Application of the Health Belief Model to U.S. Magazine Text and Image Coverage of Skin Cancer and Recreational Tanning (2000-2012).

The health belief model (HBM) has been widely used to inform health education, social marketing, and health communication campaigns. Although the HBM can explain and predict an individual's willingness to engage in positive health behaviors, its application to, and penetration of the underlying constructs into, mass media content has not been well characterized. We examined 574 articles and 905 images about skin cancer and tanning risks, behaviors, and screening from 20 U.S. women's and men's magazines (2000-2012) for the presence of HBM constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Susceptibility (48.1%) and severity (60.3%) information was common in text. Perceived benefits (36.4%) and barriers (41.5%) to prevention of skin cancer were fairly equally mentioned in articles. Self-efficacy (48.4%) focused on sunscreen use. There was little emphasis on HBM constructs related to early detection. Few explicit cues to action about skin cancer appeared in text (12.0%) or images (0.1%). HBM constructs were present to a significantly greater extent in text versus images (e.g., severity, 60.3% vs. 11.3%, respectively, χ(2) = 399.51, p < .0001; benefits prevention, 36.4% vs. 8.0%, respectively, χ(2) = 184.80, p < .0001), suggesting that readers are not visually messaged in ways that would effectively promote skin cancer prevention and early detection behaviors.