title: Patterns of sun protective behaviors among Hispanic children in a skin cancer prevention intervention.
abstract: BACKGROUND
  Invasive melanoma is becoming more common in U.S. Hispanics, yet little is known about the sun protection behaviors in this population, particularly children and adolescents who incur high ultraviolet (UV) exposures.
  
  
  METHODS
  We used latent class analysis to examine patterns of sun protective behaviors in a cross-sectional survey of Hispanic elementary students participating in a sun safety intervention in Los Angeles from 2013- to 2014 (N=972). Five behavior indicators in two environments (school and home) representing multiple methods of sun protection were selected for the model.
  
  
  RESULTS
  Results suggested a four-class model best fit the data. Classes were labeled in order of increasing risk as multiple protective behaviors (28%), clothing and shade (32%), pants only (15%), and low/inconsistent protective behaviors (25%). Children who reported high parental engagement with sun protection were significantly more likely to be classified in high overall protective categories (odds ratio (OR)=4.77). Girls were more likely than boys to be classified in the highest protecting class (OR=3.46), but were also more likely to be in the "pants only" class (OR=2.65). Sensitivity to sunburn was associated with less likelihood of being in the "clothing and shade" class (OR=0.53).
  
  
  CONCLUSIONS
  The differences among these classes and their predictors reveal the heterogeneity and complexity of Hispanic children's sun protective behaviors. These findings have implications for the design and delivery of future sun protection interventions targeting Hispanic children, as strategies tailored to specific subgroups may be more effective in achieving meaningful behavioral changes.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States. Electronic address: kim.miller@med.usc.edu.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Miller
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
authors.forename: Jimi
authors.initials: J
authors.lastname: Huh
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Unger
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Richardson
authors.affiliation: MacDiarmid Institute for Advanced Materials and Nanotechnology, Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand.
authors.forename: Martin W
authors.initials: MW
authors.lastname: Allen
authors.affiliation: Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
authors.forename: David H
authors.initials: DH
authors.lastname: Peng
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
authors.forename: Myles G
authors.initials: MG
authors.lastname: Cockburn
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008297:Male; D011481:Protective Clothing / Q000706:statistics & numerical data; D012878:Skin Neoplasms / Q000208:ethnology / Q000517:prevention & control; D013471:Sunburn / Q000208:ethnology* / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects; D013473:Sunscreening Agents / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D013473:Sunscreening Agents
keywords: Children; Hispanic; Latent class analysis; Melanoma; Skin cancer