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Background: Ultraviolet (UV) radiation is the most important risk factor for skin cancer development. Sunlight is the main source of UV radiation in the general population. In addition, tanning beds are a source of artificial UV radiation. Since the incidence of skin cancer is increasing worldwide, it is necessary to monitor UV-related risk behaviors such as intentional indoor and outdoor tanning, as well as sun protection behavior in the general population and specific subgroups and settings. This is the aim of the National Cancer Aid Monitoring online (NCAM-online), a continuation and further development of the NCAM. Methods: The NCAM-online is a longitudinal trend study consisting of four annual survey waves. Each year, 4,000 individuals aged 16–65 years living in Germany will be surveyed using online questionnaires. Each year, intentional indoor and outdoor tanning will be assessed. In addition, varying specific topics regarding skin cancer prevention, such as the utilization of skin cancer screening, will be addressed in the questionnaires. Discussion: The findings of the NCAM-online will provide an important basis for the German Cancer Aid and Working Group on Dermatologic Prevention (Arbeitsgemeinschaft Dermatologische Prävention, ADP) to develop targeted prevention campaigns and projects aimed at preventing skin cancer. The explorative nature of the NCAM-online allows for the identification of new potential starting points for prevention and education. In addition, the longitudinal design allows for a description of the trend in the prevalence of intentional tanning. For tanning bed use, representative trend data from 2012 are available for Germany, to which NCAM-online will add annual data until 2027. [ABSTRACT FROM AUTHOR]

Simple Summary: Skin cancer rates in Canada are rising quickly, with about one-third of Canadians likely to be affected in their lifetime. Despite this alarming trend, government actions to reduce skin cancer are limited. Our study, conducted in Manitoba, found that many residents have risky sun exposure habits and lack awareness about skin cancer. Over 65% reported a history of sunburns, more than half had used tanning beds, and a large majority recently tanned for pleasure. Misconceptions are common, with over 50% believing that tans are healthy or a sign of beauty. Moreover, sun protection practices are inadequate, with less than 60% using protective clothing and under 50% using sunscreen. These findings highlight the need for targeted public health campaigns to improve awareness and promote better sun protection behaviors to prevent future skin cancers in Manitoba. The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond. [ABSTRACT FROM AUTHOR]

This article presents the findings of a survey conducted at an outdoor football game to understand sun protection behaviors and barriers among spectators. The survey had a response rate of 90.6% and included questions on demographics, sun protection habits, barriers to use, and history of skin examination. The results showed that older individuals used more sun protection methods compared to younger individuals, and women were more likely to use sunscreen and get skin checks by a dermatologist. The overall rate of sunscreen use was high, but participants aged 18-23 and men were less likely to use sun protection. The article suggests targeted interventions to promote sun safety, increase skin health literacy among college-aged students, and encourage more men to adopt sun-protective practices. [Extracted from the article]

There's growing proof of the impact of sun rays, in their various wave lengths and strengths, on the human skin. That yields more knowledge and recommendations on the means to protect and preserve that vital organ. Nowadays, such information is available thanks to the various formulae and filters of sunscreen products. Protection from UV rays is particularly important due to the high risk of sunburn, DNA mutation and changes, and skin cancer. This report will explore practical recommendations regarding the use of sunscreen, as well as advice on how we can protect ourselves from the impact of sun rays. The general methods for safeguarding from the sun include finding a shade, when you are outside, applying products to keep safe from the sun, wearing protective clothing, a hat and sunglasses. Sunscreen is just one of many measures that are used to protect the skin from the sun rays. [ABSTRACT FROM AUTHOR]

Background Objectives Animals Materials and Methods Results Conclusions and Clinical Relevance Protection from solar ultraviolet radiation (UVR) is paramount in light‐skinned pig breeds such as Yorkshire or Landrace to avoid sunburn.Determination of the UVR exposure of a pig and the sun protection abilities of shade cloths with different shade rates.Life‐sized plastic model of a Landrace pig.The model was equipped with 20 UVR meters at various anatomical positions that recorded the erythemal effective solar irradiance. A turntable enabled irradiation from different directions. Solar irradiance was measured in direct sunlight as well as under three shade cloths with different shade rates (50%, 75% and 90%) and a camouflage net. The sun protection factors (SPF) were determined as the ratio of unshaded‐to‐shaded measurements at the same solar elevation. The exposure ratio to ambient (ERTA) was calculated for each body site with respect to ambient irradiance. It allows determination of when pigs are at risk of sunburn and protection is needed.The calculated ERTA values show that some body parts may receive higher values than ambient UVR. Measurements showed that the SPF of shade cloths depends on textile denseness. Selected shade cloths reached values of 3.5 (shade rate 50%), 4.2 (75%) and 5.8 (90%). Protection by the camouflage net was poor. The highest SPF was gained on body sides where ERTA was highest.Shade cloths can protect all body sites effectively and vulnerable sites in particular. The results of our study enable an estimation of when pigs are at risk of sunburn and provide quantitative metrics for sun protection. This allows effective prevention of UVR‐caused skin damage and secondary disorders. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusions\nKEY POINTSHigh melanoma rates in Queensland, Australia suggest that sun protection campaign message content may require revision. The aim of this experimental study was to explore young Queensland adults’ sun-related exposure and knowledge level, before investigating the effectiveness of five health text messages at improving sun protection intentions.Ninety-five young adults aged 17 to 24 years participated in the study. Most content was modelled on Protection Motivation Theory. The texts allowed for the comparison of fear appeals with and without efficacy messages, health-versus appearance-based messages, and the exploration of understudied, appearance-based message content alluding to melanoma surgery scarring.Proportionally, significantly more females (60.34%) sunbathed compared to males [26.47%, χ2 (1, n = 92) = 8.55, p = .003, phi = -.33], and females (M = 16.03) had significantly greater knowledge levels than males [M = 12.81, t(89), −.3.99, p < .001, η2 = .01]. There was no difference between health and appearance-based messages on participants’ sun protection intentions as assessed by the Protection Motivation Theory χ2 (5, n = 94) = 2.97, p = .704.Future research should contribute to the debates surrounding fear appeals and health-versus appearance-based messages with different communication modalities. Health promotion campaigns on sun protection should target message content to audiences.What this topic adds: Text messages may not be robust enough to distinguish between the effects of appearance and health-based information in determining sun-protective behaviours.Knowledge about melanoma does not deter young females from sunbathing.More robust health communication approaches than health text messages are required for testing the Protection Motivation Theory in predicting sun protective behaviours in samples of young adults with high health literacy.Text messages may not be robust enough to distinguish between the effects of appearance and health-based information in determining sun-protective behaviours.Knowledge about melanoma does not deter young females from sunbathing.More robust health communication approaches than health text messages are required for testing the Protection Motivation Theory in predicting sun protective behaviours in samples of young adults with high health literacy.What is already known about this topic: Queensland Australia is one of the most melanoma susceptible regions of the world.Many young Australian adults are not practicing sun safety.Appearance-based approaches are bett er at persuading younger people to protect against the sun than health-based ones.Queensland Australia is one of the most melanoma susceptible regions of the world.Many young Australian adults are not practicing sun safety.Appearance-based approaches are bett er at persuading younger people to protect against the sun than health-based ones. [ABSTRACT FROM AUTHOR]

