Abstract

Background. Skin cancer is one of the most common types of cancers in the United States. An analysis of literature shows that skin cancer can be partially mitigated through personal behavior changes (Glanz, Buller, & Saraiya; 2007, Canadian Centre of Occupational Health and Safety [CCOHS], 2010). Currently national sun-safety educational campaigns promote sun-protective behaviors to individuals who receive exposure due to their work environment (Task Force on Community Preventive Services, 2004). Preschool teachers employed with San Bernardino County Head Start are inadvertently exposed to sunlight during mandatory recess periods posing risks to their health.

Purpose. This study evaluated two instructional approaches to skin cancer prevention. The collective efficacy intervention was designed to promote sun-protective behaviors by enhancing teamwork and collaborative work friendships to achieve behavior change. The individual self-efficacy intervention was designed to promote sun protective behaviors by emphasizing personal, rather than collective, responsibility for behavior change. It was theorized that the collective efficacy approach would have a greater impact on knowledge, personal skin cancer attitudes, and lower sun risk-level behaviors than the individual self-efficacy approach.

Methods. Teachers from San Bernardino County Head Start were the participants for this educational intervention. Twenty-four preschools were randomized into three groups (n = 8 schools per group); a Collective Efficacy Group (CE), Self-Efficacy Group (SE), or the Delayed Control Group (DC). A prospective multi-center pretest/posttest control group design was used, with data collected at baseline using a self-administered questionnaire. The study group was the independent variable. The dependent variables were population characteristics, participant demographics, sun risk-level (behavior, knowledge, and attitudes.

Analysis and Results. Across study groups, the respondents (N = 175) were female (94.9%), married (59%), Hispanic/ Mexican American (53%), Black/African American (20%), and with some college (39%). MANCOVA analysis showed significant improvements for both the collective efficacy and self-efficacy groups in post-test knowledge, attitude, and sun risk-level when compared to the control group (p=.001). Multiple regression analyses assessed whether certain demographics (pretest knowledge, age Hispanic, Black, married, education and Fitzpatric Skin Color affected knowledge, attitude, and sun risk-level. For the three intervention groups the six demographic variables accounted for 36% to 53% of the variance in the regression models for predicting posttest knowledge, attitude, and sun risk-level (behavior).

Conclusion. Both intervention types (CE and SE) produced positive results when compared to a delayed intervention control group. Although between-group effects for the two intervention groups were not found, both were superior to the control group indicating that either could be used successfully to teach skin cancer prevention. This study underscores the need for additional studies to determine if between group differences exist and provides initial evidence about using a collective efficacy approach for occupationally-based sun-protective educational interventions.

School

School of Public Health

First Advisor

Naomi Modeste

Second Advisor

R. Patti Herring

Third Advisor

Helen Hopp Marshak

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

2011

Date (Title Page)

9-2011

Language

English

Library of Congress/MESH Subject Headings

Skin -- Cancer -- Prevention; Preschool teachers; Health education; Health promotion; Sunscreens (Cosmetics); Efficacy expectations; Skin Neoplasms -- prevention and control; Sunburn -- prevention and control; Sunscreening Agents; Health Behavior; Health Promotion; Health Knowledge, Attitudes, Practice; School Health Services; Evaluation Studies

Type

Dissertation

Page Count

xi; 113

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

Download

Share

COinS