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TB 2020, 19(5): 21-32 |
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Mazloomy Mahmoodabad S S, Gerayllo S, khaleghi moori M, Yoshany N, Mizani N. Determinants of Skin Cancer Prevention Behaviors in Yazd Students: An Application of the Extended Parallel Process Model. TB 2020; 19 (5) :21-32
URL: http://tbj.ssu.ac.ir/article-1-3084-en.html
URL: http://tbj.ssu.ac.ir/article-1-3084-en.html
Seyed saeed Mazloomy Mahmoodabad 
, Sakineh Gerayllo * , Mahdiyeh Khaleghi moori , Nooshin Yoshany , Nafiseh Mizani
, Sakineh Gerayllo * , Mahdiyeh Khaleghi moori , Nooshin Yoshany , Nafiseh Mizani
, gerayllo65@yahoo.com
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Determinants of Skin Cancer Prevention Behaviors in Yazd Students: Application of the Extended Parallel Process Model
Seyed Saeed Mazloomy Mahmoodabad(Ph.D.)1, Sakineh Gerayllo(Ph.D.)2, Mahdiye Khaleghi Moori(B.S.)3, Nooshin Yoshany(Ph.D)4, nafise mizani(B.S)3
1.Professor, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2.Corresponding Author: PhD in Health Educaion and Health Promoion, Department of health, School of Public Health, Golestan Faculty of Medical Sciences, Gorgan, Iran.
Email:Gerayllo65@yahoo.com Tel:09112728832
3. M.Sc. student in Health Education, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4.Assistant Professor,Department of Health education and promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abstract
Introduction: Skin cancer is one of the most common cancers with an increasing global rate. In preventing this disease, the most basic measure is sun protection behaviors. Given the importance of health for medical students as health ambassadors, the aim of this study was to investigate the effect of extended parallel process model on the skin cancer preventive behaviors in Yazd students.
Methods: This descriptive-analytical study was conducted on 280 students of Yazd universities in 2019. The participants were selected using the random sampling method. A questionnaire based on the extended parallel processes model was used to collect the information. After entering SPSS 18 software, the data were analyzed using appropriate parametric statistical tests including independent t-test, analysis of variance, Pearson correlation, and linear regression at the significance level of 0.05.
Results: The participants’ mean age and standard deviation was 22.69±3.18 years within the range of 18 to 41 years. Among the participants, 62.5% were women. Application of hats and sunscreen was 15.7% and 30.9%, respectively. According to the findings, the perceived severity structural had the highest score among the model structures. Among the constructs of model, self-efficacy was the strongest predictor of behavioral intention (β = 0.376) and preventive behaviors of skin cancer (β = 0.109).
Conclusion: Due to the low level of protective behaviors and self-efficacy perceived construct, as the most effective factors on the preventive behaviors of skin cancer, it is recommended to consider educational interventions in this regard.
Keywords: Skin Cancer, Students, Extended parallel process model, Preventive behaviors
1-Babazadeh T, Tazval J, Moradi F, et al. Coping with skin cancer in farmers of rural areas of Chalderan County. J Health Field. 2016;3(4):32-41.
2-Afzali M, Mirzaei M, Saadati H, et al. Epidemiology of skin cancer and changes in its trends in Iran. Feyz. 2013;17(5):501-11.[Persian]
3-Janda M, Youl P, Marshall AL, et al. The HealthyTexts study: A randomized controlled trial to improve skin cancer prevention behaviors among young people. Contemporary clinical trials. 2013;35(1):159- 67.
4-Babazadeh T, Nadrian H, Banayejeddi M, et al. Determinants of skin cancer preventive behaviors among rural farmers in Iran: an application of protection motivation theory. Journal of Cancer Education. 2017;32(3):604-12.
5-https://msu.edu/~wittek/scale.htm.
6-Livingston PM, White V, Hayman J, et al. Australian adolescents' sun protection behavior: who are we kidding?. Preventive medicine. 2007;44(6):508-12.
7-Zareban I, Izadirad H, Masoudy G. The Effect of Educational Intervention on Preventive Practices of Skin Cancer among Female High School Students Based on BASNEF Model. Journal of Health. 2016;7(3):302-11.[Persian]
8- Kim RH, Armstrong AW. Nonmelanoma skin cancer. Dermatologic clinics. 2012;30(1):125-39.
