After offering information about UV light and sun-protective behaviors, the two health-ed videos diverge: one describes the increased skin cancer risk of UV exposure and the other describes effects on appearance including wrinkles and premature aging. Which of these two videos do you think caused teenagers to use more sunscreen six weeks after it was shown?
A University of Colorado Cancer Center study published in the Journal of the American Academy of Dermatology shows that while teens who watched both videos learned and retained the same amount of knowledge about UV light and sun-protective behaviors, only the teens who watched the appearance-based video (and not the health-based video) actually changed these behaviors.
"We see this anecdotally in the clinic. The teens who come in, often it's because their parents are dragging them. A lot have undergone tanning or never wear sunscreen. You can tell that when we talk about the skin cancer risk, it doesn't faze them. But when you talk about premature wrinkling and aging, they listen a little more closely," says April W. Armstrong, MD MPH, investigator at the CU Cancer Center and vice chair of Clinical Research at the CU School of Medicine Department of Dermatology.
The current study aimed to quantify this observation. First, Armstrong and colleagues went to local high schools to recruit 50 subjects. All subjects completed questionnaires demonstrating their baseline knowledge about UV light and use of sun-protective behaviors. Then subjects were randomized into two groups, one of which viewed the health-based video that emphasized skin cancer risk, and the other of which viewed the appearance-based video that emphasized cosmetic changes due to UV exposure. Six weeks later, all subjects again completed questionnaires that showed the knowledge they retained and changes in sun-protective behaviors.
"Interestingly, we didn't see any difference in teenagers' knowledge -- no matter if they had watched the health-based or appearance-based video, students learned and retained the same amount of information," Armstrong says.
However, despite knowing the skin cancer risk from UV exposure, the group that had watched the health-based video showed no statistically significant increase in their sun-protective behaviors. On the other hand, the group that had been shown the appearance-based video reported a dramatic increase in the use of sunscreen.
"For teenagers, telling them UV exposure will lead to skin cancer is not as effective as we would hope. If our endgame is to modify their behavior, we need to tailor our message in the right way and in this case the right way is by highlighting consequences to appearance rather than health. It's important to address now -- if we can help them start this behavior when younger, it can affect skin cancer risk when older," Armstrong says.
- William Tuong, April W. Armstrong. Effect of appearance-based education compared with health-based education on sunscreen use and knowledge: A randomized controlled trial. Journal of the American Academy of Dermatology, 2014; DOI: 10.1016/j.jaad.2013.12.007
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