Skin Cancer Knowledge, Beliefs, Self-Efficacy, and Preventative Behaviors among North Mississippi Landscapers

Abstract

There are slightly over one million workers in the landscape service industry in the US. These workers have potential for high levels of solar ultraviolet radiation exposure, increasing their risk of skin cancer. A cross-sectional sample of 109 landscapers completed a self-administered questionnaire based on Health Belief Model (HBM). The participants correctly answered 67.1% of the knowledge questions, 69.7% believed they were more likely than the average person to get skin cancer, and 87.2% perceived skin cancer as a severe disease. Participants believed that the use of wide-brimmed hats, long sleeved shirts/long pants, and sunscreen was beneficial but reported low usage of these and other sun protective strategies. The primary barriers to using sun protection were “I forget to wear it” and “it is too hot to wear.” Of the HBM variables, perceived benefits outweighing perceived barrier (r = .285, P = .003) and self-efficacy (r = .538, P = .001) were correlated with sun protection behaviors. The reasons for absence of the relationship between perceived skin cancer threat and sun protection behaviors could be lack of skin cancer knowledge and low rate of personal skin cancer history.

Skin cancer preventative behaviors in state park workers: a pilot study

“…This finding is in concordance with previous studies that included other professionals, such as landscapers and dairy farmers (67.1 and 70 %, respectively) [11,12]. While the vast majority (87.4 %) believed that skin cancer is a serious disease, less (42.5 %) believed they would develop skin cancer during their lifetime, and even fewer (35.6 %) believed their risk was higher than average.…”

“…It is noteworthy that a substantial number of participants reported ''rarely or never'' wearing long-sleeved shirts (67.8 %), wide-brimmed hats (58.6 %), or sunscreen (60.9 %). The SPB patterns in this study are similar to those reported by outdoor workers in previous studies [11,12]. Collectively, state park workers in the present study showed low levels of SPBs.…”

“…To assess skin cancer risk, participants' characteristics were recorded regarding skin type, hair and eye color, and sun exposure during the day, while at work and during the weekend. A detailed description of the instrument utilized in this study has been provided in our recent previous study [12]. A panel of researchers (one psychologist, one dermatologist, and three park and recreation professionals) established face validity of the instrument.…”

“…A large body of research addressed outdoor workers' SPBs during the summer months and these studies have documented inadequate levels of sun protection practices [11][12][13][14][15][16][17][18][19][20][21]. For example, a Japanese [16] study targeting traffic control and construction workers found that slightly over half (53 %) of the participants wore longsleeved shirts and just 15 % wore sunscreen.…”

Skin cancer risk in outdoor workers: a European multicenter case–control study

“…In the same study, outdoor workers’ sun‐related knowledge and attitudes were found largely inadequate, with many workers stating that they never or only rarely wore a long‐sleeved shirt (50–80%), sun‐protective headgear (30–80%) and sunscreen (30–100%) while working in the sun. Outdoor workers were generally exposed to UVR during work for two to eight hours which far exceeds recommended guidelines . Additionally, many outdoor workers also spent a substantial time outdoors in their leisure time leaving their skin exposed to high doses of UVR .…”