Sun protection behavior beliefs among adults living in rural United States - A qualitative study in Minnesota - Research article

Sep 23, 2026

Uploaded by Jasmine

Although skin cancers are largely preventable, skin cancer diagnoses in the United States exceed those of all other cancers combined. Sun safety guidance includes protective clothing, wide-brimmed hats, seeking shade, and sunscreen, yet rural populations show higher sun risk behavior and skin cancer frequency. This study used belief elicitation and qualitative analysis (content analysis with ranked codes) with 278 rural adults in Minnesota, focusing on outcome, normative, and control beliefs across four sun protection behaviors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

Study context and rationale

Methods and belief elicitation

Key findings on protective behaviors and beliefs

Implications for rural interventions

OPEN ACCESS Citation: Jewett P, Solomon M, Brown K, Flanagan D, Kelly E, Kunkel K, et al. (2025) Sun protection behavior beliefs among adults living in rural United States: A qualitative study in Minnesota. PLoS One 20(9): e0331685. [https://](https://)[ ](https://)[doi.org/10.1371/journal.pone.0331685](doi.org/10.1371/journal.pone.0331685) [Editor:](Editor: Caroline Watts)[ Caroline Watts](Editor: Caroline Watts), The University of Sydney, AUSTRALIA Received: February 24, 2025 Accepted: August 19, 2025 Published: September 12, 2025 Copyright: © 2025 Jewett et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: Data are publicly available from the Data Repository for the University of Minnesota (DRUM): [https://doi](https://doi). org/10 . 13020/WH9E-ZN86 . Funding: This study was funded by a pilot grant from the Masonic Cancer Center, University of Minnesota (National Institutes of Health RESEARCH ARTICLE Sun protection behavior beliefs among adults living in rural United States: A qualitative study in Minnesota Patricia Jewett1, Matia Solomon2, Katherine Brown2, Deveny Flanagan3, Emma Kelly2, Kelly Kunkel4, Megan Schossow5, Zora Radosevich6, Pamela Mason7, Rehana Ahmed8,9, Rebekah Nagler9,10, Carrie Henning-Smith9,11, DeAnn Lazovich9,12, Marco Yzer10, Rachel I. Vogel2,9* 1 Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, United States of America, 2 Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, Minnesota, United States of America, 3 University Survey & Assessment Services, University of Minnesota, Minneapolis, Minnesota, United States of America, 4 University of Minnesota Extension, Mankato, Minnesota, United States of America, 5 Upper Midwest Agricultural Safety and Health Center (UMASH), University of Minnesota, Minneapolis, Minnesota, United States of America, 6 Minnesota Department of Health, St. Paul, Minnesota, United States of America, 7 American Cancer Society, Eagan, Minnesota, United States of America, 8 Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, United States of America, 9 Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America, 10 Hubbard School of Journalism & Mass Communication, University of Minnesota, Minneapolis, Minnesota, United States of America, 11 Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, United States of America, 12 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States of America * [isak0023@umn.edu](isak0023@umn.edu) Abstract Although skin cancers are considered mostly preventable, more people in the US are diagnosed with skin cancer than all other cancers combined. Sun safety recommendations include wearing sun-protective clothing, a wide-brimmed hat, seeking shade, and using sunscreen. Some evidence exists that sun risk behaviors and skin cancer rates are more frequent among rural than urban US populations, raising questions about underlying factors. We conducted a belief elicitation survey on these four sun protection behaviors among 278 adults (aged 18–60 years) living in rural Minnesota, a state with high sunburn rates and UV-attributable melanoma cases. These qualitative data were analyzed using content analysis, and the identified codes ranked by frequency. Almost all participants emphasized that spending time outside was important to them. The most frequently reported sun protection behaviors were wearing sunscreen and protective clothing. The primary outcomes were obtained from open-ended questions on outcome, normative, and control beliefs associated with each sun protection behavior.

FAQs

What sun protection behaviors were examined in the study?

The study examined four sun protection behaviors: wearing sun-protective clothing, using a wide-brimmed hat, seeking shade, and using sunscreen.

How were participants’ beliefs analyzed?

Beliefs were assessed using a belief elicitation survey and analyzed with content analysis, with identified codes ranked by frequency.

What were the most frequently reported sun protection behaviors?

Participants most frequently reported wearing sunscreen and protective clothing as their sun protection behaviors.

Sep 23, 2026

Uploaded by Jasmine