tanning to minimize UV exposure and promote sun protection habits. Moreover, athletes should be educated on the dangers of indoor tanning facilities and encouraged to avoid these facilities

Sun protection behaviors of state park workers in the southeastern USA

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Occupational Hygiene Society. Background: Due to the nature of their work, state park workers receive substantial exposure to sunlight, putting them at an increased risk of developing skin cancer. Increased use of sun protection behaviors can reduce this risk. Objectives: Using the health belief model (HBM) as a theoretical framework, the purpose of this study was to assess factors associated with sun protection behaviors among state-park workers. Methods: In this cross-sectional study, a convenience sample of participants were recruited from 23 state parks in the Southeastern USA to complete a self-administered questionnaire based on the constructs of the HBM. Results: The sample comprised 310 state park workers. The majority of participants were non-Hispanic White (61.6%), male (63.5%), and were aged 39.56 (±13.97) years on average.The average duration of sun exposure during the workday was reported as 3.51 h (±1.88). Nearly 12% of the participants reported that their workplace had a sun-safety policy and ~10% reported receiving sun-safety training at their workplace.The majority of participants reported that they did not sufficiently use sun protection methods. Factors associated with sun protection behaviors included the HBM constructs of perceived benefits outweighing perceived barriers (standardized coefficient = 0.210, P = 0.001), self-efficacy (standardized coefficient = 0.333, P \u3c 0.001), and cues to action (standardized coefficient = 0.179, P = 0.004). Conclusion: Future research should explore the barriers to adopting and enforcing sun-safety policies in the workplace. HBM appears to be efficacious in explaining sun protection behaviors among state park workers. HBM constructs should be considered in future interventions aimed at increasing sun protection behaviors in this population

A prospective, randomized clinical trial of antiretroviral therapies on carotid wall thickness

Objective: This article compares the effects of initiating three contemporary antiretroviral therapy (ART) regimens on progression of carotid artery intima-media thickness (IMT) over 3 years. Design: Randomized clinical trial. Setting: Multicenter (26 institutions). Patients: ART-naive HIV-infected individuals (n ¼ 328) without known cardiovascular disease or diabetes mellitus. Intervention: Random assignment to tenofovir/emtricitabine along with atazanavir/ ritonavir (ATV/r), darunavir/ritonavir (DRV/r), or raltegravir (RAL). Main outcome measures: Right-sided carotid IMT was evaluated by B-mode ultrasonography before ART initiation, and then after 48, 96, and 144 weeks. Comparisons of yearly rates of change in carotid IMT used mixed-effects linear regression models that permitted not only evaluation of the effects of ART on carotid IMT progression but also how ART-associated changes in traditional risk factors, bilirubin, and markers of HIV infection were associated carotid IMT progression. Results: HIV-1 RNA suppression rates were high in all arms (>85%) over 144 weeks. Modest increases in triglycerides and non-high-density lipoprotein cholesterol levels were observed in the protease inhibitor-containing arms compared with decreases with RAL. In contrast, carotid IMT progressed more slowly on ATV/r [8.2, 95% confidence interval (5.6, 10.8) mm/year] than DRV/r [12.9 (10.3, 15.5) mm/year, P ¼ 0.013]; changes with RAL were intermediate [10.7 (9.2, 12.2) mm/year, P ¼ 0.15 vs. ATV/r; P ¼ 0.31 vs. DRV/r]. Bilirubin and non-high-density lipoprotein cholesterol levels appeared to influence carotid IMT progression rates. Conclusion: In ART-naive HIV-infected individuals at low cardiovascular disease risk, carotid IMT progressed more slowly in participants initiating ATV/r than those initiating DRV/r, with intermediate changes associated with RAL. This effect may be due, in part, to hyperbilirubinemia

The 10 most commonly asked questions about dermatology maintenance of certification

The Dermatology Maintenance of Certification (DMOC) program has been adopted by the American Board of Dermatology (ABD) in concert with similar programs that have been developed by all member boards of the American Board of Medical Specialties (ABMS). The development of the DMOC program has prompted many questions from board-certified dermatologists who would like more information about the potential impact of the program on their practice, the value of the program, and the motives of those who created the program. Having served as a director of the ABD since 2002, I am convinced that the DMOC program is in the best interest of our patients as well as current and future dermatologists. My answers to the 10 most commonly asked questions are presented below. Are the interests of the dermatologists who are currently in private practice represented on the ABD? Answer: Several (5 of 16 in 2006) members of the . . . [Full text of this article