Investigation of a Behavioral Substitute for Sunbathing

描述（由申请人提供）：皮肤癌是美国最常见的癌症，也是最可预防的癌症之一，因为它与太阳的紫外线（UV）辐射暴露密切相关。虽然保护自己免受紫外线照射可以大大降低风险，但目前无保护的阳光照射率（约50%）远高于健康人2010年25%的目标。到目前为止，预防研究对防晒霜的使用有一定影响，但对实际避免阳光的影响较小。那些最抗拒干预措施的人似乎是那些被激励要变黑的人。日光浴替代品的可接受性和可行性从未被研究过。干预措施可以通过促进与日光浴功能相同的阳光照射行为替代品（即晒黑皮肤）来改善，从而减少对日光浴的需求。无太阳晒黑产品以乳霜、泡沫和喷雾剂的形式直接涂抹在皮肤上，含有二羟丙酮（DMA），一种无色的植物性糖，可以暂时将皮肤染成棕褐色。据我们所知，晒黑机还没有被评估为预防皮肤癌的工具。本研究包括两个阶段：发展阶段和试点干预阶段。最初发展阶段的目标将是：1)发展出心理测量学上合理的方法来衡量人们对晒黑者的态度；2)在2周的采样期后，确定自称是海滩游客的人对使用无太阳晒黑产品的态度；3)识别使用这些产品的障碍和益处；4)开发潜在的激励信息，鼓励使用无太阳晒黑产品。这个项目的试点干预阶段的目的是检查海滩干预的可行性和效果，包括阳光伤害，包括阳光安全建议，并提供防晒霜和无太阳晒黑产品的样本，在2个月和12个月的随访中与只接受问卷调查的对照组进行比较。主要的假设是，与只有问卷调查的对照组相比，干预会减少日光浴和对日光浴好处的认识。其次，行为替代假说认为，日光浴的减少将与日光浴产品的使用增加有关。我们还评估了干预对日光浴、使用无太阳晒黑剂、防晒、晒伤、光老化易感性和光老化严重程度的感知益处的影响。无太阳晒黑机是一种安全、经济、广泛可用的商业产品，通过适当的教育和指导可以成为一种很有前途的预防工具。在发生危险行为的环境中，针对社区高风险人群的预防干预措施有可能产生重大而集中的公共卫生影响。

DESCRIPTION (provided by applicant): Skin cancer is the most prevalent cancer and of the most preventable cancers in the US because it is strongly linked to ultraviolet (UV) radiation exposure from the sun. While protecting oneself from UV exposure can largely reduce risk, rates of unprotected sun exposure (~50%) are currently well above the Healthy People 2010 goal of 25%. Prevention research thus far has had some impact on sunscreen use, but less impact on actual sun avoidance. Those most resistant to intervention efforts appear to be those who are motivated to be tan. The acceptability and feasibility of tanning substitutes for sun avoidance have never been investigated. Interventions might be improved by promoting behavioral substitutes for sun exposure that serve the same function as sunbathing (i.e., tan skin) thereby reducing the need to sunbathe. Sunless tanners are products that come in the form of creams, foams, and sprays to be applied directly to the skin and contain dihydroxyacetone (DMA), a colorless vegetable-derived sugar that temporarily stains the skin a tan color. Sunless tanners to our knowledge have not been evaluated as a skin cancer prevention tool. The present study includes 2 phases: development and pilot intervention. The aims of the initial development phase will be to 1) develop psychometrically sound measures of attitudes toward sunless tanners; 2) identify self-described beach-goers attitudes towards sunless tanning product use after a 2 week sampling period; 3) identify perceived barriers and benefits to the use of these products; 4) to develop potential motivational messages encouraging the use of sunless tanning products. The aims of the pilot intervention phase of this project will be to examine the feasibility and effect of a beach-based intervention that includes sun damage including sun safety recommendations, and the provision of samples of both sunscreen and sunless tanning products on sun exposure compared to a questionnaire-only control group at 2-and 12-month follow-up. The primary hypothesis posits that the intervention will decrease sunbathing and perceptions of the benefits of sunbathing compared to a questionnaire only control group. Second, a behavioral substitution hypothesis posits that decreased sunbathing will be associated with increased use of sunless tanning products. We also assess the effect of the intervention on perceived benefits of sunbathing, use of sunless tanners, sun protection, sunburns, perceived susceptibility to photoaging, and perceived severity of photoaging. Sunless tanners are a safe, economical, and widely available commercial product that with appropriate education and instruction could be a promising prevention tool. Prevention interventions that target high-risk segments of the community in settings where risk behavior occurs have potential for a large and focused public health impact.