Sun Protection and Tanning Behaviors in Caregivers: Prevalence, Determinants, and Associations with Children's Behaviors

Abstract

The association between skin cancer and ultraviolet radiation (UVR) is well established, and sun protection behavior represents an important preventative measure. In children, caregivers play a key role in this regard. The subject of this study was threefold: whether caregivers of 1 to 11 year-old children are more likely to use sun protection measures compared to non-caregivers, whether considering oneself a role model is associated with sun protection behaviors, and whether their sun protection and risk behaviors are related to children’s behaviors. We used data from the 2020 wave of the National Cancer Aid Monitoring (NCAM) comprised of 4000 individuals (including 554 caregivers of at least one child aged 1−10 years) aged 16 to 65 years and living in Germany. Data were collected through telephone interviews between October and December 2020. No significant differences between caregivers and non-caregivers regarding sun protection and risk behaviors were identified (except tanning on vacation). In both groups, sun protection behaviors were deficient. Caregivers who considered themselves role models concerning sun safety were more likely to use sun protection measures (e.g., using sunscreen on the face: OR = 5.08, p < 0.001). In addition, caregivers’ sun protection behaviors were positively associated with children’s behaviors. Caregivers being highly protected against UVR were more likely to report the use of different measures by/in the child (mean = 4.03), compared to caregivers with medium (3.41) and low (2.97, p < 0.001) protection levels. However, we also found that caregivers’ risk behavior was associated with children’s reported risk behavior. For future prevention, it might be worth focusing on the aspect of caregivers serving as role models. A comprehensive public-health strategy is needed, including key figures such as pediatricians to prevent today’s children from developing skin cancer in later life.

Keywords: Germany; caregivers; children; sun protection; sun safety; sunburn; tanning.

Figure 1

Associations of sun protection behaviors in caregivers and children. (a) Measures often/always used by the child stratified by the caregiver’s use. (b) Associations of measures used by the caregiver and those used by the child. +: chi-squared test was significant on p < 0.05 level of significance; ns: not significant association.

Figure 2

Mean number of sun protection measures used in the child according to caregivers’ protection status. p-value based on Kruskal-Wallis-test; M: Mean; SD: Standard deviation; reported is the mean value of children’s sun protection measures by sun protection measures in caregivers (low vs. medium vs. high protection) Mean of measures used by the caregivers: 2.99 (SD: 1.47).