Evaluation of a multicomponent appearance-based sun-protective intervention for young women: Uncovering the mechanisms of program efficacy.

An appearance-based sun-protection intervention program was developed, implemented, and evaluated in a sample of 211 Caucasian women (ages 18-25) randomly assigned to the sun-protection program or to a stress management (control) program. The sun-protection program incorporated a novel construct of image norms of aspirational peers (i.e., female media figures, fashion models) approving paleness. The authors targeted these image norms as well as the advantages of tanning, health beliefs about photoaging and skin cancer, and self-efficacy for sun protection. The intervention produced significant differences across conditions favoring sun protection on all constructs but severity of skin cancer and barriers to sun protection. At follow-up, treatment participants exceeded controls both in intention to sun protect and sun-protective behavior and reported lower intention to sunbathe and fewer hours of sunbathing. A mediational model of intervention outcomes revealed distinct mediators for sun protection versus sunbathing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of appearance-based interventions on sun protection behaviors.

Objectives: To examine the longer term efficacies of exposure to UV photographs and photoaging information (e.g., wrinkles and age spots) for increasing sun protection intentions and behaviors of young adults. Design: Randomized controlled trial with 4- to 5-month and 12-month follow-ups. Main Outcome Measures: Participants' self-reported sun protection intentions assessed immediately after the interventions, and both self-reported sun protection behaviors and an objective assessment (via spectrophotometry) of skin color change measured at the end of summer (4-5 months following interventions) and 1 year following interventions. Results: Both interventions resulted in immediate positive effects on future sun protection intentions. Both interventions showed objective evidence of less skin darkening at the postsummer follow-up, with those in the photoaging information condition also reporting more sun protective behavior and continuing to show less skin darkening 1 year after intervention. There was also evidence that effects of photoaging information on subsequent skin color change were mediated by the earlier positive effect photoaging information had on participants' intentions to sun protect and their subsequent sun protection behaviors. Conclusions: UV photo and photoaging-information interventions each show promise as a brief and relatively inexpensive approach for motivating sun protection practices that may reduce skin cancer risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of Norwegian adolescents' sunbathing and use of sunscreen.

A nationwide random sample of 15,169 Norwegian high school students completed a questionnaire about tanning habits, physical self-concept, attitudes, beliefs, and values. Although 90% of the adolescents did use sunscreen, less than 25% used an adequate sun-protection factor, and only 50% applied the sunscreen an adequate number of times when sunbathing. Multiple regression analyses identified these predictors of sunbathing: opportunity to sunbathe, tender skin, heavy smoking, playing down the risk for skin cancer, valuing physical appearance, friends' use of sunscreen (girls only), a positive attitude toward having a tan, favorable physical self-concept, friends' use of sunbeds, and friends' sunbathing. Sunscreen use was also predicted by opportunity to sunbathe and skin type. Furthermore, the effects of perceived risk for skin cancer and peers' use of sunscreen were particularly strong. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of appearance-based intervention on sun protection intentions and self-reported behaviors.

Two appearance-based interventions designed to increase sun protection intentions and behaviors were evaluated. Sixty-eight college students in Experiment 1 and 76 beachgoers in Experiment 2 were randomly assigned to receive or not receive a photoaging (premature wrinkling and age spots) information intervention and, separately, to receive or not receive a novel ultraviolet (UV) photo intervention that makes the negative-appearance consequences of UV exposure more salient. Both experiments indicated that the UV photo intervention significantly increased intentions to use sunscreen in the future. A follow-up conducted with the beach sample indicated that UV photo information also produced greater protective behaviors for incidental sun exposure and that the combination of UV photo and photoaging information resulted in substantially lower reported sunbathing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Molecular alterations of canalicular transport systems in experimental models of cholestasis: possible functional correlations

Ajzen's (1988) theory of planned behavior (TOPB) was used to examine psychological determinants of high-risk UV radiation exposure-related behaviors (sunbathing, tanning salon use, and sunscreen use). Undergraduates at a midsized southeastern university were assessed on their psychological and behavioral tendencies toward high-risk UV radiation exposure-related behaviors. The results generally supported the utility of the TOPB as an explanatory model for high-risk behavior. Attitudes were strongly associated with high-risk intentions (e.g., not utilize sunscreen, use salons), whereas subjective norms were less so. Perceived behavioral control was found to moderate the relationship among attitudes, norms, and intentions to sunbathe and tan at a salon. Implications for intervention strategies and future model building in this area are discussed.     