Issue Addressed: While the links between sun exposure and skin cancer are well known, the benefits of sun exposure, particularly as a source of vitamin D, are less well known. This paper reports on a deliberative study exploring public perspectives about sun exposure harms and benefits. Methods: Two citizens' juries were conducted in Brisbane and Adelaide to consider questions about sun exposure, vitamin D and health promotion. Members of the general population (jurors) listened to evidence from expert witnesses about the harms and benefits of sun exposure. Most witness sessions extended for 60 min, with 6 sessions over 2 days. At each citizens' jury, jurors were asked to listen to expert testimony, consider the evidence and make policy recommendations. The planning and design of the citizens' juries were informed by well‐established citizens' jury methods. Results: Jurors proposed that Australia needs improved public information about the harms and benefits of sun exposure. They argued for information that supports personal decision‐making that accounts for differences in skin tone and geographical region. Jurors agreed that Australia needs an updated sun safety campaign that reflects new research and addresses diversity. A one‐size‐fits‐all approach to sun protection may no longer be appropriate. Conclusions: While a new campaign should address both harms and benefits, jurors felt the need for skin cancer prevention outweighs the desirability of generating vitamin D through sun exposure. More nuanced public health messages are needed, which balance the need for skin protection and vitamin D, and acknowledge the diversity of Australia's population. So What?: Previous research studies are typically siloed into the separate areas of vitamin D or skin cancer research. This study incorporated both topics and pooled the views of participants in two citizens' juries who agreed on the need for improved information about the harms and benefits of sun exposure to reflect a modern Australian population. [ABSTRACT FROM AUTHOR]

Dermatological conditions and skin cancers are common health concerns that require early detection and intervention. Primary care physicians play a crucial role in recognizing these conditions and serving as the first line of defense against skin cancers. This guide provides a systematic approach to conducting thorough skin examinations and enhancing understanding of common presentations of precancerous and cancerous lesions. We emphasize the importance of performing annual full-body skin exams to facilitate early detection and management of skin conditions, including a step-by-step, systematic protocol for conducting these exams, comprising preparing the patient, documenting findings, educating the patient, and considering biopsy or referral for suspicious lesions. Furthermore, we explore the atypical features of skin lesions that raise clinical suspicion and warrant further investigation. We describe the characteristics of common skin cancers, such as basal cell carcinoma, squamous cell carcinoma, and melanoma. We stress the importance of patient education on self-skin checks and sun protection measures. By incorporating the knowledge and skills presented in this guide, primary care physicians can confidently perform thorough full-body skin checks, identify common dermatological findings and early signs of skin cancers, and provide comprehensive care to patients. This will help ensure optimal outcomes in dermatological health. [ABSTRACT FROM AUTHOR]

Abstract Background Ultraviolet (UV) radiation is the most important risk factor for skin cancer development. Sunlight is the main source of UV radiation in the general population. In addition, tanning beds are a source of artificial UV radiation. Since the incidence of skin cancer is increasing worldwide, it is necessary to monitor UV-related risk behaviors such as intentional indoor and outdoor tanning, as well as sun protection behavior in the general population and specific subgroups and settings. This is the aim of the National Cancer Aid Monitoring online (NCAM-online), a continuation and further development of the NCAM. Methods The NCAM-online is a longitudinal trend study consisting of four annual survey waves. Each year, 4,000 individuals aged 16–65 years living in Germany will be surveyed using online questionnaires. Each year, intentional indoor and outdoor tanning will be assessed. In addition, varying specific topics regarding skin cancer prevention, such as the utilization of skin cancer screening, will be addressed in the questionnaires. Discussion The findings of the NCAM-online will provide an important basis for the German Cancer Aid and Working Group on Dermatologic Prevention (Arbeitsgemeinschaft Dermatologische Prävention, ADP) to develop targeted prevention campaigns and projects aimed at preventing skin cancer. The explorative nature of the NCAM-online allows for the identification of new potential starting points for prevention and education. In addition, the longitudinal design allows for a description of the trend in the prevalence of intentional tanning. For tanning bed use, representative trend data from 2012 are available for Germany, to which NCAM-online will add annual data until 2027.

