Predictors of sun screen use among children and adolescents: Results from the YouthStyles Survey

Risk of skin cancer is associated with excessive sun exposure while young and research has demonstrated that many health behavior patterns are established in childhood. Thus it is important to understand factors associated sun safety behaviors in children and adolescents. Objective: Assess predictors of sunscreen use, a key sun safety behavior, based on population-level data. Method: Data were drawn from the 2005 YouthStyles Survey, a U.S. nationally representative mail panel survey, that obtains detailed information about a variety of health issues, including reported sun-protection behavior of children and adolescents ages 9-18 (n=1545). The survey includes a low-income/minority supplement used to ensure adequate representation from these populations. For this analysis we focused on use of sunscreen SPF 15+, categorizing individuals into “Always/Often/Sometimes” vs. “Rarely/Never.” Unadjusted analyses were performed using chi-square. Adjusted analyses were performed using multivariate logistic regression. Results: Logistic regression revealed that poor sunscreen use among children and adolescents was associated with being older (Age 12-14: OR=1.61, 1.19-2.18; Ages 15-18: OR 2.61, 1.94-3.53), male (OR=1.85, 1.44-2.37), Black (OR=3.21, 2.20-4.69) or Hispanic (OR=1.47, 1.05-2.06), poor sunscreen use by parents (OR=3.86, 3.02-4.93) and poorer diet assessed by lower fruit consumption (OR=1.71, 1.23-2.38). Poor sunscreen use was also associated with failure to adhere to other sun safety behaviors. Conclusions: In addition to demographic factors, sunscreen use is associated with parental behavior and other health behaviors such as diet. The individuals in this sample also demonstrated consistency of poor sun safety behavior across potential preventative strategies. Implications for future interventions are discussed.