9- Mohebbipour A, Amani F. Prevalence of melanoma and nonmelanoma malignancies in patients visiting dermatology clinics in Ardabil City, 2002-2013. 2015;2(1):38-43.
10- Housman TS, Feldman SR, Williford PM, et al. Skin cancer is among the most costly of all cancers to treat for the Medicare population. Journal of the American Academy of Dermatology. 2003;48(3):425-9.
11-Afshari M, Bahrami M, Kangavari M. Factors preventing skin cancer in farmers from tuyserkan city based on protection motivation theory. Iran Occupational Health. 2016;13(1):80-90.[Persian]
12-Najafimehr H, Kavousi A. Spatial evaluation of the health aare need index for skin cancer using structural equation modeling in Iran. Journal of Health System Research. 2016;12(2):222-6.
13-Geller AC, Swetter SM, Brooks K, et al. Screening, early detection, and trends for melanoma: current status (2000-2006) and future directions. Journal of the American Academy of Dermatology. 2007;57(4):555-72.
14-Branstrom R, Kasparian NA, Chang Y-m, et al. Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiology and Prevention Biomarkers. 2010;19(9):2199-210.
15-Birmingham WC, Hung M, Boonyasiriwat W, et al. Effectiveness of the extended parallel process model in promoting colorectal cancer screening. Psycho‐Oncology. 2015;24(10):1265-78.
16-Gharghani ZG, Hazavehei SMM, Sharifi MH, et al. Study of cigarette smoking status using extended parallel process model (EPPM) among secondary school male students in Shiraz city. Jundishapur Journal of Health Sciences. 2010;2(2):26-36.
17-Karimy M, Montazeri A, Araban M. The effect of an educational program based on health belief model on the empowerment of rural women in prevention of brucellosis. Arak Medical University Journal. 2012;14(7):85-94.[Persian]
18- https://msu.edu/~wittek/scale.htm.
19-Carley A, Stratman E. Skin cancer beliefs, knowledge, and prevention practices: a comparison of farmers and nonfarmers in a midwestern population. Journal of agromedicine. 2015;20(2):85-94.
20-Gould M, Farrar M, Kift R, et al. Sunlight exposure and photoprotection behaviour of white Caucasian adolescents in the UK. Journal of the European Academy of Dermatology and Venereology. 2015;29(4):732-7.
21-McQueen A, Vernon SW, Rothman AJ, et al. Examining the role of perceived susceptibility on colorectal cancer screening intention and behavior. Annals of Behavioral Medicine. 2010;40(2):205-17.
22- Kobayashi LC, Wardle J, von Wagner C. Limited health literacy is a barrier to colorectal cancer screening in England: evidence from the English Longitudinal Study of Ageing. Preventive medicine. 2014;61(100):100-105
23-Sentell TL, Tsoh JY, Davis T, et al. Low health literacy and cancer screening among Chinese Americans in California: a cross-sectional analysis. BMJ open. 2015;5(1):1-9
24-Mohammadi S, Baghiani Moghadam MH, Noorbala MT, et al. Survey about the role of appearance concern with skin cancer prevention behavior based on protection motivation theory. Journal of Dermatology and Cosmetic. 2010;1(2):70-7. [Persian]
25-Davati A, Pirasteh A, Yahyaei M, et al. Skin protective behavior amongst girl students; based on health belief model. Acta Medica Iranica. 2013;51(9):626-32
26-Lowe J, Borland R, Stanton WR, et al. Sun-safe behaviour among secondary school students in Australia. Health Education Research. 2000;15(3):271-81.
27- Benvenuto‐Andrade C, Zen B, Fonseca G, et al. Sun Exposure and Sun Protection Habits Among High‐school Adolescents in Porto Alegre, Brazil. Photochemistry and photobiology. 2005;81(3):630-5.
28-Dalli D, Ogce F, Okcin FA. Knowledge of the effects of sun exposure of Turkish high school students and their sun bathing habits. Asian Pacific Journal of Cancer Prevention. 2004;5(4):366-9.
29-Aquilina S, Gauci AA, Ellul M, et al. Sun awareness in Maltese secondary school students. Journal of the European Academy of Dermatology and Venereology. 2004;18(6):670-5.