Abstract Background Little is known about sun‐exposure and sun‐protection behaviors among tattooed individuals. Objectives This study sought to investigate the sun‐exposure and sun‐protective habits among tattooed individuals. Methods Population‐based study using a representative sample of the general population aged ≥18 years from four countries (Brazil, China, Russia and United‐States). All participants were asked to fill in a digital structured questionnaire. We inquired about socio‐demographics, self‐evaluation of their skin phototype (from I to VI), tattoo(s) and sun‐exposure and sun‐protection habits. Results A total of 9031 adult participants responded to the questionnaire of whom 1682 (18.6%) had ≥ 1 tattoo(s). The prevalence of tattoos was significantly higher among individuals with lighter skin tone (phototype I to III, 20.2%) compared to those with darker one (phototype IV to VI, 13.9%, p

Objective Methods Results Conclusions We investigated the association between sun protection behaviours and demographic and melanoma risk characteristics of patients attending Australian melanoma specialist clinics. This may assist in targeting and tailoring melanoma prevention patient education for people at high‐risk and specific population subgroups.A cross‐sectional analysis of questionnaire data collected from participants attending the dermatology clinics at two major melanoma centres in Sydney, Australia between February 2021 and September 2023. The primary outcome was Sun Protection Habits (SPH) index (a summary score measured as habitual past month use of sunscreen, hats, sunglasses, a shirt with sleeves that covers the shoulders, limiting midday sun exposure and seeking shade, using a Likert scale). The primary analysis considered the SPH index and its component items scored as continuous.Data from 883 people were analysed. Factors associated with less frequent sun protection behaviours overall included male gender, no personal history of melanoma, lower perceived risk, lower calculated 10‐year risk of developing melanoma, and no private health insurance. People aged >61 years reported lower use of sunscreen but higher use of hats and sleeved‐shirts compared with people in the younger age group. There was no difference in overall sun protection behaviours according to family history of melanoma, country of birth or by lifetime melanoma risk among people without a personal history of melanoma.These findings highlight the potential for targeting high‐risk individuals with less frequent use of sun protection for patient education, public health messaging and ultimately improving sun protection behaviours. [ABSTRACT FROM AUTHOR]

Background: Organ transplant recipients (OTR) are more likely to develop skin cancer than the general population. One of the main components of the exposome that triggers the development of skin tumours is solar ultraviolet (UV) radiation. To reduce the incidence of harmful consequences of sun exposure, sun protection education is needed for patients taking long‐term immunosuppressive drugs. Methods: In a previous study, we assessed the sun‐safe behaviour of 221 OTR using a questionnaire before and after transplantation and personally educated the patients about proper sun protection. After the education, there were no further reminder presentations. Presently, the sun protection and sun seeking habits of the available 176 of these patients were questioned to assess the long‐term effect of the previous sun protection education. Results: Two‐four years after the education, more patients wore hats and protected their skin with long‐sleeved clothing than before the education. In terms of sun seeking habits, both occupational and recreational sun exposure decreased significantly. Significantly fewer people went on holiday after transplantation, but those who went on holiday spent significantly less time in the sun. Conclusion: The long‐term positive effects of education can be seen both in the patients' sun protection and in their sun seeking habits. However, the long‐term goal is to maintain these results and thereby reduce the likelihood of skin tumours and consequently the associated tumour death. [ABSTRACT FROM AUTHOR]

Issue Addressed: Strategies that support the implementation of the SunSmart program in primary schools are essential to optimising policy uptake. Evidence outlining the type of support required, however, is lacking. This project explored the usefulness of an implementation support approach to sun safe hat‐wearing in schools. Methods: Formative research was undertaken with 16 primary schools in Greater Western Sydney to explore current sun protection behaviours and practices, perceived barriers and motivators of sun safe hat‐wearing, and resource needs. Based on these insights, a resource toolkit was developed and tested in 14 demonstration sites. Follow‐up interviews evaluated the usefulness of the toolkit and implementation support approach. Results: Sun safe hat‐wearing practices varied among schools. Commonly reported motivators included school policies, role modelling, incentives and knowledge. Commonly reported barriers included negative social norms, forgetfulness, cost and lack of understanding. Formative insights informed the development of the 'Motivation, Access, Triggers' Model and a 23‐resource toolkit. Following toolkit rollout, champions reported that the ability to select resources according to local needs was useful, and most found that the toolkit supported their school with sun safe hat‐wearing. Conclusions: A toolkit with local champions and leadership buy‐in has the potential to improve policy implementation. The opportunity to prioritise resource selection enables schools to address their specific needs in line with their sun protection policy. So What?: The provision of policy implementation support can help schools overcome the challenges of transforming a written SunSmart policy into practice. [ABSTRACT FROM AUTHOR]

The incidence of skin cancer has risen steadily over recent decades. Childhood and adolescent sun exposure remains a critical risk factor in skin cancer development, making education of high schoolers imperative for promoting sun-safe behaviors. Medical students in North Carolina recognized this need and designed a skin cancer education program focused on portraying skin cancer in individuals with all Fitzpatrick skin phototypes. Eighty-seven students completed the pre-survey, and 84 completed the post-session survey. In the post-survey, 88% of students listed actionable behavioral changes they plan to make following the presentation. Following an educational session, students were able to demonstrate their new knowledge and provide meaningful behavioral changes. This program navigated challenges posed by COVID-19 and addressed the need for more inclusive skin cancer educational material. [ABSTRACT FROM AUTHOR]

Introduction: Children’s skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Young children are dependent on sun protection measures taken by parents and other caregivers. Objective: The aim of the study is to evaluate parental sun protection behavior and sun protection measures at preschool at 2 points in time (2010/11 and 2018/19) in Bavaria and to test for a secular trend. Methods: Two cross-sectional surveys were carried out. For each survey, more than 4,000 parents of preschoolers completed a self-administered questionnaire about parental sun protection behavior and sun protection measures at preschool. To identify possible associations between parental sun protection behavior and sociodemographic characteristics, logistic regression analysis was carried out. Results: In the survey of 2018/19, 6 out of 8 sun protection measures are adequately applied by over two-thirds of the parents. Two out of 8 sun protection measures are adequately applied by less than one-third of the parents. Those 2 measures are aligning sun protection to actual UV index and preschoolers wearing sunglasses. The comparison of the study population of the survey of 2010/11 and of 2018/19 shows an improvement in parental sun protection behavior for 7 out of 8 sun protection measures. In both surveys more than 80% of parents state that preschool staff ensures preschoolers wearing sun hats and sunscreen outside on sunny days. Conclusion: Future campaigns should focus on the use of sunglasses and promote the UV index, as these sun protection measures are used very little.

