The role of age and an expanded health belief model in predicting skin cancer protective behavior

Skin cancer (SC), the most common form of cancer in the US, with a rapidly growing incidence, has become a target for health education. Sun exposure protective behavior (SEPB) is currently believed to be the best means to prevent it. Focusing on age differences, this paper applies an expansion of the Health Belief Model (HBM) to the prediction of engagement in SC protective behaviors in four age-groups, following an intervention program. It is based on data collected by a structured questionnaire completed by 509 members of four kibbutzim in Israel. The results indicate that the proposed model explains the SC-related protective behaviors of the older age-groups (45+) much better than that of the younger groups (15-44). The older age-groups are also more likely to change risky behavior following the intervention. The youngest age-group (15-29), although being highest at risk for SC due to sun exposure habits, is least likely to change them and least likely to participate in the intervention. Beliefs about sun tanning, sun exposure habits (barriers) and degree of exposure to the intervention are the best predictors of the likelihood to engage in SEPB in the younger age-groups, while among the older groups the best predictors are the value of health and appearance. These findings suggest that health education programs should develop different messages for different age-groups. Regarding SC, it seems especially important to focus prevention efforts on adolescents and young adults by recruiting the beauty and fashion industries as well as legislation. The merits of age group analyses in the research of health behavior are discussed.