Abstract
Predicting sun protection behaviors among skin cancer patients using the information-motivation-behavioral skills model
Vinayak K. Nahar, MD, PhD1, William H. Black, MD2, M. Allison Ford, PhD3, Martha A. Bass, PhD3, John Bentley, PhD4, Paul Johnson, Ph.D.5, Stephanie Jacks, MD2, Tracy Breeden, ADN2, Jane M. Grant-Kels, MD6 and Robert T. Brodell, MD2
(1)Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, Harrogate, TN, (2)Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, Jackson, MS, (3)Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, MS, University, MS, (4)Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, University, MS, (5)Department of Management, School of Business Administration, University of Mississippi, University, MS, University, MS, (6)Department of Dermatology, University of Connecticut Health Center and School of Medicine, Farmington, CT, Farmington, CT
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Practice of sun protection behaviors (SPB) is important among individuals previously diagnosed with non-melanoma skin cancer (NMSC) because recurrences are high and risk of subsequent malignant melanoma is increased. The purpose of this study was to examine the usefulness of the Information-Motivation-Behavioral skills (IMB) model in predicting SPB among people who have had NMSC.
Methods: The study utilized a cross-sectional design enrolling patients with NMSC attending a university dermatology clinic (n=311). The inclusion criteria were: diagnosis of NMSC, age above 18 years; and ability to read and write in English. Excluded were individuals with severe physical or cognitive impairments. A face and content valid 114-item instrument was developed for this study.
Results: The majority of participants were male (59%) and the mean age was 64.12 (±12.02) years. Overall, 14-43% of the participants reported always engaging in SPB while outdoors. Cronbach’s alpha for each construct was greater than 0.70, indicating reliability. Construct validation using confirmatory factor analysis substantiated that the chosen constructs in the hypothesized IMB model had an acceptable fit to the empirical data (X2=287.618 [df=133], p< 0.001; RMSEA=0.06; CFI=0.93; TLI=0.91; SRMR=0.05). Path analysis revealed SPB was directly predicted by self-efficacy (coefficient=0.5, p<0.001) and social support (coefficient=0.199, p=0.010) and indirectly (via self-efficacy) by social support (coefficient=0.160, p<0.001) and attitudes (coefficient=0.192, p=0.001); explained variance for self-efficacy=43% and SPB=35%.
Conclusion: The IMB model was useful in predicting SPB among NMSC patients in this study. IMB model-based sun-safety interventions for NMSC patients could improve motivation (attitudes and social support) and behavioral skills (self-efficacy).
Chronic disease management and prevention Program planning Public health or related education Public health or related research Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health