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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study

Authors: Teresa Fernández-Morano, Magdalena de Troya-Martín, Francisco Rivas-Ruiz, Nuria Blázquez-Sánchez, Agustín Buendía-Eisman

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Health questionnaires must present accredited measurement properties such as validity, reliability and sensitivity to change, the latter being essential for interventions to be planned and for evaluating their effectiveness. The aim of this study was to evaluate the sensitivity to change of a Beach Questionnaire.

Methods

Quasi-experimental before-after study carried out in 2011, for a study population of adolescents attending schools in the Costa del Sol. First, the questionnaire was administered to the adolescents, after which a multicomponent educational intervention was carried out; finally, three months later, the same questionnaire was re-administered to the same adolescents. Changes were assessed in the categories of each item, using the McNemar test, and the changes in the scores, standardised to a range of 0–100, using the Student t test for paired samples, and including the mean of the differences and the 95% confidence interval. The level of statistical significance was set at p < 0.05.

Results

228 adolescents, aged 14–17 years, and 55.3% were girls. Statistically significant changes were observed in sunburn experiences, exposure to the sun at mid-day and attitudes to sun exposure and suncreams. For the seven items related to knowledge about sun exposure, a higher rate of correct answers was observed. The analysis of changes, within the standardised range, revealed a significant improvement in the scores for sun exposure habits (MD 4.33; CI 95% 2.2-6.5), attitudes to sun exposure (MD 2.22; CI 95% 1.2-3.2) and knowledge (MD 9.10; CI 95% 7.1-11.1), but not in those for sun-protection practices (MD 0.23; CI 95% -1.2-1.7).

