Abstract LB392: Associations between perceived costs and rewards of sun protection and sun safety practices among high school students

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Abstract Objectives: Adolescents frequently engage in behaviors that increase ultraviolet radiation (UVR) exposure, elevating their lifetime risk for skin cancer. This study examined cross-sectional associations between high school students’ perceptions of the costs of UVR protection, the rewards of tanning, and their engagement in UVR-protective behaviors to identify targets for intervention. Methods: Data were drawn from N=2,105 students (46% male; 77% white; 33.4% rural) at baseline who enrolled in the Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial conducted in Utah high schools from 2021-2023. Students completed self-reports of skin cancer prevention knowledge, time spent outdoors, perceived costs of UVR protection, perceived rewards of tanning, and UVR-protective behaviors. Analyses included bivariate tests and multivariable regression, adjusted for demographics and knowledge. Results: Students who perceived higher costs of UVR protection (r=-0.34, p<.001) and greater rewards of tanning (r=-0.28, p<.001) engaged in fewer UVR-protective behaviors. In an adjusted model, lower sun-safe behavior was independently predicted by lower knowledge of UVR safety (B=0.21, p<.01), higher perceived protection cost (B=-0.32, p<.001), and greater tanning reward (B=-0.19, p<.001). Conclusions: Perceived costs of UVR protection and appearance-based rewards of tanning are key attributes of adolescent UVR exposure. School-based skin cancer prevention should incorporate appearance-focused and tailored strategies (such as UV photography or photoaging feedback) to promote sustainable sun safety behaviors. Citation Format: Omar U. Anwar, Yelena P. Wu, Tammy Stump, Marcelo M. Sleiman, Muriel R. Statman, Jennifer L. Hay, David B. Buller, Jakob D. Jensen, Douglas Grossman, Jincheng Shen, Benjamin Haaland, Kenneth P. Tercyak. Associations between perceived costs and rewards of sun protection and sun safety practices among high school students [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(8_Suppl):Abstract nr LB392.

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