Open Access Open Badges Research article

Correlates of sunscreen use among high school students: a cross-sectional survey

Carolyn J Heckman1* and Elliot J Coups234

Author Affiliations

1 Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA

2 The Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA

3 Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901, USA

4 Department of Health Education and Behavioral Science, UMDNJ-School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA

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BMC Public Health 2011, 11:679  doi:10.1186/1471-2458-11-679

Published: 31 August 2011



Adolescents put themselves at risk of later skin cancer development and accelerated photo-aging due to their high rates of ultraviolet radiation exposure and low rates of skin protection. The purpose of the current study was to determine which of the Integrative Model constructs are most closely associated with sunscreen use among high school students.


The current study of 242 high school students involved a survey based on the Integrative Model including demographic and individual difference factors, skin protection-related beliefs and outcome evaluations, normative beliefs, self-efficacy, sunscreen cues and availability, intentions, and sunscreen use. Our analyses included multiple linear regressions and bootstrapping to test for mediation effects.


Sunscreen use was significantly associated with female gender, greater skin sensitivity, higher perceived sunscreen benefits, higher skin protection importance, more favorable sunscreen user prototype, stronger skin protection norms, greater perceived skin protection behavioral control, and higher sunscreen self-efficacy. Intentions to use sunscreen mediated the relationships between most skin protection-related beliefs and sunscreen use.


The current study identified specific variables that can be targeted in interventions designed to increase sunscreen use among adolescents.

sunscreen; adolescents; Integrative Model; skin cancer prevention; intentions