A mediator model of sunscreen use: a longitudinal analysis of social-cognitive predictors and mediators
Craciun, C and Schuez, N and Lippke, S and Schwarzer, R, A mediator model of sunscreen use: a longitudinal analysis of social-cognitive predictors and mediators, International Journal of Behavioral Medicine, 19, (1) pp. 65-72. ISSN 1070-5503 (2012) [Refereed Article]
Copyright 2011 International Society of Behavioral Medicine
Background Sun safety behaviors to prevent skin cancer,
such as sunscreen use, are difficult to adopt and maintain.
Purpose Most social-cognitive theories assume that the
intention to change a behavior is the best predictor of actual
change. But unforeseen barriers emerge, or people give in
to temptations, such as getting a tan despite their initial
good intentions. The Health Action Process Approach
proposed by Schwarzer (Appl Psychol 57:1–29, 1) is used
to explore the self-regulatory mechanisms of sunscreen use.
Method An international longitudinal survey was conducted
with 524 individuals. Intentions, positive outcome
expectancies, distal self-efficacy, and risk perception were
assessed at time 1, whereas intention, planning, and proximal
self-efficacy were measured 2 weeks later at time 2. Sunscreen
use was reported at 3-month follow-up (time 3).
Results A structural equation model fit the data well.
Positive outcome expectancies, risk perception, and selfefficacy
predicted the behavioral intention. Self-efficacy
and planning predicted sunscreen use, and planning
mediated the relation between intended and performed
Conclusion The findings contribute to the understanding of
psychological mechanisms in health behavior change.
They also point to the particular role of mediator
variables in the context of sun protection behaviors,
which may have implications for designing skin cancer