Sun protection and young female beachgoers: A formative theory-based approach to identifying key sun safe beliefs.

ISSUE ADDRESSED: The prevalence of skin cancer remains at a high level in Australia. Young female Australian beachgoers are an at-risk population of skin cancer. Research on sun-protective beliefs held by this at-risk group is limited. METHODS: Based on the Theory of Planned Behaviour (TPB), we conducted a formative study to understand key sun safe messages among young female beachgoers in Queensland, including an elicitation study (Phase 1; N = 21, Mage  = 24.30 years) and a two-wave questionnaire survey (Phase 2; N = 140, Mage  = 23.96 years). RESULTS: Following content analysis and regression analyses, three key beliefs were identified: "be uncomfortable and/or unstylish" (behavioural belief), "friends and peers" (normative belief) and "lack of motivation to reapply sunscreen" (control belief). CONCLUSIONS: The results highlight the influences of friends and peers on beachgoers' sun-protective behaviour for this young female adult cohort. Compared to previous findings among the general population, discrepancies in beliefs suggest interventions targeting this cohort should specifically focus on fashionable sun safe images and motivation to reapply sunscreen. SO WHAT?: Future health promotion and public education should utilise various strategies according to specific groups given the discrepancies identified in beliefs. For female beachgoers, sun safe images and motivations should be the primary foci.

Predicting the sun-protective decisions of young female Australian beachgoers.

We tested the theory of planned behaviour with additional norms to predict the sun-protective decisions of young female beachgoers in Australia. Participants (N = 336) completed standard theory of planned behaviour measures and additional normative factors (group, image and personal norms). Attitude, subjective norm, and both personal and group norms predicted intention. Intention and group norm predicted follow-up behaviour. These findings provide further evidence that it is the more proximal sources of norms reflecting one's personal and referent group influences, rather than perceptions of broader societal norms about the attractiveness of tanned images, that are important in determining young women's sun-protective decisions.

Examining young recreational sportswomen's intentions to engage in sun-protective behavior: the role of group and image norms.

Researchers examined the sun-protective intentions and behavior of young, Caucasian, Australian sportswomen aged between 17 and 35 years (N = 100). The study adopted a 2 x 2 experimental design, comparing group norms (supportive vs. non-supportive) and image norms (tanned vs. pale) related to sun protection and taking into account group identification with friends and peers in the sport. While no significant findings emerged involving image norms, regression analyses revealed a significant two-way interaction for group norm x identification on recreational sportswomen's intentions to engage in sun protection in the next fortnight. Participants identifying strongly with their group had stronger intentions to engage in sun protection when exposed to a norm reflecting fellow recreational sportswomen engaging in sun-protective actions in comparison to those exposed to a non-supportive group. In addition, while prior intentions to engage in sun protection were not significantly related to sun-protection behavior, post-manipulation intentions after exposure to the sun-protective information that was provided were significantly related to follow-up behavior. Overall, the findings supported the importance of group-based social influences, rather than tanned media images, on sun-protective decisions among young recreational sportswomen and provided a targeted source for intervention strategies encouraging sun safety among this at-risk group for repeated sun exposure.

The role of self-efficacy in dental patients' brushing and flossing: testing an extended Health Belief Model.

OBJECTIVE: In an effort to examine the decreasing oral health trend of Australian dental patients, the Health Belief Model (HBM) was utilised to understand the beliefs underlying brushing and flossing self-care. The HBM states that perception of severity and susceptibility to inaction and an estimate of the barriers and benefits of behavioural performance influence people's health behaviours. Self-efficacy, confidence in one's ability to perform oral self-care, was also examined. METHODS: In dental waiting rooms, a community sample (N=92) of dental patients completed a questionnaire assessing HBM variables and self-efficacy, as well as their performance of the oral hygiene behaviours of brushing and flossing. RESULTS: Partial support only was found for the HBM with barriers emerging as the sole HBM factor influencing brushing and flossing behaviours. Self-efficacy significantly predicted both oral hygiene behaviours also. CONCLUSION: Support was found for the control factors, specifically a consideration of barriers and self-efficacy, in the context of understanding dental patients' oral hygiene decisions. PRACTICE IMPLICATIONS: Dental professionals should encourage patients' self-confidence to brush and floss at recommended levels and discuss strategies that combat barriers to performance, rather than emphasising the risks of inaction or the benefits of oral self-care.

Predicting blood donation intentions and behavior among Australian blood donors: testing an extended theory of planned behavior model.

BACKGROUND: Donor retention poses a significant problem to blood collection agencies around the world. Previous research using an augmented theory of planned behavior (TPB) approach has demonstrated that attitude, subjective norm, self-efficacy, moral norm, anticipated regret, donation anxiety from prior blood donations, and self-identity as a blood donor predicts experienced donors' intentions and that intentions, self efficacy, moral norm, and anticipated regret may impact upon people's actual blood donation behavior. STUDY DESIGN AND METHODS: Established blood donors (n = 263) completed questionnaires assessing standard TPB constructs, anticipated regret, moral norm, donation anxiety, and self-identity as a blood donor. Three months later, a second questionnaire assessing blood donation behavior in the intervening 3 months was mailed and returned by 182 donors. RESULTS: With structural equation modeling, the final augmented TPB model provided an excellent fit to the data and included a direct path from intention to behavior and indirect paths to behavior through intention for attitude, self-efficacy, and anticipated regret. Moral norm, donation anxiety, and donor identity indirectly predicted intention through attitude. In total, 51 percent of the variance in donors' attitudes, 86 percent of variance in donors' intentions, and 70 percent of the variance in donors' behavior were accounted for in the final model. CONCLUSION: An augmented TPB framework proved efficacious in determining the predictors of the intentions and behavior of established blood donors. Further, this framework highlighted the importance of considering in the future how donors' motivations for donating blood may evolve as a function of the number of prior donations.

