Study Evaluates Sun Protection Awareness in Adolescents

Tammy Chang, MD, MPH

A recent study from Ann Arbor, Michigan, suggested that the concept of sun protection was well understood among young people, who cited product accessibility, cost and inconvenience to be among the barriers preventing consistent sunscreen use.

Among those who participated in the study, 40% believed poor sun protection behaviors would improve with appropriate education on the consequences of sun damage.

 Investigators led by Tammy Chang, MD, MPH, University of Michigan Medical School, Ann Arbor, noted that greater than 5 lifetime sunburns could double a person’s risk of developing melanoma, and that less than one-third of adolescents aged 11-18 years routinely use sun protection.

As such, investigators identified the knowledge and experiences using sun protection from several adolescent participants with the goal of understanding what interventions would be warranted to increase the use of sun protection.

The Methods

For the study, Chang and colleagues used a national text message-based polling platform MyVoice to collect data on sun protection measures.

A parental consent waiver for minor participants was approved by the University of Michigan, and the study was deemed of minimal risk.

MyVoice participants ranged from 14 to 24 years, and all participants were recruited from social media based on national benchmarks from the American Community Survey.

Race and identify were self-reported, and each participant was given $1 for responding to the weekly survey topic.

A total of 1151 youths were enrolled in the study, all of whom participated in 5 open-ended probes focused on sun protection on April 9, 2021. For the probes, 2 investigators devised a codebook based on salient topics and independently analyzed each question. Discrepancies in coding were resolved by another investigator.

The open ended questions were as followed:

• How important do you think it is to protect your skin from the sun?
• When do you protect yourself from the sun?
• How do you protect yourself from the sun?
• How many red, painful, or peeling sunburns have you had in your life?
• What could be done to encourage more people to use sun protection?

Overall, the survey response rate was 84.9% (977 of 1151).

The Findings

Among the 977 respondents in the study, nearly hald (48.1%) identified as female, 104 (10.7%) as Hispanic, 64 (6.6%) as non-Hispanic Black, and 607 (62.2%) as non-Hispanic white. The mean age was 19.3 years.

Investigators reported that when asked about the importance of sun protections, 62.1% (594/957) stated that it was “very important”, while 25.5% (244/957) stated important, and 5.4% (54/857) stated somewhat important.

Skin cancer was most frequently cited as the reason for sun protection (51.7%).

Additionally, while 90.1% of youth (840/932) reported the use of sunscreen, 81.1% (751/926) noted having 1 or more sunburns. With 263 respondents (28.4%) reporting 5 or more.

It was suggested by respondents that demonstrating the consequences of sun exposure (41%), using traditional media (16.8%) and increasing product accessibility (10.6%) could increase the use of sun protection in young people.

“Implementing these strategies suggested by youth may help prevent sunburns during childhood and adolescence and, ultimately, decrease the risk of skin cancer later in life,” the team wrote.

The study, “Assessment of Sun Protection Knowledge and Behaviors of US Youth,” was published online in JAMA Open Network.