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Linguistic Acculturation and Skin Cancer–Related Behaviors Among Hispanics in the Southern and Western United States

Elliot J. Coups, PhD; Jerod L. Stapleton, PhD; Shawna V. Hudson, PhD; Amanda Medina-Forrester, MA, MPH; Stephen A. Rosenberg, MSc; Marsha A. Gordon, MPH; Ana Natale-Pereira, MD, MPH; James S. Goydos, MD
JAMA Dermatol. 2013;149(6):679-686. doi:10.1001/jamadermatol.2013.745.
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Objective To examine the association between linguistic acculturation (assessed using the Language Use and Linguistic Preference subscales from the Bidimensional Acculturation Scale for Hispanics) and skin cancer–related behaviors among US Hispanic adults to determine whether, compared with Hispanics denoted as Spanish-acculturated, English-acculturated Hispanics would report less frequent shade seeking and use of sun protective clothing and higher rates of sunscreen use, sunbathing, and indoor tanning.

Design Online survey study conducted in September 2011.

Setting Five southern and western US states.

Participants A population-based sample of 788 Hispanic adults drawn from a nationally representative web panel.

Main Outcome Measures Self-reported sunscreen use, shade seeking, use of sun protective clothing, sunbathing, and indoor tanning.

Results Multivariate regression analyses were conducted to examine predictors of the skin cancer–related behaviors. As hypothesized, English-acculturated Hispanics had lower rates of shade seeking and use of sun protective clothing and reported higher rates of sunbathing and indoor tanning than Spanish-acculturated Hispanics. English-acculturated Hispanics and bicultural Hispanics (ie, those with high Spanish and high English acculturation) reported comparably high rates of sunbathing and indoor tanning. Results suggested that bicultural Hispanics seek shade and wear sun protective clothing less often than Spanish-acculturated Hispanics but more often than English-acculturated Hispanics. Acculturation was not associated with sunscreen use.

Conclusions Hispanic adults do not routinely engage in behaviors that reduce their risk of skin cancer. Bicultural and English-acculturated Hispanics are particularly in need of skin cancer prevention interventions.

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