OBJECTIVE: Skin cancer remains prevalent despite numerous studies reporting the benefits of sunscreen for reducing risk of skin cancer and sunburn. While the risks of not wearing sunscreen are well-documented, there are no effective interventions to promote sunscreen use across populations, and existing interventions have modest outcomes. The current study investigated a novel intervention to increase sunscreen use. METHODS: Participants (n=15) first reported their baseline daily sunscreen use then completed sunscreen sampling and selection procedures that included testing sunscreen samples, choosing preferred sunscreens to take home and sample further, and ultimately selecting a preferred sunscreen to use for the remainder of the study. Participants then self-reported their daily sunscreen use for approximately two weeks (+/-5 days). RESULTS: All participants increased sunscreen use following intervention. LIMITATIONS: Data were collected between January and May; individuals may increase sunscreen use as temperatures increase (and time outdoors increases). Additionally, the current study relied on self-report of sunscreen use primarily. CONCLUSION: Our findings suggest that sampling and election procedures may be an effective strategy to promote sunscreen use. The findings of this study may inform future research examining sunscreen intervention strategies. [ABSTRACT FROM AUTHOR]

Abstract Background Skin cancers resulting from excessive exposure to solar ultraviolet (UV) radiation are on the rise. This study aims to investigate the impact of facial-aging app intervention on promoting safe and healthy behaviors and its influence on reducing students' UV exposure. Method Utilizing a Pretest–Posttest repeated-measures design, we developed a theory-guided web app on the WhatsApp platform, named the Sunshine and Skin Health app. This app allows users to visualize their altered faces in three stages of adolescence, middle age, and old age based on sun protection behavior. The intervention continued within WhatsApp, incorporating 27 health messages grounded in the PMT theory, eight educational files, and a skin cancer video clip. The primary outcome is the change in sun protection behavior between the two groups (intervention and control) immediately after the intervention (T2) and the secondary outcome is the change in sun protection behavior between the two groups at 3 months follow-up (T3). The data are analyzed in SPSS 22 and a significance level of 0.05 is considered. Results The results revealed no significant difference between the two groups before the intervention. However, in the intervention group, there were significant differences in the utilization of sunglasses, hats, and sunscreen in the last month, as well as sunscreen reapplication after washing their hands and face, both immediately after the intervention and at the 3-month follow-up, compared to the control group (P = 0.001). Furthermore, a significant intervention effect, time effect, and interaction effect between group and time were observed in behaviors related to using sunscreen in the last month and sunscreen reapplication after washing hands and face (P = 0.001). Specifically, the intervention group exhibited a significant difference from Time 1 to 2 and from Time 1 to 3 (p = 0.001), but no significant difference from Time 2 to 3. In contrast, the control group did not show any significant differences over time. Conclusions This study indicated that the Facial-Aging web app can effectively encourage safe behaviors in sunlight. To ensure the maintenance and sustainability of these behaviors over the long term, it is crucial to consider implementing booster sessions. Trial registration Iranian Registry of Clinical Trials IRCT20200924048825N1. Registered prospectively on 8 February 2021.

Background: Chronic exposure to sunlight is known to cause melanomas, cancers, and photoaging of the skin. The major risk factor associated with these conditions is chronic exposure to ultraviolet rays from the sun, and this can be mitigated with sun protective measures including frequent use of sunscreens as these are known to reflect or absorb these rays. The study aimed to assess the knowledge and prevalence of sunscreen use among undergraduate medical students in a university in Lagos, Nigeria. Methods: A descriptive, cross-sectional study was conducted among medical undergraduate students in the College of Medicine, University of Lagos. Data were collected through an online self-administered questionnaire from 273 participants across all the levels. Analysis was done using IBM SPSS version 26 for Windows. The data obtained were evaluated using the descriptive and parametric tests. Results: Most of the participants were knowledgeable about the sunscreen use. The mean percentage knowledge score was 69% ± 16.2%. This knowledge, however, did not translate into use as only 77; 28.2% of the participants currently used a sunscreen; out of which 83.1% (64) were females. The study showed that the most common reasons for not using sunscreens included no reason in particular, high cost, and not thinking it was necessary for black skin in 58%, 38%, and 26% of the respondents, respectively. Other methods of sun protection used more frequently among the respondents were sun avoidance, hats, and sunglasses. Conclusion: The prevalence of sunscreen use among medical students in Nigeria is low compared to other studies done in similar populations in the West and Asia. More enlightenment is needed to improve the awareness and practice of sunscreen use in young adults.

Background: Skin cancers resulting from excessive exposure to solar ultraviolet (UV) radiation are on the rise. This study aims to investigate the impact of facial-aging app intervention on promoting safe and healthy behaviors and its influence on reducing students' UV exposure. Method: Utilizing a Pretest–Posttest repeated-measures design, we developed a theory-guided web app on the WhatsApp platform, named the Sunshine and Skin Health app. This app allows users to visualize their altered faces in three stages of adolescence, middle age, and old age based on sun protection behavior. The intervention continued within WhatsApp, incorporating 27 health messages grounded in the PMT theory, eight educational files, and a skin cancer video clip. The primary outcome is the change in sun protection behavior between the two groups (intervention and control) immediately after the intervention (T2) and the secondary outcome is the change in sun protection behavior between the two groups at 3 months follow-up (T3). The data are analyzed in SPSS 22 and a significance level of 0.05 is considered. Results: The results revealed no significant difference between the two groups before the intervention. However, in the intervention group, there were significant differences in the utilization of sunglasses, hats, and sunscreen in the last month, as well as sunscreen reapplication after washing their hands and face, both immediately after the intervention and at the 3-month follow-up, compared to the control group (P = 0.001). Furthermore, a significant intervention effect, time effect, and interaction effect between group and time were observed in behaviors related to using sunscreen in the last month and sunscreen reapplication after washing hands and face (P = 0.001). Specifically, the intervention group exhibited a significant difference from Time 1 to 2 and from Time 1 to 3 (p = 0.001), but no significant difference from Time 2 to 3. In contrast, the control group did not show any significant differences over time. Conclusions: This study indicated that the Facial-Aging web app can effectively encourage safe behaviors in sunlight. To ensure the maintenance and sustainability of these behaviors over the long term, it is crucial to consider implementing booster sessions. Trial registration: Iranian Registry of Clinical Trials IRCT20200924048825N1. Registered prospectively on 8 February 2021. [ABSTRACT FROM AUTHOR]

