Factors associated with sun protection compliance: results from a nationwide cross-sectional evaluation of 2215 patients from a dermatological consultation.

ABSTRACT

BACKGROUND: Campaigns designed to promote sun protection often fail to induce long-term changes in behaviour. There is limited information on patients with low compliance to sun protection recommendations from dermatologists. OBJECTIVES: To characterize dermatology patients at higher risk of low compliance to sun protection measures, and to investigate the relationship between sun protection behaviour, knowledge about accurate sun protection recommendations, ultraviolet (UV)-associated risks and level of UV exposure. METHODS: An anonymous self-administered multiple-choice questionnaire was distributed by dermatologists to patients receiving a sunscreen prescription. Four domains were explored sun protection behaviour, sun protection knowledge, level of UV exposure and knowledge about UV-associated risks. We modelled sun protection behaviour and determined factors associated with low compliance to sun protection measures. RESULTS: In total 2215 questionnaires were analysed. Patients stratified by risk who better complied with sun protection measures had a better knowledge of UV-associated risks (mean score 14·45 ± 3·20 vs. 12·75 ± 3·29 and 11·20 ± 3·80, P < 0·0001) and sun protection measures (mean score 12·08 ± 2·79 vs. 10·68 ± 3·11 and 9·00 ± 3·63, P < 0·0001). Patients who better complied with sun protection measures also reported higher levels of sun exposure (mean score 4·24 ± 2·26 vs. 4·02 ± 2·05 and 3·34 ± 2·14, P < 0·0001). Factors associated with low adherence to sun protection behaviour were age below 20 or over 64 years, male sex, lower knowledge about accurate sun protection recommendations and UV-associated risks, and low UV exposure. CONCLUSIONS: This study shows the complex relationship between UV exposure, knowledge about UV-associated risks, and knowledge about sun protection recommendations and behaviour. Future skin cancer prevention programmes should focus on specific populations with low sun protection behaviour and high UV exposure.