Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. R. Wayne Fuqua

Second Advisor

Dr. C. Richard Spates

Third Advisor

Dr. Scott Kollins

Fourth Advisor

Dr. William Fenn


Skin cancer is the most commonly diagnosed cancer in the United States with 20% of people developing some form of skin cancer in their lifetime (American Cancer Society, 1999). In spite of the high incidence of skin cancer, it is highly preventable. Approximately 90% of the cases are caused by exposure to ultraviolet radiation from the sun (Skin Cancer Foundation, 1992). The effect of an intervention aimed at reducing skin cancer risk was compared to a survey only control group in 99 Chicago beach-goers. The intervention was based on the Transtheoretical Stages of Change Model (TTM) and included sun sensitivity assessment, sun damage assessment via UV photography, pamphlet, and commitment contract. The intervention was associated with significant increases in sun protection behaviors (p < .05) and consistent sunscreen use (p < .01) on all exposed body areas (p < .01) at 2-month follow-up. The intervention group participants were more likely than control group participants to cite “preventing skin cancer” as a primary motivating variable for sunscreen use (p< .05) at follow-up. The intervention was also associated with significant movement across the stages of change (p < .01). The number of intervention participants in the precontemplative stage of change decreased by 9% at follow-up while the number in the action and maintenance stages of change increased by nearly 30%. Although intervention participants increased their use of sunscreen, no differences between groups were observed in the frequency of sun exposure at follow-up. The present study supports the TTM as a useful framework for developing interventions aimed at reducing skin cancer risk. Future research should target sun exposure as well as sun protection behaviors for skin cancer risk reduction.

Access Setting

Dissertation-Open Access