The health of children and adults is clearly related to daily decisions about prevention and wellness behaviors. The World Health Organization, U.S. Centers for Disease Control, and American Cancer Society identified a need to develop new strategies to protect against skin cancer in specific populations including children and adolescents. Primary prevention must begin during early childhood to reduce excessive exposure to ultraviolet (UV) radiation. It is necessary to modify unhealthy practices by a) limiting the amount of sun exposure, b) using sun protection measures when outdoors, and c) ensuring skin cancer prevention education includes skills for risk reduction. A particular subgroup at risk is adolescent athletes who often practice and compete outdoors at peak UV hours (between 10 a.m. and 4 p.m.).
The purpose of the thesis study was to develop an instrument to measure predisposing factors for sun protection among adolescent athletes. Following systematic review of professional literature, the authors selected constructs of the Social Cognitive Theory, which emphasize the dynamic interaction of health knowledge, outcome expectations, and behaviors.
Few studies have reported the validity or reliability of a new instrument to assess the predisposing factors of sun protection in similar populations. Content validation should receive the highest priority during instrument development; otherwise, resulting data may be misinterpreted. Expert panelist appraisal of survey content is necessary to more accurately measure the domain of interest, in this case, sun protection knowledge and practices.
The authors used a systematic process to estimate the content validity of the proposed instrument. The tasks included: (a) creating an initial draft of the instrument, (b) selecting a jury or panel of experts to evaluate the instrument, (c) having the jurors conduct a qualitative review of the instrument, and (d) having the jurors conduct a quantitative review of the instrument. Analysis revealed 49 items received a minimum Content Validity Ratio (CVR) score of 0.54 and were retained (p<.05). Twelve items fell below the minimum CVR score. The authors chose to retain seven of these items for further consideration based upon review of professional literature and thematic analysis of interviews. These steps indicated that items are related to predisposing factors of sun protection in adolescent athletes. Future research should estimate the reliability and construct validity of the instrument by administering the instrument to a larger sample of high school athletes in Alabama or the Southeastern region of the United States.