Skin cancer prevention: behaviour and motives of Dutch adolescents.

Skin cancer incidence is rising in the Netherlands and prevention programmes are needed. We analysed sun protection behaviours and beliefs in 500 adolescents aged 15-20 years using the Integrated Model for Change. The results show that adolescents with the fairest skin type exposed themselves significantly less to the sun, but had more burns than groups with a darker skin type. Sunscreen was the most commonly used method by adolescents to protect themselves and 77% of adolescents frequently used this strategy. Sunscreen use was also higher in females than in males. Wearing protective clothing (34%) and seeking shade between 1200 and 1500 h (26%) were less popular and used by adolescents in our study. Frequent use of sunscreen was most strongly predicted by positive intentions to use sunscreen, parental support, a positive attitude towards using sunscreen, support of friends and perceiving skin cancer risks. Wearing protective clothing was predicted most strongly by parental support, having a positive attitude towards wearing protective clothing, seeking shade, support of friends, high self-efficacy levels, low exposure to the sun and being male. Seeking shade was most strongly predicted by a positive attitude towards seeking shade, support of friends, using protective clothing, high self-efficacy, parental support, a negative attitude towards tanning, and perceiving skin cancer risks. Implications for Dutch skin cancer prevention programmes are that the efficacy and advantages of all protective methods need to be outlined more clearly in health education programmes on skin cancer prevention.