Application of protection motivation theory (PMT) on skin cancer preventive behaviors amongst primary school students in rural areas of Fasa city-Iran

Considering that exposure to sunlight in childhood and adolescence has an important role in skin cancer, so it seems that training protective behaviors in this period is more effective. Objectives: To survey the application of protection motivation theory (PMT) on skin cancer preventive behaviors among students in rural areas of Fasa city, Iran.
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Application of protection motivation theory (PMT) on skin cancer preventive behaviors amongst primary school students in rural areas of Fasa city-IranKhaniJeihoonietal. BMC Cancer (2022) 22:21https://doi.org/10.1186/s12885-021-09142-3 RESEARCH Open AccessApplication ofprotection motivation theory(PMT) onskin cancer preventive behaviorsamongstprimary school students inrural areasofFasa city-IranAliKhaniJeihooni1*, SomayehBashti2, BaharehErfanian3, JeyranOstovarfar4and PooyanAfzaliHasirini5  Abstract  Background:  Considering that exposure to sunlight in childhood and adolescence has an important role in skin cancer, so it seems that training protective behaviors in this period is more effective. Objectives:  To survey the application of protection motivation theory (PMT) on skin cancer preventive behaviors among students in rural areas of Fasa city, Iran. Methods:  This study was done in two stages: Phase I of this study, the descriptive-analytic and cross-sectional study was conducted in 2018 to investigate the predictive value of the protection motivation theory on skin cancer preven- tive behaviors. In the second stage, a quasi-experimental interventional study was conducted on 400 primary school students in 2019. The educational intervention was performed in the experimental group for 8 sessions. Data were collected using a demographic information questionnaire and protection motivation theory before and six months after the intervention. Results:  The constructs of protection motivation theory predicted 58.6% of skin cancer preventive behaviors. The results indicated that there was no significant difference between the two groups in terms of knowledge, perceived sensitivity, perceived severity, reward, fear, protection motivation, response efficacy, self-efficacy, response costs, and the skin cancer preventive behaviors in before the intervention (p > 0.05). However, six months after the intervention, the experimental group showed a significant increase in each of the mentioned constructs and skin cancer protective behaviors (p KhaniJeihoonietal. BMC Cancer (2022) 22:21 Page 2 of 10ultraviolet light as a major contributor to skin cancer and response costs. The response efficacy is the expecta-melanoma [1, 2]. A study carried out in the United States tion of the person that the adaptive response (self-in 2016 showed that new cases of skin cancer in women protection) can eliminate the threat, and the effectare 31,860 and deaths from this are 4320 cases per year the proposed preventive behavior is expected to[3]. Skin cancer is the most common cancer in the Mid- increase the response [16]. The self-efficacy is a per-dle East [4]. In Iran, due to the high sunlight in most sea- son’s belief in his/her ability to successfully performsons of the year and the lack of suitable coverings such as the adaptive and prescribed behaviors. The percep-outdoor clothing and hats, the prevalence of skin cancer tion of high self-efficacy is expected to lead to moreis high [5] so that skin cancer is a public health problem positive responses in the individual [16, 17]. Responsein the country [6]. Studies in Iran have shown that cancer costs are any costs (e.g., monetary, personal, time,is high in society [7]. effort) associated with taking the adaptive coping Behaviors such as staying in the shade, less or no expo- response. Increasing the cost of using prescribedsure to sunlight during peak hours (10 am to 3 pm), use health behaviors reduces the motivation to behaveof protective clothing such as hats with long edges and [15]. Response efficacy and self-efficacy will increaselong-sleeved shirt, use of sunscreen with a SPF of 30 or the probability of selecting the adaptive response,higher, use of standard sunglasses, and the avoidance of whereas response costs will decrease the probabilityartificial sources of ultraviolet light (fluorescent lamps, of selecting the adaptive response [15]. The effective-etc.) can be determining factors in reducing the damage ness of the two cognitive mediational processes leadscaused by sunlight [8, 9]. to the formation of protection motivation and behav- Considering that exposure to sunlight during childhood ior [16]. In order that the protection motivation to beand adolescence plays an important role in skin cancer recalled, perceived severity and perceived sensitivity[10], and since c ...