The use of sun protection products has seen a significant evolution in terms of usage frequency in recent years. These products have transitioned from only offering protection against erythema – i.e., sunburns caused by UV rays – to broad-spectrum UV protection products. They not only prevent erythema but also offer multiple benefits in the fight against photoaging of the skin, depigmentation, protects the integrity of cellular DNA, and reduce the risk of photocarcinogenesis. A synthesis of research in the field of UV protection highlights the essential aspects regarding sunscreen products, including the advantages and disadvantages of the most commonly used UV filters. This article underscores the crucial aspects that healthcare professionals need to consider in order to provide informed guidance to patients regarding sun protection products. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ultraviolet Radiation (UVR) from the sun is a significant environmental component that impacts on human health. Excessive UVR exposure has immediate impacts like burning and tanning, as well as long-term consequences including skin damage, photo-aging, skin malignancies. The objective for this study is to determine the student's knowledge, attitude and practice regarding solar ultraviolet exposure in Karachi, Pakistan. METHODS: A cross-sectional study was done in Public Sector University; total 361 students were recruited through stratified cluster sampling from different colleges of university. Data collection was done by validated structured questionnaire. Logistic regression was used to determine the association of outcome variables with risk factors and p-value of <0.05 as a threshold of statistical analysis. RESULTS: Most of the students were appropriate knowledge (71%), positive attitude (51%) and safe practice (54%) regarding ultraviolet solar exposure. Almost half (69%) of participants were used sun protective agents. After adjustment of covariate, female gender (OR 2.20 (95% CI 1.29-4.07) (p-value 0.004), significantly associated with in-appropriate knowledge, third year students (OR 2.93 (95% CI 1.01-8.95) p-value 0.048) were significantly associated with negative attitude. Age group 18-21 years (OR 1.75(95% CI 1.43-5.31) p-value 0.003) were significantly associated with un-safe practice regarding solar ultraviolet exposure harmful effects. CONCLUSION: This study found that knowledge level was appropriate but attitude and practice level need to improve for prevention of harmful effects of solar ultra violet ray exposure. The study encourages students to be more aware of sun protection behavior in order to avoid the long-term effects of sun exposure. [ABSTRACT FROM AUTHOR]

Introduction: Skin cancer is currently the most common cancer type worldwide, and numbers are rapidly increasing. To improve primary prevention, individualised prevention strategies may be of interest as this enhances the chance of long-term behavioural change. The Sun Exposure and Protection Index (SEPI), previously validated in multiple languages, is a tool that could help identify individuals with risky behaviour and tailor interventions to the person's propensity to change. The aim of the present study was to investigate the reliability and validity of a Dutch version of the SEPI for both usage in daily clinical practice and research. Methods: Patients were included at primary care settings and dermatology outpatient settings in a 1:1 ratio. Participants were asked to fill out the SEPI together with some baseline characteristics and the previously validated FACE-Q Skin Cancer – Sun Protection module. Construct validity was tested by comparing SEPI part I and the FACE-Q module using Spearman's Rho. Internal consistency was assessed with Cronbach's Alpha for both SEPI parts separately. To assess test-retest reliability, the SEPI was again filled out 3 weeks later, and scores were compared with Cohen's weighted Kappa. Results: Of the 171 participants completing the first questionnaire, 147 (86.0%) participants also completed the follow-up questionnaire. Comparison between the corresponding SEPI part I and FACE-Q module questions showed good correlations regarding sun exposure habits (correlation coefficients ranging from 0.61 to 0.85). Internal consistency of SEPI part I was 0.63 and SEPI part II was 0.65. The test-retest analysis indicated reproducibility over time (weighted Kappa ranging from 0.38 to 0.76). Conclusion: In conclusion, the Dutch version of the SEPI is shown to be a valid and reliable tool for both usages in daily clinical practice and research to evaluate individual ultraviolet exposure and measure a person's propensity to limit it. [ABSTRACT FROM AUTHOR]

Issue Addressed Method Results Conclusion So What? It is unknown whether SunSmart health promotion campaigns in Western Australia are still effectively reaching their target audience of young people (under 45 years). This study examined trends over time in awareness, relevancy and believability of SunSmart advertisements and identified socio‐demographic characteristics and risk factors associated with campaign awareness.Linear regression and log‐binomial modelling were undertaken using data from the annual SunSmart post‐campaign evaluation surveys between 2008/2009 and 2021/2022. SunSmart campaigns were analysed and categorised into the following themes: (1) personal real‐life stories; (2) daily activities/sun exposure leads to skin cancer; or (3) cartoon/animated.Between 2008 and 2022, there were declines in total awareness (74.2% to 20.4%), unprompted awareness (33.7% to 4.9%) and relevancy (89.5% to 54.8%) of SunSmart advertisements (representing annual percent decreases of 3.6%, 3.1% and 1.8%, respectively). However, believability remained high over time (>94% in each annual survey). Trends were inconsistent between the awareness of campaign themes and socio‐demographic characteristics and risk factors. Several campaigns had greater awareness in their subsequent years, compared with the first campaign year.In more recent years, SunSmart advertisements and campaigns may not have reached their target audience. In addition to socio‐demographic characteristics, particularly age, advertisement factors may also affect the awareness of specific campaigns.Given the changing advertising landscape and its rising costs, ongoing funding is pertinent to increase the reach of future SunSmart campaigns. Increasing advertisements on alternative platforms and designing campaigns which separately target adolescents and adults need to be considered. [ABSTRACT FROM AUTHOR]

Objective: In contrast to previous research that has primarily focused on gender differences in health behaviour compliance, this study explored the association between gender consciousness and sun protection in China – a cultural setting in which there is a pronounced gender bias towards sun protection. These article is the first attempt to examine gender norms concerning sunscreen use among Chinese individuals, encompassing both young women and young men. Design and setting: Cross-sectional analysis conducted on one Chinese campus. Methods: Utilising data from the 2020 cohort of first-year students (549 male students and 1,489 female students) at a local university in Shanghai and employing OLS regression analysis, our analysis sheds light on gendered patterns of sun protection use among young individuals in China. Results: Findings reveal that gender attitudes affect women's sun protection frequency without influencing their choice of specific products. Conversely, men's gender conciousness shapes their sun protection methods but not their overall frequency of sun protection. In addition, despite lower aggregate levels of sun protection, young women exhibit higher heterogeneity in their responses than young men. Socioeconomic status, health awareness and gender consciousness are all significant factors influencing sun protection among female students; however, among men, only health awareness shows a positive correlation with the use of sun protection. Conclusion: The results of this study exhibit some differences from initial expectations, suggesting that the full adoption of sun protection measures is still a work in progress. However, despite the differences identified, findings provide valuable insights to inform future public health efforts to promote sun protection among youth. [ABSTRACT FROM AUTHOR]

