The Effect of Educational Intervention Based on Health Belief Model and Social Support on Promoting Skin Cancer Preventive Behaviors in a Sample of Iranian Farmers

Abstract

Skin cancer is one of the most common cancers in Iran. Farmers are exposed to the sun's ultraviolet radiation due to their job and are susceptible to skin cancer. The aim of this study is to survey the effect of educational intervention based on health belief model and social support on promoting skin cancer preventive behaviors in farmers of Fasa City, Fars province, Iran. In this quasi-experimental study, 200 farmers (100 in experimental group and 100 in control group) in Fasa City, Fars, Iran, were selected in 2017. The educational intervention for the experimental group consisted of eight training sessions (introduction to skin cancer, risk factors, complications, benefits and barriers to proper use of sunscreen, UV sunglasses and physical protection, self-efficacy in applying preventive behaviors, role of social support). A questionnaire consisting of demographic information, knowledge, HBM constructs (perceived susceptibility, severity, benefits, barriers, self-efficacy and cues to action), and social support was used to measure skin cancer preventive behaviors before, 3 months after the intervention, and 6 months later. Data were analyzed using SPSS-22 via chi-squared, independent samples t test, Mann-Whitney, and repeated measures ANOVA at a significance level of 0.5. The mean age of the farmers was 42.21 ± 10.52 years in the experimental group and 44.28 ± 10.16 years in the control group. Three months after the intervention and 6 months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, cues to action, social support, and skin cancer preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and social support in adoption of skin cancer preventive behaviors in 3 and 6 months post intervention in farmers. Hence, these models can act as a framework for designing and implementing educational interventions for the prevention of skin cancer.

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“…This finding is consistent with the results of (5). Perceived severity also directly affects protective behavior, which is also consistent with previous studies (23)(24)(25)(26). The influence of self-efficacy on behavioral intention is justified by the consideration that when respondents perceive that they have the ability to take preventive measures, they are expressing mental readiness to participate in coping behaviors.…”

Effect of Educational Program-Based Protection Motivation Theory on Preventive Behaviors of Skin Cancer Among Farmers in Kashan

“…The results of a study by Maseudi et al showed a significant difference between the scores of the construct of perceived vulnerability in the intervention group that was measured before and 2 months after the intervention (19). Our findings are also consistent with the results of a study by Jeihooni and Rakhshani entitled "the effect of educational intervention based on health belief model and social support on promoting skin cancer preventive behaviors in a sample of Iranian farmers" (20). This is probably due to the increase in the farmers' sensitivity to the risk of exposure to sunlight after educational program; because of the intervention, they might have found themselves at risk for diseases caused by sunlight, including skin cancer, which occurs due to climate change such as changes in the thickness of the ozone layer.…”

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“…Twenty‐two studies focused on education programmes. Four of the six intervention studies assessing the influence of particular educational programmes on sun‐related knowledge found a significant improvement …”

“…Four studies assessed sun‐related attitudes, of which three found significant differences in the sun risk attitude and perceived sun damage susceptibility . Sixteen studies found a significant protective behavioural changes and two studies reported significant changes in the intention to change sun protection behaviour …”

“…[77][78][79][80] Four studies assessed sun-related attitudes, of which three found significant differences in the sun risk attitude and perceived sun damage susceptibility. [81][82][83] Sixteen studies found a significant protective behavioural changes [20][21][22][79][80][81][83][84][85][86][87][88][89][90][91][92] and two studies reported significant changes in the intention to change sun protection behaviour. 82,93 Four of the nine studies assessing the effect on appearance of sunburns reported a significant change in sunburn incidences.…”