30- Allahverdipour H, Hidarnia A, Kazemnejad A, et al. Assessment of substance abuse behaviors in adolescents’: integration of self-control into extended parallel process model. SSU_Journals. 2005;13(1):21-31. [Persian]
31- Shi J, Smith SW. The effects of fear appeal message repetition on perceived threat, perceived efficacy, and behavioral intention in the extended parallel process model. Health Communication. 2016;31(3):275-86.
32- De Vries H, Lezwijn J, Hol M, et al. Skin cancer prevention: behaviour and motives of Dutch adolescents. European Journal of Cancer Prevention. 2005;14(1):39-50.
33- Paine LE, Caltabiano ML. The effects of a skin cancer educational intervention on beliefs, knowledge and behaviours of outdoor workers in the tropics. eTropic: electronic journal of studies in the tropics. 2016;3(2):1-14.
34- Novak CB, Young DS, Lipa JE, et al. Evaluation of sun protection behaviour in patients following excision of a skin lesion. Canadian Journal of Plastic Surgery. 2007;15(1):38-40.
35- Jin SS, Kai B, Chen FF. Correlates of condom-use self-efficacy on the EPPM-based integrated model among Chinese college students. Biomedical and Environmental Sciences. 2017;30(2): 97-105.
36- Ndabarora E, Mchunu G. Factors that influence utilisation of HIV/AIDS prevention methods among university students residing at a selected university campus. SAHARA-J: 2014;11(1): 202-10.
37- Lai D, Hao J, Fu Y, et al. Evaluation of a Sun Safety Education Program for High School Students in Beijing, China. Education Journal. 2017;6(2):94-9.
38- Najafi A, Nadrian E, Bakri G et al. Skin cancer preventive behaviors and its determinants among high school students in Sanandaj, Iran: an application of PRECEDE model. Journal of Education and Community Health. 2017;4(1):1-11.
39- Luszczynska A, Durawa AB, Scholz U, et al. Empowerment beliefs and intention to uptake cervical cancer screening: three psychosocial mediating mechanisms. Women & Health. 2012;52(2):162-81.
40- Maunsell E, Lauzier S, Brunet J, et al. Health‐related empowerment in cancer: Validity of scales from the Health Education Impact Questionnaire. Cancer. 2014;120(20):3228-36.
41- Heckman CJ, Manne SL, Kloss JD, et al. Beliefs and intentions for skin protection and UV exposure in young adults. American journal of health behavior. 2011;35(6):699-711.
42- Jasemzadeh M, Jaafarzadeh N, Khafaie MA, et al. Predicator of pregnant women’s self-care behavior against air pollution: an explanation based on the extended parallel process model (EPPM). Electronic physician. 2016;8(9):2871-77
Seyed Saeed Mazloomy Mahmoodabad(Ph.D.)1, Sakineh Gerayllo(Ph.D.)2, Mahdiye Khaleghi Moori(B.S.)3, Nooshin Yoshany(Ph.D)4, nafise mizani(B.S)3
1.Professor, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2.Corresponding Author: PhD in Health Educaion and Health Promoion, Department of health, School of Public Health, Golestan Faculty of Medical Sciences, Gorgan, Iran.
Email:Gerayllo65@yahoo.com Tel:09112728832
3. M.Sc. student in Health Education, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4.Assistant Professor,Department of Health education and promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abstract
Introduction: Skin cancer is one of the most common cancers with an increasing global rate. In preventing this disease, the most basic measure is sun protection behaviors. Given the importance of health for medical students as health ambassadors, the aim of this study was to investigate the effect of extended parallel process model on the skin cancer preventive behaviors in Yazd students.
Methods: This descriptive-analytical study was conducted on 280 students of Yazd universities in 2019. The participants were selected using the random sampling method. A questionnaire based on the extended parallel processes model was used to collect the information. After entering SPSS 18 software, the data were analyzed using appropriate parametric statistical tests including independent t-test, analysis of variance, Pearson correlation, and linear regression at the significance level of 0.05.
Results: The participants’ mean age and standard deviation was 22.69±3.18 years within the range of 18 to 41 years. Among the participants, 62.5% were women. Application of hats and sunscreen was 15.7% and 30.9%, respectively. According to the findings, the perceived severity structural had the highest score among the model structures. Among the constructs of model, self-efficacy was the strongest predictor of behavioral intention (β = 0.376) and preventive behaviors of skin cancer (β = 0.109).