This audience segmentation of visitors at coastal parks in Hawaii and North Carolina addresses an emergent natural resource management concern and risk to aquatic ecosystems: sunscreen chemical pollution. Four audiences were identified that correspond to different behavioral profiles: sunscreen protection tourists, multimodal sun protection tourists, in‐state frequent park visitors, and frequent beachgoers who skip sunscreen. The second‐largest audience, sunscreen protection tourists, represents 29% of visitors at Cape Lookout National Seashore and 25% at Kaloko‐Honokōhau National Historical Park. This group ranks of most concern for chemical pollution because they use sunscreen, but not typically mineral formulations or other methods such as protective clothing, and they have lower levels of sunscreen chemical issue awareness. The identification of similar audience segments across regions with differing cultural characteristics and sunscreen regulation status suggests the robustness of the model and its indicator variables, with implications for both environmental protection and public health. Further, coastal visitors' interest in enacting pro‐environmental sun protection behaviors during their next park or beach visit indicates the potential for natural resource managers to holistically address risks in both domains through targeted interventions with audiences of most concern. [ABSTRACT FROM AUTHOR]

The concept of modern human sun protection is no more than one hundred years, but real development of it, including protection against UVA + UVB radiation (and more recently also the IR and blue light), has been no more than 30 years. One fundamental issue while formulating sunscreens is the photostability of the UV filters, which is particularly feeble for the UVA. The gold standard for the determination of sunscreen UVA protection "in vitro" is ISO 24443:2021. Still, interlaboratory results are not as consistent as expected. The Technical Committee for Cosmetics (ISO TC 217) has tried to standardize the method with precise specifications for the materials and equipment used. In particular, the standardization of UV exposure sources based on Xe arc lamps. This fact requires expensive equipment out of the reach of many laboratories to achieve adequate temperature control on the samples. In this paper, it will be shown that, within the experimental error, satisfactory results were achieved with a cheap commercial LED source irradiating only in the UVA spectra. Evidence is presented to conclude that other more relevant factors must be considered as the main cause of uncertainties. [ABSTRACT FROM AUTHOR]

Excessive exposure to ultraviolet (UV) light leads to acute and chronic UV damage and is the main risk factor for the development of skin cancer. In most countries with western lifestyle, the topical application of sunscreens on UV‐exposed skin areas is by far the most frequently used preventive measure against sunburn. Further than preventing sunburns, increasing numbers of consumers are appreciating sunscreens with a medium‐ to high‐level sun protective factor (SPF) as basis for sustainable‐skin ageing or skin cancer prevention programs. However, recent investigations indicate that clinically significant DNA damages as well as a lasting impairment of cutaneous immunosurveillance already occur far below the standard of one minimal erythema dose (MED) sunburn level, which contributes to the current discussion of the clinical value of high‐protective SPF values. Ex vivo investigations on human skin showed that the application of SPF30 reduces DNA damage for a day long sun exposure (24 MED) drastically by about 53% but is significantly surpassed by SPF100 reducing DNA damage by approx. 73%. Further analysis on different SPF protection levels in UV‐exposed cell culture assays focusing on IL‐18, cell vitality and cis/trans‐urocanic acid support these findings. Whereas SPF30 and SPF50+ sunscreens already offer a solid UVB cover for most indications, our results indicate that SPF100 provides significant additional protection against mutagenic (non‐apoptotic‐) DNA damage and functional impairment of the cutaneous immunosurveillance and therefore qualifies as an optimized sunscreen for specifically vulnerable patient groups such as immunosuppressed patients, or skin cancer patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the knowledge, attitudes, and practices of people with albinism (PWAs) related to photoprotection and prevention of skin cancers in Togo. Materials and Method: A qualitative, cross-sectional study was conducted over a period of three months in the year 2020 among PWAs over eighteen years of age residing in Lomé, Togo. Results: A total of 78 PWAs were interviewed. Their mean age was 23.38 ± 15.11 years (extremes: 18 and 63 years), and their sex ratio (M/F) was 0.81. In terms of knowledge, all PWAs declared that photoprotection was essential to prevent skin cancers. Interview data revealed the following strengths: wearing a wide-brimmed hat (n = 77; 98.7%) and using sunscreen cream (n = 75; 96.2%) were the main means/measures of prevention. In terms of attitudes, only 27 PWAs (34.6%) said that a dermatology consultation would be their first reaction to an unusual skin lesion. The main prevention means/measures in their possession were wide-brimmed hats (91.3%), sunscreen creams (85.9%), dark clothes (76.9%), and tinted glasses (70.5%). Regarding the practices, sunscreen creams were used by 88.5% of PWAs (n = 69). About two-thirds (64.1%) of respondents used tinted glasses to protect themselves from the sun. Finally, less than a quarter of the respondents (17.9%) consulted a dermatologist for a skin lesion in the last twelve months. Conclusion: The results of this study indicated that PWAs in Togo have fairly good knowledge about photoprotection and prevention of skin cancers. Attitudes and practices were generally positive but some behaviors such as dermatological follow-up still require improvement. [ABSTRACT FROM AUTHOR]

