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Do forecasts of UV indexes influence people's outdoor behaviour?

Do forecasts of UV indexes influence people's outdoor behaviour? awareness of the ultraviolet (UV) indexes forecast in the media, and whether these UV forecasts influence their behaviour in the sun. Anouk M. Alberink Rijksuniversiteit, Groningen, The Netherlands Patricia Casarolli Valery, Anne Russell and Adele Green Epidemiology and Population Health Unit, Queensland Institute of Medical Research Methods: A self-administered questionnaire was used on two occasions in 1997 to ask about knowledge of UV indexes shown in the media and about possible influence on outdoor behaviour. Setting and participants: Participants were 977 residents (423 men; 554 women) of Nambour originally randomly selected in 1986 from the electoral roll, who have been followed up subsequently. Results: The majority of people – 92% of men and 86% of women – reported having seen or heard the UV indexes forecast during summer. Of these, significantly fewer men (107; 28%) than women (209; 46%) reported that their outdoor behaviour was influenced by knowledge of the forecast (p=0.001). Neither age nor skin type, nor history of sunburns or skin cancer, affected knowledge of UV forecasts or their influence on behaviour. Conclusions and Implications: Although most people are aware of the forecasts of UV indexes in the media, the majority do not take them into account in their outdoor behaviour. Compared with women, men were more aware of, but less influenced by, forecasts of UV indexes. Better communication of the implications of the UV indexes is needed, particularly to men, if they are to adapt their outdoor behaviour to improve their sun protection. (Aust N Z J Public Health 2000; 24: 488-91) he predominantly Caucasian population of Queensland inhabiting tropical and subtropical latitudes, have the highest incidence rates of skin cancer in the world.1 This incidence is expected to rise even further with stratospheric ozone depletion and the consequent increase in terrestrial ultraviolet (UV) B radiation.2,3 The simplest and most effective strategy to control skin cancer is protection from the sun. Programs aiming at promoting sun protection behaviour such as ‘Slip, slop, slap!’4 and ‘SunSmart’5 have been conducted in Australia for almost two decades and a decrease in rates of basal cell carcinoma among younger generations suggests that the campaigns are beginning to have some effect.6 Less direct approaches to control skin cancer aim at teaching children about skin cancer;7 encouraging people to examine their own skin for lesions;8 and drawing people’s attention to the daily ambient levels of solar UV radiation, which is the topic of this paper. Information about measured UV radiation has been disseminated daily to the media by the Australian Radiation Laboratory for almost a decade. This has been in the form of UV indexes since 19959 when the International Commission on Non-Ionizing Radiation Protection (ICNIRP) introduced the UV index as a standard measure. The UV index is a dimensionless number that represents the estimated solar erythemal irradiance incident on a horizontal surface at the surface of the earth. 9 There are three common methods used to represent this index: a numerical index (ranging from 0 to 20 in Australia), a text scale (ranging from ‘moderate’ for UV indexes values below 3 to ‘extreme’ for values above 9) and the estimated time to sunburn.9 The UV index forecast for each day is issued by the Bureau of Meteorology (BoM). UV indexes have been published as part of the weather forecast in the paper and broadcast on television and radio since September 1996. Little is known about the notice people take of UV indexes or whether knowledge of UV indexes influences their exposure to solar UV radiation. A study of awareness of UV indexes among white adults in 58 US cities in 199510 found that 445 (64%) indicated that they had ‘ever heard of ’ or read anything about the UV indexes. Among these 445, 90% accurately explained the UV indexes (in an open-ended question) and 38% reported that awareness of the UV indexes prompted them or their family to change behaviour with respect to sun exposure. Although men and women were equally aware of UV indexes, women reported changing sun-protection behaviour more frequently. In Australia, a report by the New South Wales Cancer Council11 showed that 64% of 504 respondents (18 years and older) Submitted: January 2000 Revision requested: May 2000 Accepted: August 2000 