Family Attitudes and Communication about Sun Protection and Sun Protection Practices among Young Adult Melanoma Survivors and Their Family Members

ABSTRACT

Young melanoma survivors and their family are at increased risk for developing melanoma, but seldom engage in sun protection behaviors. Little is known about the role of family factors in sun protection. Our goals were: 1) examine correspondence between survivors and family sun protection, individual attitudes, and family attitudes and communication about risk-reducing behaviors, and; 2) evaluate the mediating role of family attitudes and communication in the association between individual sun protection attitudes and behavior. Measures of individual attitudes, family attitudes and communication, and sun protection behaviors were completed by 529 participants. Multilevel modeling assessed family correspondence in sun-related attitudes and behaviors and mediation. Families had varying levels of shared attitudes and behaviors, with higher correspondence for family norms. Survivors reported stronger family norms, greater family benefits, and more discussion than siblings. For both sexes, family discussion was associated with higher sun protection. For women only, more favorable attitudes were associated with sun protection partly because women discussed sun protection with family and held stronger norms. Because families’ attitudes and practices correspond, family-focused interventions may prove effective. Among females, increasing risk awareness and sunscreen efficacy and overcoming barriers may foster enhanced normative standards, communication about, and engagement in sun protection.

Acknowledgments

This publication was supported by an R01 grant from the National Cancer Institute, CA221854. The content is entirely the author’s responsibility. We would like to thank the following individuals for their valuable contributions to this project: Carolina Lozada, Lisa Paddock, Anna Mitarotondo, Evangelynn Murphy, Josselyn Hernandez, and Maria Camero Garcia. We would like to acknowledge the following for their assistance with recruitment: the Cancer Registry of Greater California (Public Health Institute), the Cancer Surveillance Research Program (CSRP) and the New Jersey State Cancer Registry (NJSCR)), the Ohio Cancer Incidence Surveillance System and the Ohio Department of Health (OOH), a cancer registry partially supported by the National Program of Cancer Registries at the Centers for Disease Control and Prevention (CDC) through Cooperative Agreement Number NU58DP006284, the Utah Cancer Registry and the tumor registrar at Robert Wood Johnson University Hospital New Brunswick, and the MD Anderson Cancer Center.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Notes

¹ The exception was a modest role by sunscreen self-efficacy interaction, F (2,440) = 3.15, p = .044. The association between sunscreen and family norms was smaller for parents than for either probands or siblings. However, because the association between sunscreen self-efficacy and family norms was significantly different from zero in all cases, we chose to conduct the mediation models without including this interaction.

Additional information

Funding

Supported by the National Cancer Institute under R01 CA221854, awarded to Sharon Manne. Services, results and/or products in support of the research project were generated by Rutgers Cancer Institute of New Jersey Population Science Research Support Shared Resource.