Published in Cancer Detection and Prevention 2001; 25(5):486-495.

Using Structural Equation Modeling to Examine Factors That Influence Sunburn Frequency and Severity Among Adults Living in Canada

Jean A. Shoveller, PhD,a Pamela A. Ratner, PhD, RN,b.c and Joy L. Johnson, PhD, RNb

aDepartment of Health Care and Epidemiology and Centre for Community Health and Health Evaluation Research and bSchool of Nursing, University of British Columbia, and cInstitute of Health Promotion Research

Address all correspondence and reprint requests to: Jean Shoveller. PhD, Department of Health Care and Epidemiology, University of British Columbia. 5804 Fairview Avenue. Vancouver, BC, Canada, V6T 1Z3.

ABSTRACT: This study uses structural equation modeling to examine hypothesized relationships between sunburn and physical characteristics and potentially modifiable behavior. The analysis was based on self-reported data collected from a randomly selected national sample of Canadian adults. An initial model was tested with 50% of the cases (n = 1,408); the remaining cases (n = 1,298) were reserved for confirmatory testing. After the initial model failed, theoretically plausible effects were added incrementally to improve overall model fit. The initial model yielded: X2(68 d.f.) = 3199.41 (P < .001) and the AGFI = .56. With 32 added effects, a fit model resulted in: X2(36 d.f.) = 394.35 (P < .001), AGE! = 0.87, and IFI = 0.91 (the Critical-N was 210). Model fit was confirmed. Suntanning, failure to wear protective clothing, and sun exposure were associated with the frequency of severity-adjusted sunburns. Sunscreen use was not associated with sunburn frequency-severity.

KEY WORDS: sunburn, behavior, skin cancer, awareness.