College Students' Knowledge, Attitudes and Perceptions of Risks Regarding Intentional Sun Exposure: A 17-Year Follow-Up

Background: Skin cancer, the most common cancer in the United States, accounts for over one million cases per year. Risk can be mediated by limiting UV radiation exposure, yet efforts to increase adoption of protective measures have met with limited success. Purpose: This study compares the results of surveys conducted in 1990 and 2007 assessing the knowledge, attitudes and behaviors of college students regarding intentional sun exposure. Methods: The 44-item 'Sun and Skin Inventory' was administered to students enrolled in personal health classes during the fall semesters in 1990 and 2007. Results: Mean knowledge scores were no different in 2007 than 1990 and knowledge scores were not related to sunbathing frequency in either survey. Risk perception was negatively related to sunbathing frequency and students reporting greater perceived risk had more positive attitudes toward protective behaviors. Overall, sunbathing behavior was unchanged over 17 years, but students did report more frequent sunscreen use in the latter survey. Discussion: Despite educational efforts regarding risks related to intentional UV exposure, high risk behavior continues among adults. Translation to Health Education Practice: Comprehensive prevention initiatives that include education as well as policy and environmental strategies integrated across state, regional and local levels need to be implemented.