Fear, not data, motivates sunscreen users, research shows

BUFFALO, N.Y. – We’re often told that worrying can be harmful to one’s health. But University at Buffalo researchers say that when it comes to preventing skin cancer, a little fear is good for you.

In a study published in the Journal of Behavioral Medicine, the UB researchers found that fear and worry about skin cancer had a bigger influence on people’s use of sunscreen than information about the statistical likelihood of developing the disease.

“Most health behavior studies don’t account for the more visceral, emotional reactions that lead people to do risky behaviors, like eat junk food or ignore the protective benefits of sunscreen,” says Marc Kiviniemi, lead researcher and assistant professor of community health and health behavior in the UB School of Public Health and Health Professions.

“This study is important because most of what we do in public health communications focuses on spreading knowledge and information. By not addressing emotions, we’re potentially missing a rich influence on behavior when interventions don’t address feelings.”

Kiviniemi’s study analyzed data from a nationwide study conducted by the National Cancer Institute.  Nearly 1,500 randomly selected participants with no personal history of skin cancer were asked about their sunscreen use, and questioned to gauge their perceived risk and worry for getting skin cancer.

Frequency of sunscreen use varied, with 32 percent reporting ‘‘never’’ using it, and 14 percent ‘‘always’’ using it.  Education was associated with increased sunscreen use and men and non-White participants were both less likely to use sunscreen.

In each case, however, worry more directly influenced people’s behavior than informational findings, and increasing degrees of worry were associated with increased sunscreen use.

“Our research looked at the interplay of emotions and facts in decision making– that is, how do cognitive and affective risks jointly work to influence behavior?” says Kiviniemi. “The nature of their interrelation as an influence on behavior has not been examined until this study.”

UB researchers say that affective risk – fear and worry about a health issue, in this case skin cancer – and cognitive risk – the informational component – are both known influences on people’s health behaviors.

However, they are often treated separately or are pitted against one another as “rational” versus “irrational” influences, says Kiviniemi.

“These findings show that clinicians might want to think more about feelings when encouraging people to use sunscreen,” says Kiviniemi. “In addition to providing educational information about risk, encouraging people to consider how they feel about cancer and how worried they are about it might inspire preventive behaviors.”

While ultimately public health professionals can use the results to design better intervention tools, researchers are still a few steps away from understanding how to shape fear so that it is beneficial, rather than paralyzing, adds Kiviniemi.

Kiviniemi will conduct further research to examine the same relationship between risk perception and behavior in other types of health behaviors, such as colonoscopy screening and condom use.