Correspondence to: Dr Patricia Valery, Queensland Institute of Medical Research, c/- Post Office, Royal Brisbane Hospital, Queensland 4029. Fax: (07) 3362 0101; e-mail: patriciV@qimr.edu.au AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2000 VOL. 24 NO. 5 Forecasts of UV indexes and people’s outdoor behaviour from metropolitan areas in NSW had seen or heard UV forecasts. We conducted the present study to investigate whether people in a provincial community in Queensland were aware of the UV forecasts in the media and, if so, whether this influenced their behaviour in the sun. winter. On the other hand, of the 140 people who said they had not seen or heard the UV forecast during winter, 79 (56%) said they had seen it in summer. Only 61 subjects (6%) had never seen or heard the UV forecast. There were no associations between awareness and either age or history of skin cancer (not shown). Methods Study participants were originally selected in 1986, at random from the electoral roll of Nambour, a south-eastern Queensland township, when they were invited to take part in a skin-cancer survey.12 They subsequently participated in a skin cancer prevention trial conducted from 1992 to 1996,13 and follow-up has continued since 1996. In 1997, a self-administered questionnaire was completed by participants at the end of summer (April) and again at the end of winter (October), to cover seasonal differences. Subjects were asked if they had seen or heard reports of forecasts about UV levels in the past six months. If they answered yes, they were asked whether knowing the UV forecast had influenced their behaviour in that period outdoors and at what level of forecast UV they thought it sensible to take extra precautions when out in the sun. Levels were specified as ‘extreme’, ‘very high’, ‘high’, ‘moderate’; a fifth category of response was given for those who were undecided. During the period of investigation, UV indexes were being forecast on radio and television stations, but were not being published in newspapers. Data were analysed using SAS. Influence on behaviour Among people who were aware of the UV indexes, 316 (37%) said their behaviour had been influenced by the UV forecast in summer and 235 (32%) in winter. For both summer and winter months, significantly fewer men than women were influenced by the UV forecast (p=0.001) (see Table 1). The majority of men and women thought it sensible to take extra precautions outdoors when the UV indexes forecast was ‘high’, in both summer and winter. This was true for people in every 10-year age group, from 30-39 years to 70-79 years (see Table 2). Of the 451 women who answered the questions about the UV level at which precautions were taken in both questionnaires, 55% took no extra precautions, 11% took them when the UV forecast was ‘moderate’ and 22% when the forecast was ‘high’. Among the 375 men the corresponding percentages were 73%, 7% and 11%, respectively, and these differences between women and men were significant (p=0.001). When people’s responses to UV indexes were related to their skin reaction after acute sun exposure, no significant differences were found. Indeed people whose skins burned tended to be less influenced in their behaviour in the sun by the UV forecast than the group who tanned only, with 60% of the 82 people whose skins tanned without burning taking no extra precautions when outdoors as opposed to 62% (n=578) and 69% (n=166) of people who ‘burned then tanned’ and ‘always burned’ respectively (see Table 3) (p=0.039). This pattern of association with skin type was similar in summer and winter. Among those with a history of skin cancer, or those who had been sunburnt in the previous five years, knowledge of the UV forecast influenced neither outdoor behaviour nor the UV level at which precautions were taken, compared with those with no history of skin cancer or sunburn. Results Of the 1,341 participants who were sent questionnaires in summer and winter, 1,050 returned them (78% response rate). After excluding those with missing data, there were 977 pairs of completed questionnaires for analysis. Awareness of UV forecast Based on the questionnaire covering the summer months, 389 men (92%) and 478 women (86%) reported seeing or hearing the UV forecast (p<0.005) (see Table 1). There was no corresponding difference between men and women aware of the UV forecast during the winter months. Individuals’ awareness varied during the year. Of the 110 people who said they did not see or hear the UV forecast in summer, 49 (45%) said they had seen it during Discussion