Health literacy, sunscreen and sunbed use: an uneasy association

Abstract

SummaryBackground Skin cancer can largely be prevented by avoiding unsafe ultraviolet radiation (UVR) exposure. The evidence on potential drivers of sunscreen and sunbed use is extensive, yet in some cases, such as education, remains rather unclear. Health literacy is receiving increasing attention, but its effect on tanning decisions has not yet been explored. Objectives To explore the association between health literacy and tanning behaviour, in terms of sunscreen and sunbed use. Methods Self-reported data were collected through a common questionnaire in eight European countries under a common protocol. A three-item measure was used to assess health literacy; one item was collected to measure current sunscreen use and one item to measure current sunbed use. Descriptive statistics and analysis of variance tests were applied to explore the profile of sunbed and sunscreen users and health literacy among a number of variables. Univariate and multivariate logistic regressions were used to assess the relation between health literacy and sunscreen and sunbed use. Results Univariate results suggested that health literacy has opposite effects on sunscreen use vs. sunbed use. Increased health literacy was associated with the skin cancer protective practice of using sunscreen, but also with more sunbed use. In the multivariate models, health literacy had a significant effect only on sunscreen use. Conclusions The findings suggest that health literacy can be an interesting approach for influencing sunscreen use. In the case of sunbeds, based on the findings and contrary to what was expected, it can be argued that interventions targeting health literacy seem less likely to reduce sunbed use. More research is needed to elucidate the effect of health literacy on sunscreen and sunbed use in order to improve UVR prevention strategies.

Prevalence and determinants of sunbed use in thirty European countries: data from the Euromelanoma skin cancer prevention campaign

“…Even so, we were able to detect alarmingly high prevalence rates in several European countries. Our analysis of the trend between prevalence and latitude confirmed the existence of a North‐South gradient of sunbed use in Europe, with northern countries more likely to use sunbeds, as previously reported . Nonetheless, we found interesting exceptions.…”

“…Although sunbed use has been widely associated with high educational level, we were able to confirm this association only partly. Indeed, our multivariate analysis excluded a large effect of educational attainment on sunbed use.…”

“…A more prevalent use by females was observed for each participating country and was statistically significant after adjustment for important confounders such as age, education and skin type (Georgia and Turkey were exceptions due to low overall prevalence of use; Cyprus, Malta and Moldova were exceptions due to all users being females in those countries). While many studies reported that women are two‐to‐three times more likely than men to engage in indoor tanning, we found that the predominance of female users was even higher (females/males ≥3) in half of the participating countries. Interestingly, the highest disproportions (females/males ≥4) were detected in the Balkans, which we refer to as the Balkan particularity of sunbed use.…”

Who, why, where: an overview of determinants of sunbed use in Europe

“…Women have consistently been reported to be the most eager sunbed users in Europe . Interestingly, most studies have reported that females are two to three times more likely to use indoor tanning than males . Women have also been reported to do more sessions and to spend a longer cumulative time under the lamps .…”

Analysis of methods for the assessment of patients' health literacy and skin cancer

“…U dva obrađena rada analizirana su tri pitanja, za koje je zaključeno da su efikasna u otkrivanju neefikasne ili marginalne zdravstvene pismenosti među odraslom populacijom pacijenata [10,13]. Ova tri pitanja su nastala i procenjena na osnovu njihove efikasnosti u identifikaciji pacijenata sa neefikasnom ili marginalnom zdravstvenom pismenošću upoređenom sa S-TOFHLA (kratka verzija, engl.…”