The prevalence and predictors of solar protection use among adolescents

Background. Adolescence has been identified as a critical period in the etiology of subsequent melanoma and nonmelanocytic skin cancer. This study examines the prevalence and predictors of solar protection use among adolescents. Methods. A total of 3,642 adolescents between the ages of 11 and 16 years were recruited from a random sample of 27 schools in an Australian state. The participants completed a validated survey that provided information on a range of demographic, knowledge, attitudinal, and behavioral factors. Sun protection practices adopted during the preceding weekend were assessed using a validated self-report diary. A formula that quantifies protection status was then employed to categorize adolescents into those who were using adequate versus low levels of solar protection. Results. Overall 54% of males and 44% of females were classified as adequately protected during the preceding weekend. Logistic regression analyses identified the following as significant predictors of having an adequate level of sun protection-gender (males more likely to be protected), age (11 to 13 year olds more likely to be protected than 14 to 16 year olds), ownership of a broad-brimmed hat or cap, attitudes relating to the discomfort associated with wearing a hat, image to peers, "hassle" associated with the use of sun protective measures, school attended, and sun protective policies of the school. Conclusions. Implications of these findings for future preventive strategies are discussed and include improved targeting of sun protection programs to nonadopters, modification of attitudes relating to suntans and image to peers, reducing the level of perceived difficulty associated with utilizing sunscreen, and the potential role that schools may play in fostering sun protection. (C) 1998 American Health Foundation and Academic Press.