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Background: Chronic exposure to sunlight is known to cause melanomas, cancers, and photoaging of the skin. The major risk factor associated with these conditions is chronic exposure to ultraviolet rays from the sun, and this can be mitigated with sun protective measures including frequent use of sunscreens as these are known to reflect or absorb these rays. The study aimed to assess the knowledge and prevalence of sunscreen use among undergraduate medical students in a university in Lagos, Nigeria. Methods: A descriptive, cross-sectional study was conducted among medical undergraduate students in the College of Medicine, University of Lagos. Data were collected through an online self-administered questionnaire from 273 participants across all the levels. Analysis was done using IBM SPSS version 26 for Windows. The data obtained were evaluated using the descriptive and parametric tests. Results: Most of the participants were knowledgeable about the sunscreen use. The mean percentage knowledge score was 69% ± 16.2%. This knowledge, however, did not translate into use as only 77; 28.2% of the participants currently used a sunscreen; out of which 83.1% (64) were females. The study showed that the most common reasons for not using sunscreens included no reason in particular, high cost, and not thinking it was necessary for black skin in 58%, 38%, and 26% of the respondents, respectively. Other methods of sun protection used more frequently among the respondents were sun avoidance, hats, and sunglasses. Conclusion: The prevalence of sunscreen use among medical students in Nigeria is low compared to other studies done in similar populations in the West and Asia. More enlightenment is needed to improve the awareness and practice of sunscreen use in young adults. [ABSTRACT FROM AUTHOR]

ObjectiveWe sought to evaluate the impact of the coronavirus-19 (COVID-19) pandemic on sun-seeking and sun-safe behaviors.MethodsWe conducted an online, cross-sectional, population-based survey.ResultsIn total, 1,001 respondents participated in the survey and reported being exposed to 12 or more hours of sunlight (i.e., direct and indirect ultraviolet light, and blue light) each day. Participants self-reported a net increase in all types of light exposure since the onset of the COVID-19 pandemic, especially to blue light (+38%). Notably, while the effects of direct sunlight were well known among survey respondents, they were less aware of the potential damaging impact of indirect sunlight and blue light.LimitationsAs the survey was only conducted among residents of the United States, results might not be generalizable to all geographical regions.ConclusionSocial outreach strategies are required to improve sun-safe behaviors. Future behavioral interventions should encourage the implementation of broad-spectrum sun protection.

Analytics for behavioral habit typically model one behavior at a time, despite the fact that habit often involves multiple cooccurring behaviors, such as food choices and physical activities, where interrelated behaviors are often equally recommended. We propose a novel Mixed-Effects Dynamic hAbit model (MEDA) to simultaneously model multiple related, habitual behaviors. As an illustrative example, MEDA was applied to real-time assessments of sun protection (sunscreen, shade, hat, and protective clothing) reported twice daily by first-degree relatives of melanoma patients who are themselves at an elevated risk of skin cancer. MEDA aims to explicate habits in sun protection under varying environmental cues (e.g., sunny and hot weather). We found consistent between-group differences (e.g., men responding to weather cues more consistently than women) and interactions between cooccurring behaviors (e.g., being in shade discourages sunscreen wearing, more so in men than women). Moreover, MEDA transcends conventional methods to address longstanding challenges—how cue to action and volitional choices differ by groups or even by individual persons. Such nuances in interrelated habitual behaviors are relevant in numerous other applications, such as recommended dietary or physical activity behaviors. These methods best inform personalized behavioral interventions targeting individual preferences for precision behavioral intervention.

Simple Summary: A clear understanding of why the incidence of cutaneous melanoma continues to rise despite the increased use of sunscreens within the last several decades is lacking. Given how aggressive cutaneous melanoma can be, the aim of this communication is to better elucidate the relationship between sunscreen use and melanoma development and if there are other preventative measures to be aware of. We summarize some of the limitations of existing studies that investigated sunscreen use and melanoma development and highlight the importance of performing new studies that minimize such limitations to obtain more reliable results. This communication is intended to emphasize the importance of continued research not only to determine the most important factors contributing to increasing melanoma rates but also to establish clear guidelines and recommendations to reduce the risk of melanoma development. The incidence of cutaneous melanoma continues to rise despite the increased use of sunscreens within the last several decades. Some research even suggests that the use of sunscreen is associated with increased rates of melanoma. Given the aggressive, and often deadly, nature of cutaneous melanoma, the aim of this communication is to better elucidate the relationship between sunscreen use and melanoma development and if there are other preventative measures to be aware of. A search was performed to identify the studies that have investigated melanoma development in individuals who used sunscreen and those who did not. Study limitations and possible confounding variables were identified, which guided a subsequent search to determine what data were available to support that these limitations and confounding variables may explain the perplexing association between sunscreen use and melanoma development. Five hypotheses were generated, which were related to increased awareness and reporting, the relationship between sunscreen use and the duration of sun exposure, the importance of broad-spectrum protection, and the effect of sunscreen on reactive oxygen species formation. The main conclusion is that more recent studies that control for confounding variables are required to determine the true effect of adequate broad-spectrum sunscreen use today on the development of melanoma. [ABSTRACT FROM AUTHOR]

Background: Sunburn can increase one's risk of developing skin cancer. We aimed to quantify the prevalence of sunburn during recreational outdoor sport (ROS) in summer, to explore the use of different sun protection measures, and to examine factors associated with sunburn during ROS using a population‐based sample from Germany. Methods: For this cross‐sectional study, 2081 individuals aged 16–65 years who reported being engaged in ROS in summer were surveyed via standardized telephone interviews in 2020 (National Cancer Aid Monitoring, NCAM). Results: Overall, 16.7% reported experiencing at least one sunburn during ROS in the past twelve months. Sunburn occurrence was negatively associated with the age of the participants (e.g. OR = 0.49 in 56–65 year‐olds, p <.001), and positively associated with skin type I/II (OR = 1.55, p <.001) and with having a higher number of nevi (OR = 1.42, p =.005). While wearing sleeved shirts was the most frequently‐used sun protection measure during ROS (74.9%), wearing headgear was least common in our sample (29.0%). In multivariate analyses, sunburn was positively associated with the use of sun protection measures (e.g. OR = 1.32 for wearing sleeved shirts, p =.02). Conclusions: Our nationwide data show that ROS is one of the settings where sun protection should play a greater role. Especially in organized sports, particular attention should be devoted to organizational (e.g. exercise outside peak hours) or contextual measures (e.g. shade by the natural or built environment) to prevent skin cancer in later life. [ABSTRACT FROM AUTHOR]

