title: Are interventions to promote sun-protective behaviors in recreational and tourist settings effective? A systematic review with meta-analysis and moderator analysis.
abstract: BACKGROUND
  Intermittent sun exposure and sunburn are risk factors for skin cancer that mostly occur in recreational/tourist settings. This review assesses the efficacy of skin cancer prevention interventions designed to promote sun-protective behaviors in recreational/tourist settings.
  
  
  METHODS
  Systematic review with meta-analyses of controlled trials with outcome measures of sun-protective behaviors and/or sunburn published until January 2011.
  
  
  RESULTS
  Twenty-three studies were included. We found no evidence for the efficacy of current interventions in reducing tanning or promoting protective clothing and seeking shade. Meta-analyses show a small heterogeneous effect for interventions on sun-protective behavior indices. Larger but heterogeneous effects were observed for self-reported sun exposure and sunburns. Modest methodological quality suggests risk of bias. Effective interventions were more likely to stimulate social norms supporting sun-protective behaviors and provide appearance-based information about photoaging illustrated with ultraviolet photographs.
  
  
  CONCLUSIONS
  There is weak and inconclusive evidence for the efficacy of interventions in promoting sun-protective behaviors.
authors.affiliation: Health Psychology Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Falko F
authors.initials: FF
authors.lastname: Sniehotta
authors.forename: Vera
authors.initials: V
authors.lastname: Araujo-Soares
mesh_terms: D018849:Controlled Clinical Trials as Topic; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D011481:Protective Clothing / Q000706:statistics & numerical data; D011998:Recreation / Q000523:psychology*; D012878:Skin Neoplasms / Q000517:prevention & control; D013471:Sunburn / Q000517:prevention & control*; D013473:Sunscreening Agents / Q000627:therapeutic use*
chemical_list: D013473:Sunscreening Agents