Conclusion: Due to the low level of protective behaviors and self-efficacy perceived construct, as the most effective factors on the preventive behaviors of skin cancer, it is recommended to consider educational interventions in this regard.
Keywords: Skin Cancer, Students, Extended parallel process model, Preventive behaviors
1-Babazadeh T, Tazval J, Moradi F, et al. Coping with skin cancer in farmers of rural areas of Chalderan County. J Health Field. 2016;3(4):32-41.
2-Afzali M, Mirzaei M, Saadati H, et al. Epidemiology of skin cancer and changes in its trends in Iran. Feyz. 2013;17(5):501-11.[Persian]
3-Janda M, Youl P, Marshall AL, et al. The HealthyTexts study: A randomized controlled trial to improve skin cancer prevention behaviors among young people. Contemporary clinical trials. 2013;35(1):159- 67.
4-Babazadeh T, Nadrian H, Banayejeddi M, et al. Determinants of skin cancer preventive behaviors among rural farmers in Iran: an application of protection motivation theory. Journal of Cancer Education. 2017;32(3):604-12.
5-https://msu.edu/~wittek/scale.htm.
6-Livingston PM, White V, Hayman J, et al. Australian adolescents' sun protection behavior: who are we kidding?. Preventive medicine. 2007;44(6):508-12.
7-Zareban I, Izadirad H, Masoudy G. The Effect of Educational Intervention on Preventive Practices of Skin Cancer among Female High School Students Based on BASNEF Model. Journal of Health. 2016;7(3):302-11.[Persian]
8- Kim RH, Armstrong AW. Nonmelanoma skin cancer. Dermatologic clinics. 2012;30(1):125-39.
9- Mohebbipour A, Amani F. Prevalence of melanoma and nonmelanoma malignancies in patients visiting dermatology clinics in Ardabil City, 2002-2013. 2015;2(1):38-43.
10- Housman TS, Feldman SR, Williford PM, et al. Skin cancer is among the most costly of all cancers to treat for the Medicare population. Journal of the American Academy of Dermatology. 2003;48(3):425-9.
11-Afshari M, Bahrami M, Kangavari M. Factors preventing skin cancer in farmers from tuyserkan city based on protection motivation theory. Iran Occupational Health. 2016;13(1):80-90.[Persian]
12-Najafimehr H, Kavousi A. Spatial evaluation of the health aare need index for skin cancer using structural equation modeling in Iran. Journal of Health System Research. 2016;12(2):222-6.
13-Geller AC, Swetter SM, Brooks K, et al. Screening, early detection, and trends for melanoma: current status (2000-2006) and future directions. Journal of the American Academy of Dermatology. 2007;57(4):555-72.
14-Branstrom R, Kasparian NA, Chang Y-m, et al. Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiology and Prevention Biomarkers. 2010;19(9):2199-210.
15-Birmingham WC, Hung M, Boonyasiriwat W, et al. Effectiveness of the extended parallel process model in promoting colorectal cancer screening. Psycho‐Oncology. 2015;24(10):1265-78.
16-Gharghani ZG, Hazavehei SMM, Sharifi MH, et al. Study of cigarette smoking status using extended parallel process model (EPPM) among secondary school male students in Shiraz city. Jundishapur Journal of Health Sciences. 2010;2(2):26-36.
17-Karimy M, Montazeri A, Araban M. The effect of an educational program based on health belief model on the empowerment of rural women in prevention of brucellosis. Arak Medical University Journal. 2012;14(7):85-94.[Persian]
18- https://msu.edu/~wittek/scale.htm.
19-Carley A, Stratman E. Skin cancer beliefs, knowledge, and prevention practices: a comparison of farmers and nonfarmers in a midwestern population. Journal of agromedicine. 2015;20(2):85-94.
20-Gould M, Farrar M, Kift R, et al. Sunlight exposure and photoprotection behaviour of white Caucasian adolescents in the UK. Journal of the European Academy of Dermatology and Venereology. 2015;29(4):732-7.
21-McQueen A, Vernon SW, Rothman AJ, et al. Examining the role of perceived susceptibility on colorectal cancer screening intention and behavior. Annals of Behavioral Medicine. 2010;40(2):205-17.