Effects of a multicomponent intervention on motivation and sun protection behaviors among midwestern beachgoers.

Skin cancer is the most prevalent of all cancers in the United States. Although avoiding sun exposure and using sun protection reduces skin cancer risk, rates of such behaviors are moderate at best. The present study examined the impact of a multicomponent intervention that aimed to increase the saliency of skin cancer risk while promoting the use of sun protection. Midwestern beachgoers (n=100) participated in an intervention or questionnaire-only control group. Sun protection, stage of change, and sun exposure were measured at baseline and 2-month follow-up. The intervention group significantly improved in sun protection use and stage of change, but not sun exposure, compared with the control group. Personalizing the risks of unprotected sun exposure combined with providing education about sun protection facilitated healthy changes in behavior and motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial antecedents of needle/syringe disinfection by drug users: a theory-based prospective analysis

Working from the AIDS risk reduction model and other theories of behavior change, we tested psychosocial antecedents of needle/syringe disinfection by 136 injection drug users. High perceived self-efficacy for risk reduction exerted a positive effect on needles/syringe disinfection attempts 1 year later. Self-efficacy was, in turn, related to lower perceived infection risk, peer norms more favorable to risk reduction, and greater knowledge of AIDS. Behavioral intention had no significant effect on subsequent disinfection attempts. These results suggest that disinfecting needles/syringes is partly non-volitional; that high perceived infection risk may be counterproductive to injection risk reduction; and that perceive self-efficacy, but not intention to change behavior, may be a useful leverage point for AIDS preventive intervention.     

Reconceptualizing decisional balance in an adolescent sun protection intervention: Mediating effects and theoretical interpretations.

Objective: The Transtheoretical model (TTM) integrates principles of operant learning, such as stimulus control and reinforcement, and psychological factors, such as decisional balance. Understanding interrelationships between decisions, behavior, and consequences from multiple-theoretical perspectives can advance theory and inform development of more effective interventions. Method: This analysis examined the mediating effects of a special case of the decisional balance construct in which the pros of competing behaviors (i.e., sun protection vs. exposure) were measured rather than the pros and cons of the same behavior. Participants included 819 adolescents (10 to 16 years old, 53.5% girls, 58.4% White) randomized to a 24-month expert system intervention (SunSmart) or a physical activity and nutrition comparison group. Main Outcome Measures: Self-report measures included sun protection behaviors, pros for protection, and pros for exposure. Mediation analysis using latent growth curve models found both the treatment-to-mediator and mediator-to-behavior paths significant for decisional balance, producing an indirect effect of .323 (p Results: Multiple strategies for conceptualizing and measuring decisional balance appear to be valid. Results are interpreted from the TTM and operant perspectives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The theory of planned behavior as a model of heavy episodic drinking among college students.

This study provided a simultaneous confirmatory test of the theory of planned behavior (TPB) in predicting heavy episodic drinking (HED) among college students. It was hypothesized that past HED, drinking attitudes, subjective norms, and drinking refusal self-efficacy would predict intention, which would, in turn, predict future HED. Participants consisted of 131 college drinkers (63% women) who reported having engaged in HED in the previous 2 weeks. Participants were recruited and completed questionnaires within the context of a larger intervention study (see Collins & Carey, 2005). Latent factor structural equation modeling was used to test the ability of the TPB to predict HED. Chi-square tests and fit indices indicated good fit for the final structural models. Self-efficacy and attitudes but not subjective norms significantly predicted baseline intention, and intention and past HED predicted future HED. Contrary to hypotheses, however, a structural model excluding past HED provided a better fit than a model including it. Although further studies must be conducted before a definitive conclusion is reached, a TPB model excluding past behavior, which is arguably more parsimonious and theory driven, may predict HED among college drinkers better than a model including past behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term efficacy of two computer-tailored physical activity interventions for older adults: Main effects and mediators.

