title: Predictors of sun protection behaviors and severe sunburn in an international online study.
abstract: BACKGROUND
  The incidence of melanoma continues to increase in many countries, and primary prevention of melanoma includes avoidance of sunburn as well as adequate sun protection behavior. The aim of this study was to examine the prevalence of self-reported sun protection behaviors and sunburn in users of the Internet, and to identify the demographic, clinical, and attitudinal/motivational correlates of sun protection behaviors.
  
  
  METHODS
  Self-report data were gathered on behalf of the GenoMEL consortium using an online survey available in 10 different languages, and 8,178 individuals successfully completed at least 80% of survey items, with 73% of respondents from Europe, 12% from Australia, 7% from the United States, 2% from Israel, and 6% from other countries.
  
  
  RESULTS
  Half of all respondents and 27% of those with a previous melanoma reported at least one severe sunburn during the previous 12 months. The strongest factors associated with sun protection behavior were perceived barriers to protection (beta = -0.44/beta = -0.37), and respondents who reported a positive attitude toward suntans were less likely to protect (beta = -0.16/beta = -0.14). Reported use of protective clothing and shade, as well as avoidance of midday sun exposure, were more strongly related to reduced risk of sunburn than sunscreen use.
  
  
  CONCLUSIONS
  Despite widespread dissemination of public health messages about the importance of sun protection, a substantial proportion of this international sample, including respondents with a previous melanoma, reported inadequate sun protection behaviors resulting in severe sunburn.
  
  
  CONCLUSIONS
  Future strategies to decrease sunburn should target the practical, social, and psychological barriers associated with nonuptake of sun protection.
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. richard.branstrom@ki.se
authors.forename: Richard
authors.initials: R
authors.lastname: Bränström
authors.forename: Nadine A
authors.initials: NA
authors.lastname: Kasparian
authors.forename: Yu-mei
authors.initials: YM
authors.lastname: Chang
authors.forename: Paul
authors.initials: P
authors.lastname: Affleck
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Aspinwall
authors.forename: Esther
authors.initials: E
authors.lastname: Azizi
authors.forename: Orna
authors.initials: O
authors.lastname: Baron-Epel
authors.forename: Linda
authors.initials: L
authors.lastname: Battistuzzi
authors.forename: Wilma
authors.initials: W
authors.lastname: Bergman
authors.forename: William
authors.initials: W
authors.lastname: Bruno
authors.forename: May
authors.initials: M
authors.lastname: Chan
authors.forename: Francisco
authors.initials: F
authors.lastname: Cuellar
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Debniak
authors.forename: Dace
authors.initials: D
authors.lastname: Pjanova
authors.forename: Slawomir
authors.initials: S
authors.lastname: Ertmanski
authors.forename: Adina
authors.initials: A
authors.lastname: Figl
authors.forename: Melinda
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Nicholas K
authors.initials: NK
authors.lastname: Hayward
authors.forename: Marko
authors.initials: M
authors.lastname: Hocevar
authors.forename: Peter A
authors.initials: PA
authors.lastname: Kanetsky
authors.forename: Sancy A
authors.initials: SA
authors.lastname: Leachman
authors.forename: Olita
authors.initials: O
authors.lastname: Heisele
authors.forename: Jane
authors.initials: J
authors.lastname: Palmer
authors.forename: Barbara
authors.initials: B
authors.lastname: Peric
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.forename: Nelleke A
authors.initials: NA
authors.lastname: Gruis
authors.forename: Julia
authors.initials: J
authors.lastname: Newton-Bishop
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Brandberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D012307:Risk Factors; D057566:Self Report; D012878:Skin Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D013471:Sunburn / Q000453:epidemiology / Q000517:prevention & control*; D013472:Sunlight; D013473:Sunscreening Agents / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D013473:Sunscreening Agents