Around 90% of people in this Queensland community sample had seen or heard the UV indexes as part of weather forecasts Table 1: Awareness of the UV indexes forecast in summer and winter, and reported influence on outdoor behaviour. Men Awareness of the UV indexes forecast? Yes Total Behaviour influenced by UV indexes forecast? Yes Totalc 107 (28%) 381 209 (46%)b 459 74 (22%) 332 161 (39%)b 409 389 (92%) 423 478 (86%)a 554 368 (87%) 423 469 (85%) 554 Summer Women Winter Men Women Notes: (a) Differences between men and women in summer were significant (p=0.005). (b) Differences between men and women were significant in both summer (p=0.001) and winter (p=0.001). (c) Excluding those ‘not sure’ or with missing data. 2000 VOL. 24 NO. 5 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH Alberink et al. Table 2: Distribution of UV forecast levels at which precautions are taken during summer according to age. UV forecast Extreme Very high High Moderate Total 30-39 7 (14%) 6 (12%) 29 (59%) 7 (14%) 49 40-49 7 (13%) 8 (15%) 22 (40%) 18 (33%) 55 50-59 8 (9%) 11 (13%) 38 (43%) 31 (35%) 88 60-69 11 (17%) 12 (18%) 33 (50%) 10 (15% 66 70-79 9 (20%) 7 (16%) 18 (41%) 10 (23%) 44 Total 42 (14%) 44 (15%) 140 (47%) 76 (25%) 302 during the year, but only one-third said their behaviour was influenced by them. This difference between awareness and behaviour is consistent with a survey in Victoria in which 78% of people had ever seen or heard forecast of UV indexes but only approximately 40% said the indexes had influenced their behaviour in the sun.14 Another population-based survey in New South Wales,11 where people were interviewed by a market research firm in a routine omnibus survey reported a smaller proportion of people who had ever seen or heard of the UV indexes (64% of people 18 years and older). These people were even less influenced by them (75% reported they rarely used the information about UV levels on weekends to decide about sun protection, while only 13% reported regular use). Also, a study in the US10 suggested that just over one-third of participants who reported awareness of UV indexes changed their outdoor behaviour in relation to sun exposure. There may be several reasons for the widespread discrepancy between awareness and behaviour. It has been suggested that people in Queensland may lose interest in the index during summer because it is either ‘very high’ to ‘extreme’ on most days.15 Also, anecdotal evidence from sun protection program staff in Queensland, South Australia and Victoria suggests that some people who watch the UV forecast might not understand what the index actually means.16 Differences between men and women in awareness and response to media reports of UV indexes have not previously been reported in Australia. In this Queensland study, significantly more men than women were aware of the UV forecast in both summer and winter, which may, in part, indicate that more men than women watched or heard the news and weather broadcasts. Despite their greater awareness, however, only a quarter of the men were influenced in their outdoor behaviour, compared with almost half the women. Unlike results from a US study,10 fewer women than men in this Queensland community were aware of the UV forecast in the media. However, it appears from our study that women are not less interested than men in the UV forecast in the media, just less aware of it. Results from other studies also suggest men do not care for their skin to the same extent as women, particularly young women.6 It may also be that people who say they are not influenced by the UV forecast are already taking adequate precautions against sun exposure, so they are not additionally influenced in this behaviour by the UV forecast. It was surprising that people with a history of skin cancer were not more influenced in their outdoor behaviour than people without a history of skin cancer, and that having sunburn in the past five years did not affect the influence of the UV forecast on people’s outdoor behaviour. Perhaps these people protect themselves whatever the weather and there is little room for improvement in sun protection behaviour. If that is not true, this suggests that such high-risk groups may need special targeting when planning a whole array of programs aiming at promoting sun protection behaviour. There are some limitations to the interpretation of our findings. First, the community sample under study has been involved in skin cancer studies since 1986. One would think that this would tend to heighten their awareness of UV indexes, and