Behavior Modification Obtained by Sun Protection Education Coupled With Removal of a Skin Cancer

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Abstract
• The 1042 people in this study who had a nonmelanoma skin cancer surgically removed received repetitive and interactive oral and written education in forms of sun protection. One year after these educational efforts, the subjects responded to a questionnaire that measured their compliance. Sixty-two percent complied with starting to use sunscreens and 56% changed their habits of outdoor activities. The portion of behavioral change attributable to surgery alone vs surgery plus education was unable to be determined. Despite intensive educational efforts, the noncompliance was 38%. This study identifies a health risk-taking pattern of behavior among those who were noncompliant. Those over age 65 years tended to be less compliant. When the data were analyzed by the transtheoretical model of behavior change, those already acting on some form of sunscreen use prior to this study achieved 100% compliance with increasing to a sunscreen with a sun protection factor of 15 or greater. It is hoped that with more educational efforts those in the precontemplative and contemplative phases of behavior can be recruited to take action, and those who acted by acquiring one sun protective behavior will add other behaviors. (Arch Dermatol. 1990;126:477-481)

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