Most beachgoers accurately report their sun habits

October 16, 2006

Adult beachgoers participating in a research study accurately report their sun habits, including sunscreen use and clothing worn on the beach, according to a report in the October issue of Archives of Dermatology, one of the JAMA/Archives journals.

The skin cancer cutaneous melanoma has become much more common and deadly in the United States over the past few decades, according to background information in the article. To reduce the risk of developing skin cancer, physicians recommend limiting the amount of time spent in the sun; seeking shade, especially during the hours at which ultraviolet rays are strongest; applying sunscreen with a sun protection factor (SPF) of 15 or higher; and wearing protective clothing, such as a hat, shirt, pants and sunglasses. Research on skin cancer prevention generally depends on the honesty of study participants reporting their behaviors.

David L. O'Riordan, Ph.D., and colleagues at the University of Hawaii, Honolulu, surveyed and assessed the behavior of 88 adults (51 percent men, average age 40) who visited a beach in Honolulu on one of three days in February or March 2004. The participants answered questions about sun habits when they arrived at the beach and again when they left; their arms, legs and face were swabbed to detect the presence of sunscreen; and an observer took notes on their clothing and whether they appeared to have a sunburn. Twenty-five of the study participants were given fluorescent wristbands; these participants were located by an observer who took additional notes about clothing worn during their stay at the beach.

Overall, most participants' reports were consistent with what the observers recorded regarding time spent outside, sunscreen use and clothing worn. Thirty-eight (44 percent) of participants reported spending two to three hours at the beach, 18 (21 percent) one to two hours, 17 (18 percent) three to four hours, 10 (11 percent) four to five hours and five (6 percent) zero to one hour, which was consistent with what the researchers recorded. Most of the beachgoers, including those who were observed during the day, accurately reported what they wore on their upper body, lower body and head, but were less likely to wear sunglasses than reported. There was moderate to substantial agreement between participants who reported wearing sunscreen and those whose skin swabs indicated they had applied sunscreen either at the beach or before they arrived.

"This study contributes to the paucity of existing research describing the validity of self-report sun habits and has demonstrated that multiple strategies can be effectively adopted to achieve this goal," the authors write. "The moderate to substantial agreement obtained for many self-report measures when compared with objective procedures confirms that self-report is a suitable approach to assess sun habits of beachgoers."

The sunscreen-swabbing procedure, previously used only in indoor, controlled environments, proved effective in real-world conditions as well, the authors continue. "When used as an adjunct to other assessment instruments, this innovative procedure could be a useful addition to interventions aimed at improving the sun protection practices of individuals," they write.
(Arch Dermatol. 2006;142:1304-1311. Available pre-embargo to the media at

Editor's Note: This study was supported by Friends of the Cancer Research Center of Hawaii. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail

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