Predictors of Sun-Protective Behaviors and Sunburn in the United States Population

ABSTRACT Skin cancer is the most diagnosed cancer in the United States. Despite years of education about prevention, incidence is increasing. There are mixed findings about sun protection factors' relationship to preventing sunburn. This study aimed to identify the factors associated with the performance of sun-protective behaviors and understand sunburn risk factors, which relate to skin cancer risk, controlling for demographic factors. This is a secondary analysis of cross-sectional data from the National Health and Nutrition Examination Survey from 2017 to 2018. Data were subset to U.S. participants ages 20 years and older who answered the dermatology questions, which included 3,404 people. A hierarchical logistic regression analysis was conducted in SPSS to investigate the contribution of several factors predicting sun-protective behaviors while controlling for demographic variables. In addition, multiple logistic regression analyses were used to examine potential factors related to getting a sunburn. Statistical significance was p < .05. Race, education, birth country, gender, and sun sensitivity were significant predictors of sun protection behaviors. Those who used sunscreen with a higher frequency and those with severe sun sensitivity had the highest odds of reporting a sunburn. Younger age and severe sun sensitivity were associated with multiple sunburns. The discrepancy between the perceived level of sun sensitivity and the incidence of sunburn suggests that people need to be adequately informed about the risks of sunburn. This finding supports the need for additional research to understand the attitudes and health beliefs toward sunburn and skin cancer prevention.