Predicting intentions to donate blood among nondonors in Australia: an extended theory of planned behavior.

BACKGROUND: With an increasing demand for blood and blood products in Australia, there is a continual need to recruit blood donors. As such, it is important to investigate the factors that impact on nondonors' decision-making processes with regard to donating blood for the first time. Previous research has established the efficacy of the theory of planned behavior (TPB) in predicting blood donor intentions. The current research aimed to test a TPB model augmented with constructs implicated in previous blood donor research; specifically descriptive norm, moral norm, anticipated regret, and donation anxiety. STUDY DESIGN AND METHODS: Participants completed measures assessing the standard TPB variables of attitude, subjective norm, and perceived behavioral control (PBC) as well as descriptive norm, moral norm, donation anxiety, and anticipated regret. Path analysis examined the utility of the augmented TPB model to predict 195 non-blood donors' intentions to donate blood. RESULTS: A final revised model provided a very good fit to the data and included attitude, PBC, moral norm, descriptive norm, anticipated regret, and donation anxiety as direct predictors of intention, with these factors accounting for 70 percent of the variance in intentions to donate blood. CONCLUSION: A revised TPB model provided a more efficacious predictor of nondonors' intentions to donate than the standard TPB model and highlights the role that norm-based factors and affective-laden constructs play in predicting non-blood donors' intentions to donate.

Young people and sun safety: the role of attitudes, norms and control factors.

ISSUE ADDRESSED: Differences in the behavioural, normative and control beliefs of young Australian sun-protectors and non sun-protectors are analysed using a theory of planned behaviour belief-based framework. METHODS: A questionnaire assessed the sun-safety-related beliefs and perceptions of a Queensland sample (n=858) of young people aged between 12 and 20 years. Two weeks later, participants reported their sun-protective behaviour for the previous fortnight. RESULTS: The study found that clear differences emerged between sun-protectors and non-protectors on underlying normative and control beliefs related to sun-safety behaviours (but not behavioural beliefs). Specifically, sun-protectors were more likely to believe that their friends and family think they should perform sun-protective behaviours. Sun-protectors were also more likely to perceive that a range of motivating factors would encourage them to perform sun-safety behaviours. Finally, non-protectors were more likely to report forgetfulness and laziness as barriers preventing them from performing sun-protection behaviours than sun-protectors. CONCLUSIONS: Findings indicate that future interventions should target young people's normative and control beliefs related to sun safety.

Testing an extended theory of planned behaviour to predict young people's sun safety in a high risk area.

OBJECTIVES: The present research examined the sun protection intentions and behaviours of young people in a high risk skin cancer area using an extended theory of planned behaviour (TPB) incorporating additional social influences of group and image norms. DESIGN: The study employed a prospective design to examine young people's sun protection intentions and behaviour. METHOD: Participants (N=1,134), aged 12-20 years, were students (school, university, TAFE) and young employees living in Queensland, Australia. Participants completed a questionnaire assessing the TPB predictors (attitude, subjective norm, perceived behavioural control) and additional social influences (group norm, image norm) of sun protection intentions. Two weeks later, participants (N=734) reported their sun protection behaviour for the previous fortnight. RESULTS: Results revealed that the TPB variables of attitude, subjective norm and perceived behavioural control and the additional social influence variable of group norms, but not image norms, emerged as significant predictors of intentions to engage in sun protection. The extended TPB variables accounted for 36% of the variance in intentions. For behaviour, the extended TPB variables accounted for 27% of the variance with both intention and, unexpectedly, group norm as the significant direct predictors of sun protective behaviours. CONCLUSIONS: Results of this study provide support for the application of the TPB in the sun safety context and highlight the importance of considering the influence of group norms in the development of future interventions to increase young people's sun protection intentions and behaviour.

Consumers' understanding of the Dietary Guidelines for Americans: insights into the future.

The purpose of this study was to examine consumers' knowledge and understanding of the 1995 Dietary Guidelines for Americans and the sources from where consumers obtain their health information. A telephone survey was administered to 400 adults in the Twin Cities area in Minnesota. The number of guideline recommendations recalled per person was, on average, less than 2.5 of a total of 13 recommendations. Participants had difficulties interpreting the guidelines. Knowledge of the dietary fat guideline was especially poor. Only 17% of survey participants correctly stated the amount of total fat they should have in their diet. The total number of media sources used to obtain health information was the variable that best explained the variance in knowledge of the Dietary Guidelines recommendations. To effectively change dietary behavior, health educators must work effectively with the media to develop behavior-focused nutrition messages that are meaningful and clear to consumers.