Abstract
Background
The effect of a self-regulatory intervention with its focus on planning sunscreen use is evaluated in comparison to a standard educational condition.
Purpose
This paper studied whether planning mediates between the experimental conditions and the behavioral outcome. Further, it is examined who benefits more: already motivated or unmotivated individuals.
Method
College students (N = 253) were randomly assigned to two groups: a self-regulatory and a standard-care condition. Sunscreen use, intention to use sunscreen, and planning were assessed at two points in time, 1 month apart.
Results
The self-regulatory intervention improved planning to use sunscreen but not the behavior directly. Planning emerged as the mediator between conditions and later sunscreen use, controlling for baseline behavior. Moreover, participants who were less motivated benefited more from the intervention.
Conclusions
Although it is generally assumed that planning interventions are best designed for already motivated persons, the present findings suggest that less prepared individuals might have more to gain from a brief self-regulatory intervention.
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References
Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013;132:1133–45. doi:10.1002/ijc.27711.
Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166:1069–80. doi:10.1111/j.1365-2133.2012.10830.x.
Oliveria SA, Saraiya M, Geller AC, Heneghan MK, Jorgensen C. Sun exposure and risk of melanoma. Arch Dis Child. 2006;91:131–8. doi:10.1136/adc.2005.086918.
Gonzalez S, Fernandez-Lorente M, Gilaberte-Calzada Y. The latest on skin photoprotection. Clin Dermatol. 2008;26:614–26. doi:10.1016/j.clindermatol.2007.09.010.
World Health Organization. Sun protection. Simple precautions in the sun. 2010. http://www.who.int/uv/sun_protection/en/.
Lazovich D, Isaksson Vogel R, Berwick M, Weinstock MA, Warshaw EM, Anderson KE. Melanoma risk in relation to use of sunscreen or other sun protection methods. Cancer Epidemiol Biomarkers Prev. 2011;20:2583–93. doi:10.1158/1055-9965.EPI-11-0705.
Mahler HIM, Kulik JA, Gibbons FX, Gerrard M, Harrell J. Effects of appearance-based interventions on sun protection intentions and self-reported behaviors. Health Psychol. 2003;22(2):199–209. doi:10.1037/0278-6133.22.2.199.
Pagoto SL, Schneider KL, Oleski J, Bodenlos JS, Ma Y. The sunless study: a beach randomized trial of a skin cancer prevention intervention promoting sunless tanning. Arch Dermatol. 2010;146(9):979–84. doi:10.1001/archdermatol.2010.203.
Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.
Fishbein M, Ajzen I. Predicting and changing behavior: the reasoned action approach. New York: Psychology Press; 2010.
Jones F, Abraham C, Harris P, et al. From knowledge to action regulation: modelling the cognitive prerequisites of sun screen use in Australian and UK samples. Psychol Health. 2001;16:191–206. doi:10.1080/08870440108405499.
Fisher WA, Fisher JD, Harman J. The information–motivation–behavioral skills model: a general social psychological approach to understanding and promoting health behavior. In: Suls J, Wallston K, editors. Social psychological foundations of health and illness. London: Blackwell; 2003. p. 87–106.
Sheeran P, Harris PR, Epton T. Does heightening risk appraisals change people’s intentions and behavior? A meta-analysis of experimental studies. Psychol Bull. 2014;140(2):511–43. doi:10.1037/a0033065.
Rodrigues A, Sniehotta FF, Araujo-Soares V. Are interventions to promote sun-protective behaviors in recreational and tourist settings effective? A systematic review with meta-analyses and moderator analyses. Ann Behav Med. 2013;45:224–38. doi:10.1007/s12160-012-9444-8.
Hagger MS, Luszczynska A. Implementation intention and action planning interventions in health contexts: state of the research and proposals for the way forward. Appl Psychol Health Well Being. 2014;6:1–47. doi:10.1111/aphw.12017.
Kwasnicka D, Presseau J, White M, Sniehotta FF. Does planning how to cope with anticipated barriers facilitate health-related behaviour change? A systematic review. Health Psychol Rev. 2013;7(2):129–45. doi:10.1080/17437199.2013.766832.
Craciun C, Schüz N, Lippke S, Schwarzer R. Facilitating sunscreen use in women by a theory-based online intervention: a randomized controlled trial. J Health Psychol. 2011;17:207–16. doi:10.1177/1359105311414955.
Pincock T, Bernstein P, Warthman S, Holst E. Bundling hand hygiene interventions and measurement to decrease health care-associated infections. Am J Infect Control. 2012;40(4):S18–27. doi:10.1016/j.ajic.2012.02.008.
Cheng S, Lian S, Hao Y, Kang N, Li S, Nie Y, et al. Sun exposure knowledge and protection behavior in a North Chinese population: a questionnaire-based study. Photodermatol Photoimmunol Photomed. 2010;26:177–81. doi:10.1111/j.1600-0781.2010.00513.x.
Zhou H, Zhu HG, Zhang ZN. Research on sun protection and the effectiveness of sunscreens in undergraduates. Environ Health. 1998;15:247–50.
Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol Int Rev. 2008;57:1–29. doi:10.1111/j.1464-0597.2007.00325.x.
Craciun C, Schüz N, Lippke S, Schwarzer R. A mediator model of sunscreen use: a longitudinal analysis of social-cognitive predictors and mediators. Int J Behav Med. 2012;19:65–72. doi:10.1007/s12529-011-9153-x.
Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46:81–95. doi:10.1007/s12160-013-9486-6.
Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: The Guilford Press; 2013.
Arbuckle JL. IBM SPSS Amos 21 user’s guide. Amos Development Corporation, SPSS Inc; 2012.
Kline RB. Principles and practice of structural equation modeling. 2nd ed. New York: Guilford Press; 2005.
Hayes AF. PROCESS: a versatile computational tool for observed variable mediation, moderation, and conditional process modeling. 2012. http://www.afhayes.com/public/process2012.pdf.
Van Osch L, Reubsaet A, Lechner L, de Vries H. The formation of specific action plans can enhance sun protection behavior in motivated parents. Prev Med. 2008;46:127–32. doi:10.1016/j.ypmed.2008.02.025.
Chapman J, Armitage CJ, Norman P. Comparing implementation intention interventions in relation to young adults’ intake of fruit and vegetables. Psychol Health. 2009;24:317–32. doi:10.1080/08870440701864538.
Gholami M, Lange D, Luszczynska A, Knoll N, Schwarzer R. A dietary planning intervention increases fruit consumption in Iranian women. Appetite. 2013;63:1–6. doi:10.1016/j.appet.2012.12.005.
Lange D, Richert J, Koring M, Knoll N, Schwarzer R, Lippke S. Self-regulation prompts can increase fruit consumption. A 1-hour randomized controlled online trial. Psychol Health. 2013;28(5):533–45. doi:10.1080/08870446.2012.751107.
Luszczynska A. Effects of an implementation intention intervention on physical activity after MI are mediated by cognitive processes, change in forming action plans. Soc Sci Med. 2006;62:900–8.
Sniehotta F, Scholz U, Schwarzer R. Action plans and coping plans for physical exercise: a longitudinal intervention study in cardiac rehabilitation. Br J Health Psychol. 2006;11:23–37. doi:10.1348/135910705X43804.
Van Osch L, Lechner L, Reubsaet A, Wigger S, de Vries H. Relapse prevention in a national smoking cessation contest: effects of coping planning. Br J Health Psychol. 2008;13:525–35. doi:10.1348/135910707X224504.
Armitage CJ. Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: a randomized exploratory trial. Health Psychol. 2009;28(5):545–53. doi:10.1037/a0015984.
Hagger MS, Lonsdale AJ, Chatzisarantis NLD. A theory-based intervention to reduce alcohol drinking in excess of guideline limits among undergraduate students. Br J Health Psychol. 2012;17:18–43. doi:10.1111/ j.2044-8287.2010.02011.x.
Lippke S, Schwarzer R, Ziegelmann JP, Scholz U, Schüz B. Testing stage-specific effects of a stage-matched intervention: a randomized controlled trial targeting physical exercise and its predictors. Health Educ Behav. 2010;37:533–46. doi:10.1177/1090198109359386.
Schüz B, Sniehotta FF, Schwarzer R. Stage-specific effects of a self-monitoring intervention on dental flossing. Health Educ Res. 2007;22:332–41. doi:10.1093/her/cyl084.
Bau A, Cohen L. Successful behavioural interventions to prevent cancer: the example of skin cancer. Annu Rev Public Health. 1998;19:319–33. doi:10.1146/annurev.publhealth.19.1.319.
Jackson KM, Aiken LS. A psychosocial model of sun protection and sunbathing in young women: the impact of health beliefs, attitudes, norms, and self-efficacy for sun protection. Health Psychol. 2000;19:469–78. doi:10.1037/0278-6133.19.5.469.
O’Riordan DL, Lunde KB, Steffen AD, Maddock JE. Validity of beachgoers’ self-report of their sun habits. Arch Dermatol. 2006;142:1304–11. doi:10.1001/archderm.142.10.1304.
Wiedemann A, Gardner B, Knoll N, Burkert S. Intrinsic rewards, fruit and vegetable consumption, and habit strength: a three-wave study testing the associative cybernetic model. Appl Psychol Health Well Being. 2014;6(1):119–34. doi:10.1111/aphw.12020.
Acknowledgments
We would sincerely thank the research assistant and the college students involved in this study.
Conflict of Interest
Guangyu Zhou, Liang Zhang, Nina Knoll, and Ralf Schwarzer declare that they have no conflict of interest. Authors conformed to the Helsinki Declaration concerning human rights and informed consent, and followed correct procedures concerning treatment of humans and animals in research.
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Zhou, G., Zhang, L., Knoll, N. et al. Facilitating Sunscreen Use Among Chinese Young Adults: Less-Motivated Persons Benefit from a Planning Intervention. Int.J. Behav. Med. 22, 443–451 (2015). https://doi.org/10.1007/s12529-014-9458-7
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DOI: https://doi.org/10.1007/s12529-014-9458-7