this may be the reason for the higher levels reported than in other studies. On the other hand, lower proportions of people changed their outdoor practices as a consequence, suggesting that involvement in skin cancer studies has minimal influence on behaviour or that they have already modified their behaviour and information on the UV index makes no difference. Also, similarities with studies in Victoria,14 where 40% of people who had seen or heard the UV forecast said it had influenced their behaviour in the sun, tend to be reassuring. Second, we had virtually no participants under 30 years of age, and younger adults may behave differently. Finally, we did not ascertain the type of UV indexes broadcast in the me- Table 3: Distribution of UV forecast levels at which precautions are taken during summer, according to propensity for skin to burn and/or tan after acute sun exposure. UV forecast level at which precautions taken None Extreme Very high High Moderate Total Always burn 114 (69%) 13 (8%) 7 (4%) 16 (10%) 16 (10%) 166 Skin reaction to acute sun Burn then tan Tan only 361 (62%) 23 (4%) 32 (6%) 113 (20%) 49 (8%) 578 49 (60%) 6 (7%) 5 (6%) 11 (13%) 11 (13%) 82 Total 524 (64%) 42 (5%) 44 (5%) 140 (17%) 76 (9%) 826 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2000 VOL. 24 NO. 5 Forecasts of UV indexes and people’s outdoor behaviour dia (numerical, text scale or estimated time to sunburn) or ask subjects if they knew what the indexes meant. Notwithstanding these limitations, we conclude: • there is a major discrepancy between people’s awareness of the daily level of UV when outdoors and their behaviour in response to this knowledge; • although more men than women were aware of the UV levels forecast, significantly more women appeared to translate their awareness of the indexes into changing their outdoor behaviour; and • although the majority of people hear or see the UV indexes, we still do not know whether they understand them. Better communication of the implications of the UV indexes is needed, particularly to men, if they are to adapt their outdoor behaviour to improve their sun protection. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

Do forecasts of UV indexes influence people's outdoor behaviour?

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Publisher
Wiley
Copyright
Copyright © 2000 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/j.1467-842X.2000.tb00498.x
Publisher site
See Article on Publisher Site

Abstract

awareness of the ultraviolet (UV) indexes forecast in the media, and whether these UV forecasts influence their behaviour in the sun. Anouk M. Alberink Rijksuniversiteit, Groningen, The Netherlands Patricia Casarolli Valery, Anne Russell and Adele Green Epidemiology and Population Health Unit, Queensland Institute of Medical Research Methods: A self-administered questionnaire was used on two occasions in 1997 to ask about knowledge of UV indexes shown in the media and about possible influence on outdoor behaviour. Setting and participants: Participants were 977 residents (423 men; 554 women) of Nambour originally randomly selected in 1986 from the electoral roll, who have been followed up subsequently. Results: The majority of people – 92% of men and 86% of women – reported having seen or heard the UV indexes forecast during summer. Of these, significantly fewer men (107; 28%) than women (209; 46%) reported that their outdoor behaviour was influenced by knowledge of the forecast (p=0.001). Neither age nor skin type, nor history of sunburns or skin cancer, affected knowledge of UV forecasts or their influence on behaviour. Conclusions and Implications: Although most people are aware of the forecasts of UV indexes in the media, the majority do not take them into account in their outdoor behaviour. Compared with women, men were more aware of, but less influenced by, forecasts of UV indexes. Better communication of the implications of the UV indexes is needed, particularly to men, if they are to adapt their outdoor behaviour to improve their sun protection. (Aust N Z J Public Health 2000; 24: 488-91) he predominantly Caucasian population of Queensland inhabiting tropical and subtropical latitudes, have the highest incidence rates of skin cancer in the world.1 This incidence is expected to rise even further with stratospheric ozone depletion and the consequent increase in terrestrial ultraviolet (UV) B radiation.2,3 The simplest and most effective strategy to control skin cancer is protection from the sun. Programs aiming at promoting sun protection behaviour such as ‘Slip, slop, slap!’4 and ‘SunSmart’5 have been conducted in Australia for almost two decades and a decrease in rates of basal cell carcinoma among younger generations suggests that the campaigns are beginning to have some effect.6 Less direct approaches to control skin cancer aim at teaching children about skin cancer;7 encouraging people to examine their own skin for lesions;8 and drawing people’s attention to the daily ambient levels of solar UV radiation, which is the topic of this paper. Information about measured UV radiation has been disseminated daily to the media by the Australian Radiation Laboratory for almost a decade. This has been in the form of UV indexes since 19959 when the International Commission on Non-Ionizing Radiation Protection (ICNIRP) introduced the UV index as a standard measure. The UV index is a dimensionless number that represents the estimated solar erythemal irradiance incident on a horizontal surface at the surface of the earth. 9 There are three common methods used to represent this index: a numerical index (ranging from 0 to 20 in Australia), a text scale (ranging from ‘moderate’ for UV indexes values below 3 to ‘extreme’ for values above 9) and the estimated time to sunburn.9 The UV index forecast for each day is issued by the Bureau of Meteorology (BoM). UV indexes have been published as part of the weather forecast in the paper and broadcast on television and radio since September 1996. Little is known about the notice people take of UV indexes or whether knowledge of UV indexes influences their exposure to solar UV radiation. A study of awareness of UV indexes among white adults in 58 US cities in 199510 found that 445 (64%) indicated that they had ‘ever heard of ’ or read anything about the UV indexes. Among these 445, 90% accurately explained the UV indexes (in an open-ended question) and 38% reported that awareness of the UV indexes prompted them or their family to change behaviour with respect to sun exposure. Although men and women were equally aware of UV indexes, women reported changing sun-protection behaviour more frequently. In Australia, a report by the New South Wales Cancer Council11 showed that 64% of 504 respondents (18 years and older) Submitted: January 2000 Revision requested: May 2000 Accepted: August 2000 Correspondence to: Dr Patricia Valery, Queensland Institute of Medical Research, c/- Post Office, Royal Brisbane Hospital, Queensland 4029. Fax: (07) 3362 0101; e-mail: patriciV@qimr.edu.au AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2000 VOL. 24 NO. 5 Forecasts of UV indexes and people’s outdoor behaviour from metropolitan areas in NSW had seen or heard UV forecasts. We conducted the present study to investigate whether people in a provincial community in Queensland were aware of the UV forecasts in the media and, if so, whether this influenced their behaviour in the sun. winter. On the other hand, of the 140 people who said they had not seen or heard the UV forecast during winter, 79 (56%) said they had seen it in summer. Only 61 subjects (6%) had never seen or heard the UV forecast. There were no associations between awareness and either age or history of skin cancer (not shown). Methods Study participants were originally selected in 1986, at random from the electoral roll of Nambour, a south-eastern Queensland township, when they were invited to take part in a skin-cancer survey.12 They subsequently participated in a skin cancer prevention trial conducted from 1992 to 1996,13 and follow-up has continued since 1996. In 1997, a self-administered questionnaire was completed by participants at the end of summer (April) and again at the end of winter (October), to cover seasonal differences. Subjects were asked if they had seen or heard reports of forecasts about UV levels in the past six months. If they answered yes, they were asked whether knowing the UV forecast had influenced their behaviour in that period outdoors and at what level of forecast UV they thought it sensible to take extra precautions when out in the sun. Levels were specified as ‘extreme’, ‘very high’, ‘high’, ‘moderate’; a fifth category of response was given for those who were undecided. During the period of investigation, UV indexes were being forecast on radio and television stations, but were not being published in newspapers. Data were analysed using SAS. Influence on behaviour Among people who were aware of the UV indexes, 316 (37%) said their behaviour had been influenced by the UV forecast in summer and 235 (32%) in winter. For both summer and winter months, significantly