Skin Cancer Risk Behaviors:  A Conceptual Framework for Complex Behavioral Change

In this month’s ARCHIVES, Naylor and Robinson¹ conclude,

These observations suggest a specific failure of prevention efforts as well as a more general indictment of the inefficacy of behavior change interventions meant to reduce intentional UV exposure. Have our professional prevention efforts been a failure? Are behavior change interventions of little practical use? Before we accept such conclusions, we should first consider that (1) countless individuals have indeed benefited from the skin protection recommendations that dermatologists have delivered, and (2) a number of successful behavioral interventions have been conducted in school, recreational, and occupational settings.^2- 7 Still, we cannot deny the increasing rates of skin cancer morbidity and mortality, as well as the increasing popularity of indoor tanning among young people. It is obvious that skin cancer prevention efforts could benefit from theoretically and empirically driven modifications. The assertions of Naylor and Robinson¹ represent an important challenge to alter our conceptualization of the issues and try to use paradigms that provide us with a better understanding of our audience, our message, and the true complexity of the outcome variables we wish to target for change. We present a brief overview of our current knowledge in each of these areas and offer suggestions for alternative, more useful paradigms.