Conclusions

The Beach Questionnaire on behaviour, attitudes and knowledge related to sun exposure is the first such instrument in Spanish language to provide sufficient sensitivity to change. It constitutes a useful tool for epidemiologic research into photoprotection and for skin cancer prevention programmes.
Literature
1.
go back to reference Bränström R, Kristjansson S, Ullén H, Brandberg Y. Stability of questionnaire items measuring behaviours, attitudes and stages of change related to sun exposure. Melanoma Res. 2002;12:513–9.CrossRefPubMed Bränström R, Kristjansson S, Ullén H, Brandberg Y. Stability of questionnaire items measuring behaviours, attitudes and stages of change related to sun exposure. Melanoma Res. 2002;12:513–9.CrossRefPubMed
2.
go back to reference Rojas Tejada AJ, Fernández Prados JS, Pérez Meléndez C. Investigar mediante encuestas: fundamentos teóricos y aspectos prácticos. Madrid: Síntesis; 1998. p. 155–68. Rojas Tejada AJ, Fernández Prados JS, Pérez Meléndez C. Investigar mediante encuestas: fundamentos teóricos y aspectos prácticos. Madrid: Síntesis; 1998. p. 155–68.
3.
go back to reference Carvajal A, Centeno C, Watson R, Martínez M, Rubiales AS. How is an instrument for measuring health to be validated? An Sist Sanit Navar. 2011;34:63–72.CrossRefPubMed Carvajal A, Centeno C, Watson R, Martínez M, Rubiales AS. How is an instrument for measuring health to be validated? An Sist Sanit Navar. 2011;34:63–72.CrossRefPubMed
4.
go back to reference Saridi MI, Rekleiti MD, Toska AG, Souliotis K. Assessing a sun protection program aimed at Greek elementary school students for malign melanoma prevention. Asian Pac J Cancer Prev. 2014;15(12):5009–18.CrossRefPubMed Saridi MI, Rekleiti MD, Toska AG, Souliotis K. Assessing a sun protection program aimed at Greek elementary school students for malign melanoma prevention. Asian Pac J Cancer Prev. 2014;15(12):5009–18.CrossRefPubMed
5.
go back to reference Livingston PM, White V, Hayman J, Dobbinson S. Australian adolescents’ sun protection behavior: who are we kidding? Prev Med. 2007;44:508–12.CrossRefPubMed Livingston PM, White V, Hayman J, Dobbinson S. Australian adolescents’ sun protection behavior: who are we kidding? Prev Med. 2007;44:508–12.CrossRefPubMed
6.
go back to reference Geller AC, Cantor M, Miller DR, Kenausis K, Rosseel K, Rutsch L, et al. The Environmental Protection Agency’s Nacional SunWise School Program: Sun protection education in US schools (1999–2000). J Am Acad Dermatol. 2002;46:683–9.CrossRefPubMed Geller AC, Cantor M, Miller DR, Kenausis K, Rosseel K, Rutsch L, et al. The Environmental Protection Agency’s Nacional SunWise School Program: Sun protection education in US schools (1999–2000). J Am Acad Dermatol. 2002;46:683–9.CrossRefPubMed
7.
go back to reference Troya-Martín M, Blázquez-Sánchez N, Rivas-Ruiz F, Fernández-Canedo I, Rupérez-Sandoval A, Pons-Palliser J, et al. Validación de un cuestionario en español sobre comportamientos, actitudes y conocimientos relacionados con el exposición solar: “Cuestionario a pie de playa”. Actas Dermatosifiliogr. 2009;100:586–95.CrossRef Troya-Martín M, Blázquez-Sánchez N, Rivas-Ruiz F, Fernández-Canedo I, Rupérez-Sandoval A, Pons-Palliser J, et al. Validación de un cuestionario en español sobre comportamientos, actitudes y conocimientos relacionados con el exposición solar: “Cuestionario a pie de playa”. Actas Dermatosifiliogr. 2009;100:586–95.CrossRef
8.
go back to reference Municipal register of residents, as at 1 January 2010. Instituto Nacional de Estadística (Spanish National Institute of Statistics) www.ine.es. Accessed 8 September 2011. Municipal register of residents, as at 1 January 2010. Instituto Nacional de Estadística (Spanish National Institute of Statistics) www.​ine.​es. Accessed 8 September 2011.
9.
go back to reference Schmidt S, Garin O, Pardo Y, Valderas JM, Alonso J, Rebollo P, et al. Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res. 2014;23:2169–81.CrossRefPubMedPubMedCentral Schmidt S, Garin O, Pardo Y, Valderas JM, Alonso J, Rebollo P, et al. Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res. 2014;23:2169–81.CrossRefPubMedPubMedCentral
10.
go back to reference Rhee JS, Matthews BA, Neuburg M, Logan BR, Burzynski M, Nattinger AB. The skin cancer index: clinical responsiveness and predictors of quality of life. Laryngoscope. 2007;117:399–405.CrossRefPubMedPubMedCentral Rhee JS, Matthews BA, Neuburg M, Logan BR, Burzynski M, Nattinger AB. The skin cancer index: clinical responsiveness and predictors of quality of life. Laryngoscope. 2007;117:399–405.CrossRefPubMedPubMedCentral
11.
go back to reference Mermelstein RJ, Riesenberg LA. Changing knowledge and attitudes about skin cancer risk factors in adolescents. Health Psychol. 1992;11:371–6.CrossRefPubMed Mermelstein RJ, Riesenberg LA. Changing knowledge and attitudes about skin cancer risk factors in adolescents. Health Psychol. 1992;11:371–6.CrossRefPubMed
12.
go back to reference Mahler HI, Fitzpatrick B, Parker P, Lapin A. The relative effects of a health-based versus an appearance-based intervention designed to increase sunscreen use. Am J Health Promot. 1997;11:426–9.CrossRefPubMed Mahler HI, Fitzpatrick B, Parker P, Lapin A. The relative effects of a health-based versus an appearance-based intervention designed to increase sunscreen use. Am J Health Promot. 1997;11:426–9.CrossRefPubMed