Skin cancer is the most diagnosed cancer in the United States. Despite years of education about prevention, incidence is increasing. There are mixed findings about sun protection factors' relationship to preventing sunburn. This study aimed to identify the factors associated with the performance of sun-protective behaviors and understand sunburn risk factors, which relate to skin cancer risk, controlling for demographic factors. This is a secondary analysis of cross-sectional data from the National Health and Nutrition Examination Survey from 2017 to 2018. Data were subset to U.S. participants ages 20 years and older who answered the dermatology questions, which included 3,404 people. A hierarchical logistic regression analysis was conducted in SPSS to investigate the contribution of several factors predicting sun-protective behaviors while controlling for demographic variables. In addition, multiple logistic regression analyses were used to examine potential factors related to getting a sunburn. Statistical significance was p < .05. Race, education, birth country, gender, and sun sensitivity were significant predictors of sun protection behaviors. Those who used sunscreen with a higher frequency and those with severe sun sensitivity had the highest odds of reporting a sunburn. Younger age and severe sun sensitivity were associated with multiple sunburns. The discrepancy between the perceived level of sun sensitivity and the incidence of sunburn suggests that people need to be adequately informed about the risks of sunburn. This finding supports the need for additional research to understand the attitudes and health beliefs toward sunburn and skin cancer prevention. [ABSTRACT FROM AUTHOR]

Simple Summary: Melanoma is a form of skin cancer that can be prevented by limiting exposure to the sun. Among the Atlantic provinces of Canada, varying incidence rates of melanoma have been reported. The province of New Brunswick has melanoma incidence rates comparable to the national average, while in Nova Scotia and Prince Edward Island, the rates are above the national average, and in Newfoundland and Labrador, the rates are below. We conducted focus groups with participants in Atlantic Canada to understand the factors contributing to this difference. We found that Canadians living in Nova Scotia and Prince Edward Island—provinces with high melanoma incidence rates—were more likely to report using sun protection, more aware of the health risks of sun exposure, and more apt to follow the UV index. Despite this, they also received more sun exposure due to warmer temperatures and a tendency to engage in outdoor occupations and recreational activities. These findings suggest a sunscreen paradox, whereby individuals with higher levels of sun exposure also tend to use more but not an adequate quantity of sunscreen or other sun-protection measures, providing a false sense of security. Tailored sun protection campaigns must consider this sunscreen paradox and the unique norms of communities in Atlantic Canada and elsewhere in the world to design effective messaging. Globally, cutaneous melanoma (CM) incidence is increasing, with sun exposure identified as a key modifiable risk factor. The Atlantic provinces of Canada display varied CM incidence rates: New Brunswick aligns with the national average, while Nova Scotia and Prince Edward Island exceed it, and Newfoundland and Labrador fall below this benchmark. We investigated the relationship between sun exposure and CM in these provinces. Twenty-two focus groups encompassing 95 Atlantic Canada residents were conducted and transcribed. A thematic analysis was conducted in MAXQDA using the social–ecological model as a framework. Residents of high-CM incidence provinces demonstrated greater sun exposure awareness, consulting UV indices, and using sunscreen and sun-protective clothing. However, they received greater UV exposure due to warmer climates and outdoor work and cultural activities. Conversely, those in low-incidence provinces used sunscreen and sun-protective clothing less often, engaged in occupations and hobbies affording less sun exposure, and lived in cooler climates. Our data supports a possible "sunscreen paradox", whereby increased sunscreen use is correlated with augmented sun exposure, leading to a deceptive sense of security. Public health initiatives in Atlantic Canada promoting sun safety must address this paradox while integrating community-specific behaviors and norms in order to develop tailored campaigns. [ABSTRACT FROM AUTHOR]

The major cause for skin cancer is the excessive and unprotected exposure to ultraviolet radiation (UVR), which can be prevented by engaging in sun protection behaviours. As longitudinal studies on both adolescents’ and adults’ performances of sun protection behaviours are limited, the current study aimed to investigate changes in sun protection in these population segments in Western Australia, a region with high annual UVR. During six summer seasons (2015/16 to 2020/21), cross-sectional surveys were conducted among 1806 adolescents (14 to 17 years old) and 1808 adults (18–45 years old), investigating the frequency of five sun protection behaviours (wearing clothing, applying sunscreen, wearing a hat, wearing sunglasses, and seeking shade) and sun avoidance (staying indoors). Over the six-year period, staying indoors increased in both groups. Among adolescents, a decrease in wearing clothing and sunglasses and an increase in seeking shade was demonstrated, and hat and sunscreen use remained relatively stable. Among adults, an increase in sunscreen use was shown, whereas all other sun-related behaviours remained consistent over the six-year period. The results from this study can provide directions for health communications focusing on improving sun protection behaviours among both adolescent and adult populations.

Incidence rates of melanoma and keratinocyte skin cancers have been on the rise globally in recent decades. While there has been a select focus on personal sun protection awareness, to our knowledge, there is a paucity of legislation in place to help support citizens’ efforts to protect themselves from the harmful effects of ultraviolet radiation (UVR). Given this, we conducted a comprehensive review of legislation and guidelines pertaining to a variety of sun protection-related topics in countries of the Group of Seven (G7), Australia and New Zealand. Australia was the only country to have banned tanning beds for individuals of all ages, while other select countries have instituted bans for minors. In workplace policy, there is very little recognition of the danger of occupational UVR exposure in outdoor workers, and thus very few protective measures are in place. With regard to sports and recreation, certain dermatological/professional associations have put forward recommendations, but no legislation was brought forward by government bodies outside of Australia and New Zealand. With regard to youth, while there are various guidelines and frameworks in place across several countries, adherence remains difficult in the absence of concrete legislation and standardization of procedures. Finally, only Australia and a few select jurisdictions in the United States have implemented sales tax exemptions for sunscreen products. In light of our findings, we have made several recommendations, which we anticipate will help reduce the rates of melanoma and keratinocyte cancers in years to come. However, minimizing UVR exposure is not without risk, and we, therefore, suggest the promotion of vitamin D supplementation in conjunction with sun protective practices to limit potential harm.