Sunday, June 9, 2013

Why wear sunscreen, health or beauty?

Summer is upon us.  For me and my northern European skin, this means my Target expenditures have to increase to accommodate sunscreen and aloe vera. I suppose the past 10 years of reading Vogue religiously and admiring graceful women who could pass for 40 when they are really grandmothers (cough…Blythe Danner…cough) has taught me the importance of sunscreen and moisturizers. I haven’t always been this way though. As a child I spent half my energy running away from sunscreen because it would run into my eyes while I played soccer. And I hate to admit it, but as a high school cheerleader, it was not uncommon for my friends and I to skip lunch for a session at a tanning salon. Looking through the development of skin care values, they are driven largely by vanity and a desire to be desirable in whatever social context was most important to me at the time. In contrast, my fiancĂ© is motivated by good old-fashioned fear. During grade school, he was scarred by a lesson in health class where survivors of skin cancer visited the classroom often without their noses and lips. As a result he is a major supporter of zinc. Anecdotes aside, the empirical question here for market researchers, consumers, public health researchers and education policy-makers is:

What motivates people to protect their skin from the sun, skin cancer or beauty concerns?

Alison Williams and her colleagues at Staffordshire University recently conducted an intervention study that asked exactly this question. To do this, they recruited 70 women (aged 18-34), collected information on each woman’s beliefs and behaviors related to sun protection, and then evenly distributed them between two interventions.

The first intervention was a 45-minute health literature intervention. In this intervention, the women were given two educational brochures about the risks of sun exposure, what causes skin cancer and how to protect yourself. After reading through the materials, they engaged in a conversation with the experimenter about their reactions to the information to confirm that they had read them and understood the content.

The second intervention was a 45-minute facial aging intervention. In this intervention, the participants had their photograph taken by the experimenter, which was then uploaded to a software program called APRIL. APRIL is a program that was developed using images of thousands of individuals of different ages, ethnicities, and lifestyles. With this database, APRIL can transform the photographed face of a person to any age (up to 72 years) depending on lifestyle choices (e.g. sunbathing, smoking, exercise). The experimenter then showed the participant 2 images of their face for every other year until age 72. In one version they had hypothetically engaged in no sun protection (no sunscreen, use of tanning beds), and in the other they had used sun protection (See the APRIL transformation of Katie Holmes below). Once the participant saw all of the photographs to age 72, they discussed their reactions to the images and were allowed to further examine some of the images as they chose.

Before each intervention, all of the women reported on their current and recent skin care behavior (How often they wear sunscreen? Is it greater than SPF 15? Do they use tanning beds?), and their beliefs about the damaging effects of sun exposure. After both interventions, the women again reported their beliefs about the damaging effects of sun exposure.
The women in both conditions reported an increased understanding of the damaging effects of sun exposure and even reported increased intentions to protect their skin from the sun. However, the women in the facial-aging intervention group showed the greatest improvement in their beliefs, understanding and intentions. Therefore, showing women what they will look like with sun damage is more effective at changing beliefs about using sunscreen than educating them about skin cancer.

Unfortunately, the effects of this intervention were only measured on the day of the intervention. Much more could be learned about the effects of this study had they interviewed these women the following August about their use of sun protection during the summer. As a psychologist, I have learned through both my clinical work and research that you can seldom change behavior without first changing beliefs, but changing beliefs does not automatically change behavior.

What I find most interesting about these findings are the implications they have for how women think. Most women, including the women in this study, report that tan skin is more attractive, and recently is considered to look healthier than fair skin. This may be driven by the fact that most men report finding tan skin more attractive than fair skin. Given this information, I can’t blame anyone for preferring to be attractive now versus at age 60 or 70. Socially and evolutionarily that makes sense. What doesn’t make sense is that in this study, the fear of unattractiveness at age 60 or 70 is pitted against death. In this case, the women were more motivated by the fear of unattractiveness…

One reason, at least in this case, that educational brochures are not worth the trees sacrificed to make them is that most adults are aware of the damaging effects of sun exposure. The media does most of that heavy lifting in that arena. The challenge is simply how to integrate protection from those dangers into daily living. My sunburns have never occurred on purpose, but rather when the baseball game goes into extra innings, or we decide to sit outside for lunch on an unexpectedly sunny day. What has saved me here is good consumer decisions, and habit. The good consumer decision was reading the helpful information about which sunscreens the American Cancer Society recommends (the short answer is “broad spectrum” sunscreen products with SPF > 25, but you can read more for yourself here). The habit was putting on sunscreen every morning, never buying SPF free lip balm, and carrying both with me all of the time.  

Williams, A. L., Grogan, S., Clark-Carter, D., & Buckley, E. (2013). Impact of a Facial-ageing Intervention versus a Health Literature Intervention on Women's Sun Protection Attitudes and Behavioural Intentions. Psychology & Health.  DOI: 10.1080/08870446.2013.777965.

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