SKIN CANCER PROTECTIVE BEHAVIORS AMONG THE ELDERLY: EXPLAINING THEIR RESPONSE TO A HEALTH EDUCATION PROGRAM USING THE HEALTH BELIEF MODEL

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Abstract
An evaluation study of an intervention for prevention of skin cancer among all age groups was conducted in four kibbutzim (collective settlements) in Israel. The sample for this study was restricted to the 43 (8.4%) elderly persons aged 60 and over who participated in the study. The objectives of this study were to assess: (a) behavioral adherence to messages regarding sun‐exposure protective behaviors (SEPB) and early detection; (b) long‐term changes (after 4 months) in skin cancer related behavior and in general health beliefs; and (c) the explanatory power of the original Health Belief Model (HBM) variables (formulated specifically for skin cancer), and of an expanded HBM, which also includes the value of health (VH), the measure of internal health locus of control (HLC‐I), and the interaction of these two in the elderly's engagement in two kinds of skin cancer protective behaviors: SEPB, and self‐examination (SE). The findings of this study show a significant change in the recommended direction in SEPB. Beliefs about skin cancer generally remained stable over the 4‐month period; basic health beliefs, however, changed during this period. The addition of an interactive effect of the VH and of HLC‐I to a model built on the original HBM dimensions was found to significantly increase the explanatory power of the VH and of the HLC‐I variables, as well as of the expanded HBM, regarding engagement in the two kinds of protective behaviors. The theoretical and practical importance of these findings for health education programs for the elderly is discussed.