Factors Influencing Sun Protection Behaviors Among Patients With Skin Cancer: An Application of the Information–Motivation–Behavioral Skills Model

This study aimed to assess predictors of sun protectionbehaviors basedon the informationYmotivationY behavioral skills (IMB) model among people diagnosed with nonmelanoma skin cancer (NMSC). For this descriptive, cross-sectional study, a convenience sample of 311 patients with NMSC was recruited at a medical center in Mississippi. Patients were invited to complete a faceand content-valid, IMB-model-based questionnaire. The average age of the participants was 64.12 (T12.02) years, and most (58.8%) were male. Most participants indicated not using sun protection behaviors while outdoors. Findings showed that sun protection behaviors were directly predicted by self-efficacy (standardized path coefficient = 0.504, p G .001) and social support (standardized path VOLUME 11 | NUMBER 5 | SEPTEMBER/OCTOBER 2019 199 Vinayak K. Nahar, MD, PhD, MS, FRSPH, Center for Animal and HumanHealth in Appalachia, College of VeterinaryMedicine,DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN. Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS. William H. Black, MD, Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS. Robert T. Brodell, MD, Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS. M. Allison Ford, PhD, Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, MS. Martha A. Bass, PhD, Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, MS. John P. Bentley, PhD, Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS. Paul Johnson, PhD, Department of Management, School of Business Administration, University of Mississippi, University, MS. Vinayak K. Nahar, William H. Black, Allison Ford, Martha A. Bass, John P. Bentley, and Paul Johnson have no conflict of interest to report. Robert T. Brodell discloses the following potential conflict of interest: Honoraria have been received from presentations for Allergan, Galderma, and PharmaDerm, a division of Nycomed US, Inc. Consultant fees have been received from Galderma Laboratories, L.P. Clinical trials have been performed for Genentech and Janssen Biotech, Inc. The material in this article is not believed to be relevant to any of these reported conflicts. Correspondence concerning this article should be addressed to Vinayak K. Nahar, MD, PhD, MS, FRSPH, Center for Animal and HumanHealth in Appalachia College of VeterinaryMedicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752. E-mail: naharvinayak@gmail.com Copyright B 2019 by the Dermatology Nurses’ Association. DOI: 10.1097/JDN.0000000000000472 Copyright © 2019 Dermatology Nurses' Association. Unauthorized reproduction of this article is prohibited. coefficient = 0.199, p = .010). In addition, sun protection behavior was indirectly predicted (through self-efficacy) by social support (standardized indirect effect = 0.160, p G .001) and attitudes (standardized indirect effect = 0.192, p = .001). The explained variances for self-efficacy and sun protection behaviors were 43% and 35.4%, respectively. In conclusion, the IMB model appears to be a useful theoretical framework for predicting sunprotection behaviors among patients with NMSC. Sun safety intervention programs should be developed based on this theoretical model for patients with NMSC.