Objective: Low-cost (e.g., computer-tailored) interventions with sustained effects are needed to increase and maintain physical activity in older adults. This study examined the long-term efficacy of 2 computer-tailored physical activity interventions for older adults and its psychosocial and environmental mediators. Methods: A clustered randomized controlled trial (N = 1,971) was conducted that included 3 research arms: (a) basic computer-tailored print intervention, targeting psychosocial mediators; (b) environmentally computer-tailored print intervention, targeting psychosocial and environmental mediators; and (c) no-intervention control group. Interventions were developed using the intervention mapping approach and consisted of 3 computer-tailored letters delivered over 4 months. Questionnaires assessed the study outcomes (i.e., total weekly days and total weekly minutes of physical activity) at baseline and 12 months. Potential mediators (i.e., awareness, attitude, self-efficacy, intention, social influence, intrinsic motivation, self-regulation, and perceived environment) were assessed at baseline and at 3 or 6 months. Results: Multilevel regression analyses revealed that both interventions significantly changed total weekly days of physical activity compared with the control group, but only the environmentally computer-tailored print intervention significantly changed weekly minutes of physical activity. Multiple mediation models showed that the effects of both interventions on weekly days of physical activity were mediated by changes in awareness and intention. Conclusions: Computer-tailored interventions were effective in inducing long-term behavioral changes in physical activity behavior of older adults. Awareness and intention were found to be important mediators of changing daily physical activity and should be included in future computer-tailored intervention studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychosocial factors in sunbathing and sunscreen use.

Interviewed 120 sunbathing and nonsunbathing beachgoers about their health practices, knowledge about skin cancer, moods, and social rewards obtained through sunbathing. Ss also completed personality questionnaires. Data were considered using a theoretical perspective combining aspects of health belief, social influence, social learning, and risk-taking models. Results indicate that sunbathing was related to having a positive attitude toward risk taking, having little knowledge about skin cancer, reporting a relaxed mood, having friends who sunbathe, and engaging in activities related to maintaining a positive physical appearance. Sunscreen use was related to sex, having knowledge about skin cancer, knowing people who have had cancer, and reporting high levels of anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting healthier behaviors, attitudes, and beliefs toward sun exposure in parents of young children.

The present study examined the impact of a conceptually driven intervention designed to increase skin cancer knowledge and promote healthier, "sun-safe" attitudes, beliefs, and behaviors about sun exposure in mothers of children ages 6 months to 10 years old. Participants (N?=?55) were assigned to a comprehensive prevention program (CPP), information-only condition (IOC), or a no-information control group (NIC). An assessment battery measuring skin cancer knowledge, sun-safe behaviors, and sun exposure attitudes and beliefs was administered at baseline, 2 weeks postintervention, and 12 weeks postintervention. Consistent with prediction, mothers in the CPP and IOC groups showed significant increases in skin cancer knowledge; however, only those in the CPP condition showed increases in sun-safe behaviors, attitudes, and beliefs that were maintained at the 12-week follow-up. Also, results provide support for the influence of perceived severity, self-efficacy, response-efficacy, and perceived barriers on sun-safe behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specifying the determinants of the initiation and maintenance of behavior change: An examination of self-efficacy, satisfaction, and smoking cessation.

Using data from smokers (N = 591) who enrolled in an 8-week smoking cessation program and were then followed for 15 months, the authors tested the thesis that self-efficacy guides the decision to initiate smoking cessation but that satisfaction with the outcomes afforded by quitting guides the decision to maintain cessation. Measures of self-efficacy and satisfaction assessed at the end of the program, 2 months, and 9 months were used to predict quit status at 2, 9, and 15 months, respectively. At each point, participants were categorized as either initiators or maintainers on the basis of their pattern of cessation behavior. Across time, self-efficacy predicted future quit status for initiators, whereas satisfaction generally predicted future quit status for maintainers. Implications for models of behavior change and behavioral interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial predictors of delay of first sexual intercourse by adolescents.

