title: Self-Reported Changes in Sun-Protection Behaviors at Different Latitudes in Australia.
abstract: Sun exposure is the most important source of vitamin D, but is also a risk factor for skin cancer. This study investigated attitudes toward vitamin D, and changes in sun-exposure behavior due to concern about adequate vitamin D. Participants (n = 1002) were recruited from four regions of Australia and completed self- and interviewer-administered surveys. Chi-square tests were used to assess associations between participants' latitude of residence, vitamin D-related attitudes and changes in sun-exposure behaviors during the last summer. Multivariate logistic regression analyses were used to model the association between attitudes and behaviors. Overall, people who worried about their vitamin D status were more likely to have altered sun protection and spent more time in the sun people not concerned about vitamin D. Concern about vitamin D was also more common with increasing latitude. Use of novel item response theory analysis highlighted the potential impact of self-reported behavior change on skin cancer predisposition due concern to vitamin. This cross-sectional study shows that the strongest determinants of self-reported sun-protection behavior changes due to concerns about vitamin D were attitudes and location, with people at higher latitudes worrying more.
authors.affiliation: School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.|Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
authors.forename: Ngadiman
authors.initials: N
authors.lastname: Djaja
authors.affiliation: School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.|Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
authors.forename: Monika
authors.initials: M
authors.lastname: Janda
authors.affiliation: National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|National Centre for Epidemiology and Research School of Population Health, The Australian National University, Canberra, ACT, Australia.|Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
authors.forename: Robyn M
authors.initials: RM
authors.lastname: Lucas
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|JCU Skin Cancer Research Group, Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Qld, Australia.|Anton Breinl Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, Qld, Australia.
authors.forename: Simone L
authors.initials: SL
authors.lastname: Harrison
authors.affiliation: National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|Menzies Institute for Medical Research, Hobart, Tas., Australia.
authors.forename: Ingrid
authors.initials: I
authors.lastname: van der Mei
authors.affiliation: National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Ebeling
authors.affiliation: National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Neale
authors.affiliation: National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
authors.affiliation: JCU Skin Cancer Research Group, Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Qld, Australia.|Anton Breinl Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, Qld, Australia.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Nowak
authors.affiliation: School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.|Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.|National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kimlin
mesh_terms: D001315:Australia; D003625:Data Collection; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D013471:Sunburn / Q000517:prevention & control*; D013472:Sunlight; D013473:Sunscreening Agents; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000096:biosynthesis*; D014808:Vitamin D Deficiency
chemical_list: D013473:Sunscreening Agents; D014807:Vitamin D