Differences in skin cancer-related beliefs and psychological distress among adults living in Florida who do and do not report a sunburn

Objective: To determine a parsimonious set of skin cancer-related beliefs and distress predictors for having at least one sunburn over the past year. Sun exposure and sun protection behaviors were also assessed as predictors of sunburn. Methods: In this cross-sectional analysis of 1172 adults reporting at most modest sun sensitivity, data were collected between September 2015 and September 2018. Multivariable logistic regression was used to identify predictors of sunburn based on skin cancer-related beliefs, distress, sun exposure, and sun protection behaviors. Results: Higher levels of melanoma worry (aOR = 1.35, 95% CI [1.05, 1.75]), higher comparative chance of getting melanoma (aOR = 1.38, 95% CI [1.13, 1.69]), and reduced levels of response efficacy for skin cancer prevention activities (aOR = 0.76, 95% CI [0.61, 0.94]) were independent predictors of sunburn status after adjustment for covariates, as were higher levels of weekend sun exposure (aOR = 1.20, 95% CI [1.09, 1.32]) and more frequent outdoor intentional tanning (aOR = 1.50, 95% CI [1.28, 1.75)]). Conclusions: Melanoma worry, perceived risk, and response efficacy were independent predictors of sunburn status, as was sun exposure and intentional tanning. However, several key skin cancer-related beliefs and psychological distress did not predict burn status. Future work should examine social and cultural factors to guide intervention design.