Measuring Health Beliefs About UV Exposure Among Oregon College Students

Graduation Date: 2017Access restricted to the OSU Community, at author's request, from 2017-06-21 to 2018-06-21Exposure to ultraviolet (UV) radiation is a primary cause of melanoma and non-melanoma skin cancer and thus represents a critical public health concern. Skin cancer risk behavior research lacks an instrument designed to assess health beliefs about UV exposure that may increase skin cancer risk by increasing risky UV exposure and decreasing protective behaviors such as sunscreen use. The purpose of this dissertation was 1) to develop and validate a scale that measures health beliefs about UV related to health benefits of UV exposure, seasonal mood effects and concerns about the safety of sunscreen use, and 2) to describe the prevalence of such beliefs using the new scale, and examine the relationship of these beliefs to skin cancer risk behaviors.\ud The initial phase of this study included the development and revision an item pool through expert review and piloting. Oregon State University (OSU) undergraduate students (N = 114) completed the scale in a Qualtrics online survey. Five students completed additional item comprehension interviews. Then I incorporated pilot and interview data, examining item performance and further refining the item pool. Finally, I administered the refined item pool online to OSU students (N = 335). With these data, I eliminated poorly performing items and analyzed the factor structure of the scale. In Manuscript 1, I describe the development and factor structure of the Health Beliefs About UV (HBAU) scale. The final scale includes eleven items that represent four factors which is named Sunscreen Toxicity, Health Benefits of Tanning, Seasonal Effects and Tanning Through the Winter. The final four-factor solution demonstrated excellent fit to the data (2 = 36.43, df = 38, RMSEA = 0.000, CFI = 1.000, TLI = 1.003). \ud In Manuscript 2, I describe the prevalence of HBAU constructs in college students and use structural equation modeling to examine the relationship of the HBAU scale to skin cancer risk behaviors. Three of the subscales were associated with skin cancer risk behaviors in a model that adjusted for known covariates of UV exposure and sunscreen use. After adjusting for covariates, Sunscreen Toxicity predicted reduced sunscreen use ( = -.12, p = .021), Health Benefits of Tanning predicted outdoor tanning ( = .43, p < .001), and Tanning Through the Winter predicted indoor tanning ( = .31, p = .02). \ud These findings suggest that beliefs about benefits of UV exposure such as the belief that tanning before sun exposure is protective against skin cancer play a role in skin cancer risk behaviors. The scale developed was psychometrically sound and demonstrated the capacity to predict skin cancer risk behaviors in our final sample. Findings provide additional evidence that beliefs related to health benefits of sun exposure, the regional weather, and safety of sunscreen may play a role in skin cancer risk behaviors, and should be addressed in skin cancer prevention efforts