Sharma Manoj, Asare Matthew, Largo-Wight Erin, Merten Julie, Binder Mike, Lakhan Ram, Batra Kavita
Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA.
Department of Public Health, Baylor University, Waco, TX 76798, USA.
Healthcare (Basel). 2021 Oct 10;9(10):1343. doi: 10.3390/healthcare9101343.
Florida residents have the second highest incidence of skin cancer in the nation. Sunscreen usage was found to be the one of the most effective integrative health approaches for reducing risk of skin cancer. Given the limited information on the likelihood of adopting and continuing sunscreen usage behavior, this cross-sectional study aimed to examine the correlates of initiating and sustaining sunscreen usage behavior among Florida dwellers, using the fourth-generation, multi-theory model (MTM) of behavior change. A web-based survey containing 51 questions was emailed to Florida residents aged 18 years or above, who were randomly selected from the state voter file. Psychometric validity of the survey instrument was established using structural equation modeling, and Cronbach's alpha values were calculated for assessing the internal consistency. An independent-samples--test and hierarchical multiple regression tests were used to analyze the data. The results indicated that participants who engaged in sunscreen usage behavior, participatory dialogue (β = 0.062, < 0.05), behavioral confidence (β = 0.636, < 0.001), and changes in the physical environment (β = 0.210, < 0.001) were statistically significant and accounted for 73.6% of the variance in initiating sunscreen usage behavior. In addition, the constructs of emotional transformation (β = 0.486, < 0.001) and practice for change (β = 0.211, < 0.001), as well as changes in the social environment (β = 0.148, < 0.001) were significant predictors of maintaining sunscreen usage behavior and contributed to 59% of variance in sustenance. These findings offer a valuable insight regarding the applicability of MTM models to guiding public health interventions promoting sunscreen usage and preventing UV radiation risk and related skin cancer.
佛罗里达州居民的皮肤癌发病率在全美位居第二。研究发现，使用防晒霜是降低皮肤癌风险最有效的综合健康方法之一。鉴于关于采用和持续使用防晒霜行为可能性的信息有限，这项横断面研究旨在运用行为改变的第四代多理论模型（MTM），调查佛罗里达州居民开始并持续使用防晒霜行为的相关因素。一份包含51个问题的网络调查问卷被发送给从该州选民档案中随机选取的18岁及以上的佛罗里达州居民。使用结构方程模型确定了调查问卷工具的心理测量效度，并计算了克朗巴哈系数值以评估内部一致性。使用独立样本t检验和分层多元回归检验对数据进行分析。结果表明，参与防晒霜使用行为、参与性对话（β = 0.062，P < 0.05）、行为信心（β = 0.636，P < 0.001）以及物理环境变化（β = 0.210，P < 0.001）具有统计学意义，占开始使用防晒霜行为方差的73.6%。此外，情绪转变（β = 0.486，P < 0.001）和改变实践（β = 0.211，P < 0.001）的结构，以及社会环境变化（β = 0.148，P < 0.001）是维持防晒霜使用行为的重要预测因素，占维持方差的59%。这些发现为MTM模型在指导促进防晒霜使用、预防紫外线辐射风险及相关皮肤癌的公共卫生干预措施方面的适用性提供了有价值的见解。
