DESCRIPTION (provided by applicant): Skin cancer is the most prevalent cancer and of the most preventable cancers in the US because it is strongly linked to ultraviolet (UV) radiation exposure from the sun. While protecting oneself from UV exposure can largely reduce risk, rates of unprotected sun exposure (~50%) are currently well above the Healthy People 2010 goal of 25%. Prevention research thus far has had some impact on sunscreen use, but less impact on actual sun avoidance. Those most resistant to intervention efforts appear to be those who are motivated to be tan. The acceptability and feasibility of tanning substitutes for sun avoidance have never been investigated. Interventions might be improved by promoting behavioral substitutes for sun exposure that serve the same function as sunbathing (i.e., tan skin) thereby reducing the need to sunbathe. Sunless tanners are products that come in the form of creams, foams, and sprays to be applied directly to the skin and contain dihydroxyacetone (DMA), a colorless vegetable-derived sugar that temporarily stains the skin a tan color. Sunless tanners to our knowledge have not been evaluated as a skin cancer prevention tool. The present study includes 2 phases: development and pilot intervention. The aims of the initial development phase will be to 1) develop psychometrically sound measures of attitudes toward sunless tanners; 2) identify self-described beach-goers attitudes towards sunless tanning product use after a 2 week sampling period; 3) identify perceived barriers and benefits to the use of these products; 4) to develop potential motivational messages encouraging the use of sunless tanning products. The aims of the pilot intervention phase of this project will be to examine the feasibility and effect of a beach-based intervention that includes sun damage including sun safety recommendations, and the provision of samples of both sunscreen and sunless tanning products on sun exposure compared to a questionnaire-only control group at 2-and 12-month follow-up. The primary hypothesis posits that the intervention will decrease sunbathing and perceptions of the benefits of sunbathing compared to a questionnaire only control group. Second, a behavioral substitution hypothesis posits that decreased sunbathing will be associated with increased use of sunless tanning products. We also assess the effect of the intervention on perceived benefits of sunbathing, use of sunless tanners, sun protection, sunburns, perceived susceptibility to photoaging, and perceived severity of photoaging. Sunless tanners are a safe, economical, and widely available commercial product that with appropriate education and instruction could be a promising prevention tool. Prevention interventions that target high-risk segments of the community in settings where risk behavior occurs have potential for a large and focused public health impact.
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