fewer men than women were influenced by the UV forecast (p=0.001) (see Table 1). The majority of men and women thought it sensible to take extra precautions outdoors when the UV indexes forecast was ‘high’, in both summer and winter. This was true for people in every 10-year age group, from 30-39 years to 70-79 years (see Table 2). Of the 451 women who answered the questions about the UV level at which precautions were taken in both questionnaires, 55% took no extra precautions, 11% took them when the UV forecast was ‘moderate’ and 22% when the forecast was ‘high’. Among the 375 men the corresponding percentages were 73%, 7% and 11%, respectively, and these differences between women and men were significant (p=0.001). When people’s responses to UV indexes were related to their skin reaction after acute sun exposure, no significant differences were found. Indeed people whose skins burned tended to be less influenced in their behaviour in the sun by the UV forecast than the group who tanned only, with 60% of the 82 people whose skins tanned without burning taking no extra precautions when outdoors as opposed to 62% (n=578) and 69% (n=166) of people who ‘burned then tanned’ and ‘always burned’ respectively (see Table 3) (p=0.039). This pattern of association with skin type was similar in summer and winter. Among those with a history of skin cancer, or those who had been sunburnt in the previous five years, knowledge of the UV forecast influenced neither outdoor behaviour nor the UV level at which precautions were taken, compared with those with no history of skin cancer or sunburn. Results Of the 1,341 participants who were sent questionnaires in summer and winter, 1,050 returned them (78% response rate). After excluding those with missing data, there were 977 pairs of completed questionnaires for analysis. Awareness of UV forecast Based on the questionnaire covering the summer months, 389 men (92%) and 478 women (86%) reported seeing or hearing the UV forecast (p<0.005) (see Table 1). There was no corresponding difference between men and women aware of the UV forecast during the winter months. Individuals’ awareness varied during the year. Of the 110 people who said they did not see or hear the UV forecast in summer, 49 (45%) said they had seen it during Discussion Around 90% of people in this Queensland community sample had seen or heard the UV indexes as part of weather forecasts Table 1: Awareness of the UV indexes forecast in summer and winter, and reported influence on outdoor behaviour. Men Awareness of the UV indexes forecast? Yes Total Behaviour influenced by UV indexes forecast? Yes Totalc 107 (28%) 381 209 (46%)b 459 74 (22%) 332 161 (39%)b 409 389 (92%) 423 478 (86%)a 554 368 (87%) 423 469 (85%) 554 Summer Women Winter Men Women Notes: (a) Differences between men and women in summer were significant (p=0.005). (b) Differences between men and women were significant in both summer (p=0.001) and winter (p=0.001). (c) Excluding those ‘not sure’ or with missing data. 2000 VOL. 24 NO. 5 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH Alberink et al. Table 2: Distribution of UV forecast levels at which precautions are taken during summer according to age. UV forecast Extreme Very high High Moderate Total 30-39 7 (14%) 6 (12%) 29 (59%) 7 (14%) 49 40-49 7 (13%) 8 (15%) 22 (40%) 18 (33%) 55 50-59 8 (9%) 11 (13%) 38 (43%) 31 (35%) 88 60-69 11 (17%) 12 (18%) 33 (50%) 10 (15% 66 70-79 9 (20%) 7 (16%) 18 (41%) 10 (23%) 44 Total 42 (14%) 44 (15%) 140 (47%) 76 (25%) 302 during the year, but only one-third said their behaviour was influenced by them. This difference between awareness and behaviour is consistent with a survey in Victoria in which 78% of people had ever seen or heard forecast of UV indexes but only approximately 40% said the indexes had influenced their behaviour in the sun.14 Another population-based survey in New South Wales,11 where people were interviewed by a market research firm in a routine omnibus survey reported a smaller proportion of people who had ever seen or heard of the UV indexes (64% of people 18 years and older). These people were even less influenced by them (75% reported they rarely used the information about UV levels on weekends to decide about sun protection, while only 13% reported regular use). Also, a study in the US10 suggested that just over one-third of participants who reported awareness of UV indexes changed their outdoor behaviour in relation to sun exposure. There may be several reasons for the widespread discrepancy between awareness and behaviour. It has