Countering Indoor Tanning Arguments: An Experiment Using Skin Cancer Prevention Messages Public Deposited

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  • March 20, 2019
  • Kelley, Dannielle
    • Affiliation: Hussman School of Journalism and Media, Mass Communication Graduate Program
  • Young adult Caucasian women are disproportionately affected by melanoma, and many of these cases are preventable as indoor tanning bed use has been attributed to the steady increase in melanoma incidence. While many prevention efforts have focused on informing young women of the negative health effects associated with tanning bed use, studies have demonstrated that young women are typically aware of the cancer risks associated with indoor tanning, but continue to tan despite this knowledge. A vast amount of misinformation about the benefits of indoor tanning has been identified, suggesting the need for a novel messaging intervention approach. This dissertation project details a systematic approach to the development and testing of indoor tanning messaging guided by Inoculation Theory. To understand the communication environment surrounding indoor tanning and the prevalence and domains of misinformation, a systematic content analysis of pro-tanning websites was conducted. Guided by results from the content analysis, three message types were created: 1) two-sided refutational (i.e., inoculation) messages were developed in concordance with inoculation theory to explicitly address and correct misinformation about indoor tanning benefits; 2) one-sided persuasive messages were developed to address correct information, without acknowledging opposing arguments; and 3) a control message was developed to be free of strong persuasive arguments, but stated facts about indoor tanning. Messages were first tested qualitatively with young adult women in cognitive interviews (N=8), followed by quantitative methods in the form of an online pilot experiment (N=177). The most promising messages were selected based on this qualitative and quantitative formative research and tested in a longitudinal online messaging experiment with young adult women (N=649 baseline; N=324 one-week follow-up). Results from the content analysis revealed two major domains of misinformation: safety and health. Within safety benefits of tanning, the most prevalent claims were about 1) controlled tanning in a bed (e.g., time spent and exposure to UV rays), and 2) government regulation of tanning beds. Within health benefits of tanning, the most common claims were 1) tanning beds provide a base tan that protects against future sun damage, and 2) tanning beds are a good source of vitamin D. The pilot experiment indicated that the controlled tanning (safety) and vitamin D (health) messages were most effective across conditions and were selected for testing in the full experiment. In the main experiment, those exposed to inoculation and one-sided messages reported fewer positive health outcome expectations and greater negative health outcome expectations compared to the control condition. Those in the inoculation condition rated messages higher in perceived effectiveness, reported lower intentions to tan indoors, and more cognitive processing compared to one-sided and control conditions. At one-week follow-up, while those in the one-sided condition reported an increase in positive outcome expectations and intentions to indoor tan, those in the inoculation reported decreases in positive outcome expectations and intentions relative to the control condition, and more counterarguing and cognitive processing relative to the one-sided condition. Overall, results indicate that inoculation messages are a promising approach for addressing misinformation about the safety and health benefits of indoor tanning. Implications for indoor tanning prevention efforts, inoculation theory, and health communication are discussed.
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  • In Copyright
  • Dillman Carpentier, Francesca
  • Southwell, Brian
  • Noar, Seth
  • Comello, Nori
  • Ivanov, Bobi
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017

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