Interplay of Perceived Risk and Worry as Influences on Sunscreen Use

Behavior is part of the etiology of many cancers. Central to health behavior theories is the idea that perceived risk influences behavior. Other work shows that fear and worry influence behavior. Both cognitively-based risk perceptions and affectively-based worry/fear influence cancer prevention and control behaviors. This study explored the interplay of perceived risk and worry about skin cancer as influences on sunscreen use in data from the 2005 Health Information National Trends Survey. Participants were those respondents who answered questions skin cancer risk and who had complete data for all analyzed variables (N=1483). Analysis of the data (controlling for demographics and personal cancer history) revealed that the influence of cognitively-based risk perceptions on behavior was fully mediated by affectively-based worry about skin cancer. When examined independently, both risk perceptions and worry predicted sunscreen use; risk perception, b=-0.10, t(1477)=-3.09, p < .01; worry, b=-0.23, t=-4.92, p < .001. Perceived risk and worry were strongly related, b=0.26, t=15.76, p<.001. However, when both risk and worry were included in the regression model the relation of perceived risk to sunscreen use was reduced to non-significance, , b=-0.05, t=-1.50, p=.13, whereas the relation of worry to risk remained unchanged, b=-0.19, t=-3.71, p<.001. This suggests the need to modify the treatment of risk in health behavior models used in cancer prevention and control to include affectively-based risk components and suggests the possibility that understanding the role of affect in risk might advance development of intervention approaches to encourage change in cancer prevention and control behaviors.