been suggested that people in Queensland may lose interest in the index during summer because it is either ‘very high’ to ‘extreme’ on most days.15 Also, anecdotal evidence from sun protection program staff in Queensland, South Australia and Victoria suggests that some people who watch the UV forecast might not understand what the index actually means.16 Differences between men and women in awareness and response to media reports of UV indexes have not previously been reported in Australia. In this Queensland study, significantly more men than women were aware of the UV forecast in both summer and winter, which may, in part, indicate that more men than women watched or heard the news and weather broadcasts. Despite their greater awareness, however, only a quarter of the men were influenced in their outdoor behaviour, compared with almost half the women. Unlike results from a US study,10 fewer women than men in this Queensland community were aware of the UV forecast in the media. However, it appears from our study that women are not less interested than men in the UV forecast in the media, just less aware of it. Results from other studies also suggest men do not care for their skin to the same extent as women, particularly young women.6 It may also be that people who say they are not influenced by the UV forecast are already taking adequate precautions against sun exposure, so they are not additionally influenced in this behaviour by the UV forecast. It was surprising that people with a history of skin cancer were not more influenced in their outdoor behaviour than people without a history of skin cancer, and that having sunburn in the past five years did not affect the influence of the UV forecast on people’s outdoor behaviour. Perhaps these people protect themselves whatever the weather and there is little room for improvement in sun protection behaviour. If that is not true, this suggests that such high-risk groups may need special targeting when planning a whole array of programs aiming at promoting sun protection behaviour. There are some limitations to the interpretation of our findings. First, the community sample under study has been involved in skin cancer studies since 1986. One would think that this would tend to heighten their awareness of UV indexes, and this may be the reason for the higher levels reported than in other studies. On the other hand, lower proportions of people changed their outdoor practices as a consequence, suggesting that involvement in skin cancer studies has minimal influence on behaviour or that they have already modified their behaviour and information on the UV index makes no difference. Also, similarities with studies in Victoria,14 where 40% of people who had seen or heard the UV forecast said it had influenced their behaviour in the sun, tend to be reassuring. Second, we had virtually no participants under 30 years of age, and younger adults may behave differently. Finally, we did not ascertain the type of UV indexes broadcast in the me- Table 3: Distribution of UV forecast levels at which precautions are taken during summer, according to propensity for skin to burn and/or tan after acute sun exposure. UV forecast level at which precautions taken None Extreme Very high High Moderate Total Always burn 114 (69%) 13 (8%) 7 (4%) 16 (10%) 16 (10%) 166 Skin reaction to acute sun Burn then tan Tan only 361 (62%) 23 (4%) 32 (6%) 113 (20%) 49 (8%) 578 49 (60%) 6 (7%) 5 (6%) 11 (13%) 11 (13%) 82 Total 524 (64%) 42 (5%) 44 (5%) 140 (17%) 76 (9%) 826 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2000 VOL. 24 NO. 5 Forecasts of UV indexes and people’s outdoor behaviour dia (numerical, text scale or estimated time to sunburn) or ask subjects if they knew what the indexes meant. Notwithstanding these limitations, we conclude: • there is a major discrepancy between people’s awareness of the daily level of UV when outdoors and their behaviour in response to this knowledge; • although more men than women were aware of the UV levels forecast, significantly more women appeared to translate their awareness of the indexes into changing their outdoor behaviour; and • although the majority of people hear or see the UV indexes, we still do not know whether they understand them. Better communication of the implications of the UV indexes is needed, particularly to men, if they are to adapt their outdoor behaviour to improve their sun protection.

Journal

Australian and New Zealand Journal of Public HealthWiley

Published: Oct 1, 2000

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