Health Promotion International, Vol. 15, No. 4, 333-339,
December 2000
© Oxford University Press 2000
The role of health education versus safety regulations in generating skin cancer preventive behavior among outdoor workers in Israel: an exploratory photosurvey
1 The Center for Research and Development of Advanced Services in Plastic Surgery, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel, 2 The School of Medicine of the University of Connecticut Health Center, Department of Community Medicine and Healthcare, USA and 3 Department of Plastic and Reconstructive Surgery, Soroka Medical Center, Beer-Sheva, Israel
Address for correspondence: Esther Shani Plastic Surgery Soroka Medical Center Beer-Sheva Israel e-mail: eshani{at}bgumail.bgu.ac.il
The present photosurvey corroborated with our 1995–1997 evaluation study of a multifaceted skin cancer control program among outdoor workers of Mekorot—Israel National Water Company (Shani et al., 1998, Final Research Report presented to the Committee for Research and Prevention in Occupational Safety and Health). While the survey's primary purpose was to investigate the impact of health education versus sun-protection regulations (issued when the project ended) on workers' skin cancer preventive behavior (SCPB), it also experimented with ‘objective’ tools of data collection. Visiting working sites and mother-base, 118 workers were approached. Of these, 51 former program-involved workers (‘education’ group) and 50 former non-participants (technical barriers), and newly recruited ones (‘regulation’ group) who filled out a one-page questionnaire, had their photographs taken and were measured (spectrophotometer) for melanin presence, were included in the present study. Findings indicated that participants in the ‘regulation’ group had a significantly lower mean years of seniority and a higher number of workers in semi-skilled occupations. Both groups were identical in age, ethnic origin and reported skin type. Consistent and significant between-group differences were observed in the SCPB and melanin presence mean scores, suggesting better SCPB habits among the ‘education’ group employees in comparison to their counterparts. The multiple regression analysis indicated that former program-involved participants and older workers were significantly more likely than others to comply with desired SCPB practices. Combined, our previous and present findings suggest that the educational approach was indispensable for generating and sustaining long-term skin cancer control practices and was preferable to the use of regulations, per se. Though no final conclusions could be drawn regarding the validity of the spectrophotometer- and camera-related procedures, and both are limited with regard to uncovering the motivational factors of behavioral outcomes, it should be recognized that the camera is a low-cost and easily available tool for capturing ‘reality’ while overcoming management's claims on workers' time. Results are also discussed in terms of practical implications.
Key words: health education; outdoor workers; safety regulations; skin cancer preventive behavior