Hay Jennifer L, Shuk Elyse, Schofield Elizabeth, Loeb Rebecca, Holland Susan, Burkhalter Jack, Li Yuelin
Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center.
Health Psychol. 2017 Sep;36(9):907-915. doi: 10.1037/hea0000523.
Melanoma is the most serious skin cancer, and consistent use of sun protection is recommended to reduce risk. Yet sun protection use is generally inconsistent. Understanding the decisional factors driving sun protection choices could aid in intervention development to promote sun protection maintenance.
In 59 first-degree relatives of melanoma patients, an interactive voice response system (IVRS) on participants' cell phones was used to assess twice daily (morning, afternoon) real-time sun protection usage (sunscreen, shade, hats, protective clothing) and decision factors (weather, type of activity, convenience, social support) over a 14-day summer interval where morning and afternoon outdoor exposures were anticipated. Generalized estimating equations and hierarchical linear models were used to examine the effect of demographics and decisional factors on sun protection choices over time.
Sun protection use was inconsistent (e.g., 61% used sunscreen inconsistently). Most strategies were used independently, with the exception of moderate overlap of sunscreen and hat usage. Decision factors were highly relevant for sun protection. For instance, sunscreen use was related to the perception of having adequate time to apply it, whereas shade and hat usage were each related to convenience. Few findings emerged by gender, age, time of day, or year. Significant within-subject variation remained, however.
The findings support continued examination of decision factors in understanding sun protection consistency in real time. Interventions where cues to action and environmental supports work together in varied settings can be developed to improve sun protection maintenance in populations at risk for this common disease. (PsycINFO Database Record
黑色素瘤是最严重的皮肤癌，建议持续使用防晒措施以降低风险。然而，防晒措施的使用通常并不一致。了解影响防晒选择的决策因素有助于制定干预措施，以促进防晒措施的持续使用。
在59名黑色素瘤患者的一级亲属中，通过参与者手机上的交互式语音应答系统（IVRS），在一个为期14天的夏季时间段内，每天两次（上午、下午）评估实时防晒措施的使用情况（防晒霜、遮阳、帽子、防护服）以及决策因素（天气、活动类型、便利性、社会支持），在此期间预计会有上午和下午的户外暴露。使用广义估计方程和分层线性模型来检验人口统计学和决策因素对防晒选择随时间的影响。
防晒措施的使用并不一致（例如，61%的人使用防晒霜的情况不一致）。大多数策略是独立使用的，防晒霜和帽子的使用有适度重叠的情况除外。决策因素与防晒密切相关。例如，使用防晒霜与感觉有足够时间涂抹有关，而遮阳和戴帽子的使用则各自与便利性有关。按性别、年龄、一天中的时间或年份来看，几乎没有发现什么差异。然而，个体内部的显著差异仍然存在。
这些发现支持在实时理解防晒一致性方面继续研究决策因素。可以制定干预措施，使行动提示和环境支持在不同环境中协同发挥作用，以改善这种常见疾病高危人群的防晒持续使用情况。（PsycINFO数据库记录）
