Aims: Despite over 30 years of public health education, melanoma continues to disproportionately affect Australia’s youth and is the most common cancer in young adults aged between 15 and 45 years. In Australia, melanoma incidence among individuals under 15 years of age is approximately 30 per million, compared to only 1 per million in the US. Documented poor adherence to sun protection recommendations indicates that barriers to the uptake of sun protection still exist. This study examined melanoma-related risk perceptions amongst adolescents, hypothesizing that low perceptions of risk may be an important barrier to sun protection. In addition, this study aimed to evaluate adolescents’ preferences for interventions designed to improve sun protection behaviors.
Methods: Focus groups (10 students per group), were held in class at schools stratified by location (beachside/inland) and sector (public/private). Focus groups were transcribed verbatim and data were analyzed using NVivo8 software.
Results: 100 students (mean age=14.4 years, SD=0.5; age range=14-16 years) from six high schools participated in semi-structured focus group interviews. Students demonstrated a high level of sun-protection knowledge; however, understanding of risk was minimal with an under-estimation of melanoma prevalence and mortality rates (particularly among youth), the increased risk associated with sun burn during childhood/adolescence and an over-estimation of the age at which melanoma could first develop and the age at which clinical or self-skin examination became appropriate. Strong preferences for highly personal interventions were reported, with greatest preference expressed for first person accounts of melanoma-related experiences by young melanoma survivors. Interventions modeled on youth marketing campaigns or utilizing social media, such as Facebook, Twitter and SMS were rated poorly.
Conclusions: Despite current trends toward developing novel interventions using modern social media to appeal to adolescents, these findings suggest that theoretical models of adolescent risk perception should underpin the development of future sun protection interventions.