This investigation predicted adolescents' delay of intercourse onset from attitudes, social norms, and self-efficacy about refraining from sexual intercourse. Age, gender, ethnicity, and parental education were also examined as predictors and moderators of the relationships among the 3 psychosocial determinants and onset. The participants (N?=?827), part of a cohort initially surveyed in the 9th grade, reported at baseline that they had never engaged in intercourse. The multivariable proportional hazards regression model suggested that adolescents with more positive attitudinal and normative beliefs, as well as those with a parent who graduated from college, were less likely to engage in intercourse in the follow-up period (up to approximately 2 years). Interventions that include an objective to delay onset may benefit from addressing psychosocial determinants, especially attitudes and norms about sexual intercourse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When to fix it and when to leave: Relationships among perceived control, self-efficacy, dissent, and exit.

Using a sample of hospital nurses, the author tested the hypothesis that both self-efficacy and perceived control over decision making contribute to individuals' willingness to engage in reformist dissent when faced with injustice and to their intentions to exit. Reformist dissent is defined as dissent that occurs within the confines of an organization's rules and norms. Perceived control over decision making was expected to be positively related to willingness to engage in reformist dissent and to be inversely related to exit. Because it was expected that both dissent and exit require confidence, self-efficacy was predicted to be positively related to both dissent and exit. Control was positively related to willingness to dissent and inversely related to exit. Self-efficacy, however, predicted only dissent. Implications for worker well-being and retention are discussed, and directions for future research and theory development are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility and hearing protection behavior: the mediating role of personal beliefs and low frustration tolerance

The authors examined whether hostility would negatively be associated with occupational health behavior, namely, the use of hearing protection devices (HPDs). Also examined as possible mediators were the protection motivation theory (PMT) components and low frustration tolerance (LFT). Participants were 226 male industrial workers, all exposed to potentially hearing-damaging noise. Hostility was negatively related to HPD use. It moderately correlated with the PMT components: negatively with perceived susceptibility, severity, effectiveness, and self-efficacy and positively with perceived barriers. Hostility correlated highly with LFT. Regression analyses confirmed the mediating role of perceived barriers, low self-efficacy, and LFT in the negative relationship between hostility and the use of HPDs. Thus, intrapsychic characteristics of hostile people may be significant for hearing protection behavior.     

An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians

Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (beta=1.08; P<0.001) and self identity (beta=-0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper.     

The shadow rule: a simple method for sun protection

The intensity of ultraviolet radiation (UVR) from the sun is directly related to the angle of the sun or altitude above the horizon. Solar altitude at any given clock time varies with season and latitude-longitude. The shadow rule indirectly determines the sun's altitude by observing the length of a person's shadow during the time course of a day. When the shadow on a horizontal surface in the sun is equal in length to height of the person casting the shadow, then the altitude of the sun above the horizon is 45 degrees. The tangent of 45 degrees altitude (tan alt) equals 1 or the ratio of the height of the person casting a shadow (y) to the length of the person's shadow (x). In middle latitudes, the intensity of UVR is approximately inversely proportional to the length of the person's shadow. Thus, when a person's shadow is shorter than the person is tall, the intensity of UVR from the sun is more likely to cause sunburn.     

Understanding the unprotected sexual behaviors of gay, lesbian, and bisexual youths: An empirical test of the cognitive-environmental model.

The cognitive-environmental model (CEM; M. Fishbein et al, 1991) was used to understand the unprotected sexual behaviors of 156 gay, lesbian, and bisexual youths. Unprotected anal sex among the males was associated directly with poor protection skills (e.g., incorrect use of barrier methods, such as condoms), poor intentions to use barrier methods, and poor norms by sexual partners concerning barrier methods. Furthermore, the association between low self-efficacy and increasing unprotected anal sex was attributed to poor intentions. Direct associations of unprotected oral sex with poor intentions and poor partner norms also emerged, as did an indirect relation between unprotected oral sex and low self-efficacy via poor intentions. These last 3 findings were replicated when examining unprotected oral or vaginal-digital sex among the females. Relations among the CEM factors supported some CEM-theoretical propositions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)