13.
go back to reference Katz RC, Jernigan S. Brief report: an empirically derived educational program for detecting and preventing skin cancer. J Behav Med. 1991;14:421–8.CrossRefPubMed Katz RC, Jernigan S. Brief report: an empirically derived educational program for detecting and preventing skin cancer. J Behav Med. 1991;14:421–8.CrossRefPubMed
14.
go back to reference Hughes BR, Altman DG, Newton JA. Melanoma and skin cancer: evaluation of a health education programme for secondary schools. Br J Dermatol. 1993;128(4):412–7.CrossRefPubMed Hughes BR, Altman DG, Newton JA. Melanoma and skin cancer: evaluation of a health education programme for secondary schools. Br J Dermatol. 1993;128(4):412–7.CrossRefPubMed
15.
go back to reference Fernández-Morano T, De Troya-Martín M, Rivas-Ruiz F, Blázquez-Sánchez N, Del Boz-González J, Fernández-Peñas P, et al. Behaviour, attitudes and awareness concerning sun exposure in adolescents on the Costa del Sol. Eur J Dermatol. 2014;24:85–93.PubMed Fernández-Morano T, De Troya-Martín M, Rivas-Ruiz F, Blázquez-Sánchez N, Del Boz-González J, Fernández-Peñas P, et al. Behaviour, attitudes and awareness concerning sun exposure in adolescents on the Costa del Sol. Eur J Dermatol. 2014;24:85–93.PubMed
16.
go back to reference Liebman TN, Goulart JM, Soriano R, Dusza SW, Halpern AC, Lee KK, et al. Effect of dermoscopy education on the ability of medical students to detect skin cancer. Arch Dermatol. 2012;148:1016–22.CrossRefPubMed Liebman TN, Goulart JM, Soriano R, Dusza SW, Halpern AC, Lee KK, et al. Effect of dermoscopy education on the ability of medical students to detect skin cancer. Arch Dermatol. 2012;148:1016–22.CrossRefPubMed
17.
go back to reference Badia X, Salamero M, Alonso J. La medida de la salud. Guía de escalas de medición en español. 3ª edición, Barcelona; 2002. Badia X, Salamero M, Alonso J. La medida de la salud. Guía de escalas de medición en español. 3ª edición, Barcelona; 2002.
18.
go back to reference Brandberg Y, Sjödén PO, Rosdahl I. Assessment of sun-related behaviour in individuals with dysplastic naevus syndrome: a comparison between diary recordings and questionnaire responses. Melanoma Res. 1997;7:347–51.CrossRefPubMed Brandberg Y, Sjödén PO, Rosdahl I. Assessment of sun-related behaviour in individuals with dysplastic naevus syndrome: a comparison between diary recordings and questionnaire responses. Melanoma Res. 1997;7:347–51.CrossRefPubMed
19.
go back to reference Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol. 2008;144:217–22.CrossRefPubMed Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Arch Dermatol. 2008;144:217–22.CrossRefPubMed
20.
go back to reference Shoveller JA, Lovato CY. Measuring self-report sunburn: challenges and recommendations. Chronic Dis Can. 2001;22:83–98.PubMed Shoveller JA, Lovato CY. Measuring self-report sunburn: challenges and recommendations. Chronic Dis Can. 2001;22:83–98.PubMed
21.
go back to reference Jennings L, Karia PS, Jambusaria-Pahlajani A, Whalen FM, Schmults D. The Sun Exposure and Behaviour Inventory (SEBI): validation of an instrument to assess sun exposure and sun protective practices. J Eur Acad Dermatol Venereol. 2013;27:706–15.CrossRefPubMed Jennings L, Karia PS, Jambusaria-Pahlajani A, Whalen FM, Schmults D. The Sun Exposure and Behaviour Inventory (SEBI): validation of an instrument to assess sun exposure and sun protective practices. J Eur Acad Dermatol Venereol. 2013;27:706–15.CrossRefPubMed
22.
go back to reference Rosso S, Zanetti R, Martinez C, Tormo MJ, Schraub S, Sancho-Garnier H, et al. The multicentre south European study ‘Helios’ II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer. 1996;73:1447–54.CrossRefPubMedPubMedCentral Rosso S, Zanetti R, Martinez C, Tormo MJ, Schraub S, Sancho-Garnier H, et al. The multicentre south European study ‘Helios’ II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer. 1996;73:1447–54.CrossRefPubMedPubMedCentral
23.
go back to reference Dennis LK, Kim Y, Lowe JB. Consistency of reported tanning behaviors and sunburn history among sorority and fraternity students. Photodermatol Photoimmunol Photomed. 2008;24:191–8.CrossRefPubMedPubMedCentral Dennis LK, Kim Y, Lowe JB. Consistency of reported tanning behaviors and sunburn history among sorority and fraternity students. Photodermatol Photoimmunol Photomed. 2008;24:191–8.CrossRefPubMedPubMedCentral
24.
go back to reference Beane Freeman LE, Dennis LK, Lynch CF, Lowe JB, Clarke WR. Test-retest of self-reported exposure to artificial tanning devices, self-tanning creams, and sun sensitivity showed consistency. J Clin Epidemiol. 2005;58:430–2.CrossRefPubMed Beane Freeman LE, Dennis LK, Lynch CF, Lowe JB, Clarke WR. Test-retest of self-reported exposure to artificial tanning devices, self-tanning creams, and sun sensitivity showed consistency. J Clin Epidemiol. 2005;58:430–2.CrossRefPubMed
25.
go back to reference Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–91.CrossRefPubMed Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–91.CrossRefPubMed
Metadata
Title
Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study
Authors
Teresa Fernández-Morano
Magdalena de Troya-Martín
Francisco Rivas-Ruiz
Nuria Blázquez-Sánchez
Agustín Buendía-Eisman
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1415-0

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