22- Kobayashi LC, Wardle J, von Wagner C. Limited health literacy is a barrier to colorectal cancer screening in England: evidence from the English Longitudinal Study of Ageing. Preventive medicine. 2014;61(100):100-105
23-Sentell TL, Tsoh JY, Davis T, et al. Low health literacy and cancer screening among Chinese Americans in California: a cross-sectional analysis. BMJ open. 2015;5(1):1-9
24-Mohammadi S, Baghiani Moghadam MH, Noorbala MT, et al. Survey about the role of appearance concern with skin cancer prevention behavior based on protection motivation theory. Journal of Dermatology and Cosmetic. 2010;1(2):70-7. [Persian]
25-Davati A, Pirasteh A, Yahyaei M, et al. Skin protective behavior amongst girl students; based on health belief model. Acta Medica Iranica. 2013;51(9):626-32
26-Lowe J, Borland R, Stanton WR, et al. Sun-safe behaviour among secondary school students in Australia. Health Education Research. 2000;15(3):271-81.
27- Benvenuto‐Andrade C, Zen B, Fonseca G, et al. Sun Exposure and Sun Protection Habits Among High‐school Adolescents in Porto Alegre, Brazil. Photochemistry and photobiology. 2005;81(3):630-5.
28-Dalli D, Ogce F, Okcin FA. Knowledge of the effects of sun exposure of Turkish high school students and their sun bathing habits. Asian Pacific Journal of Cancer Prevention. 2004;5(4):366-9.
29-Aquilina S, Gauci AA, Ellul M, et al. Sun awareness in Maltese secondary school students. Journal of the European Academy of Dermatology and Venereology. 2004;18(6):670-5.
30- Allahverdipour H, Hidarnia A, Kazemnejad A, et al. Assessment of substance abuse behaviors in adolescents’: integration of self-control into extended parallel process model. SSU_Journals. 2005;13(1):21-31. [Persian]
31- Shi J, Smith SW. The effects of fear appeal message repetition on perceived threat, perceived efficacy, and behavioral intention in the extended parallel process model. Health Communication. 2016;31(3):275-86.
32- De Vries H, Lezwijn J, Hol M, et al. Skin cancer prevention: behaviour and motives of Dutch adolescents. European Journal of Cancer Prevention. 2005;14(1):39-50.
33- Paine LE, Caltabiano ML. The effects of a skin cancer educational intervention on beliefs, knowledge and behaviours of outdoor workers in the tropics. eTropic: electronic journal of studies in the tropics. 2016;3(2):1-14.
34- Novak CB, Young DS, Lipa JE, et al. Evaluation of sun protection behaviour in patients following excision of a skin lesion. Canadian Journal of Plastic Surgery. 2007;15(1):38-40.
35- Jin SS, Kai B, Chen FF. Correlates of condom-use self-efficacy on the EPPM-based integrated model among Chinese college students. Biomedical and Environmental Sciences. 2017;30(2): 97-105.
36- Ndabarora E, Mchunu G. Factors that influence utilisation of HIV/AIDS prevention methods among university students residing at a selected university campus. SAHARA-J: 2014;11(1): 202-10.
37- Lai D, Hao J, Fu Y, et al. Evaluation of a Sun Safety Education Program for High School Students in Beijing, China. Education Journal. 2017;6(2):94-9.
38- Najafi A, Nadrian E, Bakri G et al. Skin cancer preventive behaviors and its determinants among high school students in Sanandaj, Iran: an application of PRECEDE model. Journal of Education and Community Health. 2017;4(1):1-11.
39- Luszczynska A, Durawa AB, Scholz U, et al. Empowerment beliefs and intention to uptake cervical cancer screening: three psychosocial mediating mechanisms. Women & Health. 2012;52(2):162-81.
40- Maunsell E, Lauzier S, Brunet J, et al. Health‐related empowerment in cancer: Validity of scales from the Health Education Impact Questionnaire. Cancer. 2014;120(20):3228-36.
41- Heckman CJ, Manne SL, Kloss JD, et al. Beliefs and intentions for skin protection and UV exposure in young adults. American journal of health behavior. 2011;35(6):699-711.
42- Jasemzadeh M, Jaafarzadeh N, Khafaie MA, et al. Predicator of pregnant women’s self-care behavior against air pollution: an explanation based on the extended parallel process model (EPPM). Electronic physician. 2016;8(9):2871-77
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Received: 2020/07/14 | Accepted: 2020/09/21 | Published: 2021/01/20
Received: 2020/07/14 | Accepted: 2020/09/21 | Published: 2021/01/20
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