Although skin cancer (SC) is a largely preventable disease, it is the most common cancer in the United States. More than 3 million skin cancers are diagnosed annually. The lifetime risk of developing melanoma (an aggressive form of skin cancer) is higher among whites, but this disease is associated with considerable morbidity and mortality in the Latino population. Compared with whites, Latinos have lower 5-year melanoma survival rates, especially among men (76.6% in Latinos vs. 87.0% in whites). The Latino population often presents late-stage melanoma tumors, which can cause detrimental prognoses. Many of the cases of SC that are diagnosed annually could be prevented by protecting the skin from excessive sun exposure. Latinos tend to report a lower frequency of sunscreen use, and to endorse more sun protection barriers. This group is more likely to believe that not much can be done to decrease the risk of SC and to agree that there are too many recommendation about preventing SC that it's hard to know which ones to follow when compared with whites. The long-term goal is to use a strong psychosocial measure on sun protection beliefs that can be used to better understand behavior and guide intervention development. The objective of this particular application is to apply a mixed methods approach to better assess psychosocial factors of sun protection in the Latino population, using the Health Belief Model (HBM) and the PEN-3 model of cultural influence as theoretical frameworks. The approach is innovative because it will develop a culturally sensitive, theory-based, and psychometrically strong measure of sun protection barriers and facilitators in English to assess sun protection beliefs in Latinos.
In Aim 1, in-depth interviews will be conducted to collect qualitative and quantitative data using a sample of Latino adults (N=30) to create a pool of items reflecting sun protection barriers and facilitators. A cognitive interviewing session will follow u the first set of in-depth interviews (N=15), and the Sun Protection Barriers and Facilitators Scale (SP-BFS) will be developed based on information gathered in this aim.
In Aim 2, the scale will be administered to a second sample of Latino adults (N=200) and it will be psychometrically examined (reliability and validity). The proposed research is significant because it will contribut to the limited literature regarding predictors of SC prevention in Latinos as a way to investigate mechanisms to improve health promotion actions. The proposed research supports NCI's goal to identify and understand factors that contribute to disparities in the incidence and mortality of cancer, and for research to help develop appropriate initiatives that are culturally relevant.
At the conclusion of the award, we will have fulfilled the essential public health need for a culturally sensitive, psychometrically strong sun protection barriers and facilitators scale (SP- BFS). This scale will allow us to measure psychosocial factors that might predict and influence the likelihood to engage in sun protective behaviors in the Latino population. The information gained by the development of this scale will improve the assessment, development, and informed dissemination of prevention and control efforts for the decrease of skin cancer morbidity and mortality disparities.
