Development and Implementation of a Sun Protection Intervention That Resonates with Adolescents

Background: Australia has the highest incidence of skin cancer in the world, and sun protection behaviours among adolescents are particularly poor.

Program background: Our formative research highlighted that adolescents are aware of the need for sun protection, but perceive a number of barriers to ‘adequate’ sun protection, related to issues of self-efficacy and social norms.  Our review of previous sun protection interventions for adolescents and young adults demonstrated the general efficacy of appearance-based interventions in producing positive sun protection behaviour change. This paper focuses on development and testing of a communication campaign, which was part of a comprehensive intervention implemented in one community in New South Wales, Australia.  The aim was to position sun protection as an appearance and health enhancing behaviour that can fit easily within the lifestyle of adolescents and young adults. Using Social Cognitive Theory (SCT) as a guide, the intervention sought to influence young people’s expectations of sun exposure through the use of UV- photographs (both via print messages using models and the offering of UV-photographs of young people themselves). A set of print advertisements were developed by a commercial advertising agency; pre-tested with groups of young people; substantially revised based on feedback; and re-tested prior to implementation of the intervention. The print components were supported by tangible products targeting the image and convenience of sun protection, and providing ‘cues to action’.  The intervention ran for 24 days in the 2009/2010 Summer school holidays.

Evaluation Methods and Results: Social marketing theory stresses the importance of pre-testing messages with the target audience to ensure understanding and reduce the likelihood of counter-productive or unintended effects. Our messages were developed by a leading advertising agency with decades of experience; however, pre-testing resulted in substantial changes to the wording and presentation of the messages in the campaign materials. Our process evaluation suggests the campaign was well-received among adolescents. Importantly, their feedback suggests we were successful in re-branding sun protection as an appearance-enhancing (rather than cancer-preventing) behaviour, and that our intervention was seen as ‘cool’ and salient to adolescents.  The broader intervention was also well received by adolescents, with field workers reporting young people seeking them out and regularly exceeding the targets for material distribution. The partnership with the advertising agency and donations from commercial sunscreen companies meant the intervention was relatively low-cost. However, we experienced a number of unanticipated difficulties that impacted on the delivery of the intervention; while some of these are outside the control of program staff, they all have implications for delivery of future interventions. These included problems due to weather conditions; barriers to the flexibility of delivery in venues; and the very tendencies of young people that limit their sun protection. 

Conclusions: The use of an appearance-based harm minimisation approach for sun protection can allow social marketers to create strategies/messages more congruent with the prevailing social norms of this demographic.

Implications for research and/or practice: Interventions targeted at adolescents need to be congruent with their needs and social norms, and should be informed by careful pre-testing.