Do ultraviolet photos increase sun safe behavior expectations via fear? A randomized controlled trial in a sample of U.S. adults

J Behav Med. 2019 Jun;42(3):401-422. doi: 10.1007/s10865-018-9997-5. Epub 2018 Dec 6.

Abstract

Ultraviolet (UV) photos reveal the world in a different light spectrum, including damage that is caused by UV light. In the context of skin cancer control, UV photos have the potential to communicate fear because they reveal underlying skin damage. U.S. adults (N = 2219) were assigned to a 5 (visual: UV skin damage, sun exposure, sunburn, photoaging, and mole removal) × 3 (replication: three examples of each visual condition) × 4 (efficacy: no efficacy, text only, visual, visual + text) randomized controlled trial. Compared to all other visual conditions combined, UV skin damage visuals generated greater fear which triggered increased sun safe behavior expectations. Compared with other visual conditions separately, only mole removal visuals produced equivalent fear as UV skin damage visuals. Visual efficacy conditions appeared to nullify rather than magnify the indirect path through fear. The results suggest one way UV images impact sun safe behavioral expectations is via fear and that researchers should continue to examine the position of fear in fear appeal theories.

Keywords: EPPM; Fear appeal; Skin cancer; Sun-safe behaviors; UV photo; Visuals.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Fear*
  • Female
  • Health Education / methods*
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / methods*
  • Humans
  • Male
  • Motivation
  • Skin Neoplasms / prevention & control*
  • Sunburn / prevention & control*
  • Sunlight / adverse effects*
  • Sunscreening Agents / therapeutic use
  • Text Messaging
  • Ultraviolet Rays

Substances

  • Sunscreening Agents