Research Article Validity and Stability of the Decisional Balance for Sun Protection Inventory Hui-Qing Yin, Joseph S. Rossi, Colleen A. Redding, Andrea L. Paiva, Steven F. Babbin, and Wayne F. Velicer Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Road, Kingston, RI 02881, USA Correspondence should be addressed to Joseph S. Rossi; jsrossi@uri.edu Received 30 May 2014; Accepted 13 November 2014; Published 7 December 2014 Academic Editor: Silvia Moretti Copyright © 2014 Hui-Qing Yin et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. he 8-item Decisional Balance for sun protection inventory (SunDB) assesses the relative importance of the perceived advantages (Pros) and disadvantages (Cons) of sun protective behaviors. his study examined the psychometric properties of the SunDB measure, including invariance of the measurement model, in a population-based sample of  = 1336 adults. Conirmatory factor analyses supported the theoretically based 2-factor (Pros, Cons) model, with high internal consistencies for each subscale (≥ .70). Multiple-sample CFA established that this factor pattern was invariant across multiple population subgroups, including gender, racial identity, age, education level, and stage of change subgroups. Multivariate analysis by stage of change replicated expected patterns for SunDB (Pros  2 = .15, Cons  2 = .02). hese results demonstrate the internal and external validity and measurement stability of the SunDB instrument in adults, supporting its use in research and intervention. 1. Introduction Skin cancer is a major public health concern. Melanoma is the most serious form of skin cancer and accounts for the majority of skin cancer deaths. he American Cancer Society estimates there will be more than 76,000 new cases of melanoma diagnosed in 2014 in the United States. Non- melanoma skin cancers are typically nonfatal but much more prevalent; in 2006, approximately 3.5 million people in the United States were diagnosed with these malignancies, and more than 2 million were treated [1]. he incidence rates for both types of skin cancers have been increasing [1, 2]. Skin cancers lead to substantial direct medical care costs and signiicant indirect costs associated with premature mortality and morbidity [3, 4]. Preventing all skin cancers is both important and possible by adopting habitual sun protective behaviors such as reducing sun exposure and using sunscreen [5]. Interventions for increasing sun protection behaviors using tailored health communications based on the trans- theoretical model of behavior change have been developed and implemented and have demonstrated signiicant impacts in numerous applications [6–9]. he transtheoretical model (TTM) [10–13] is an integrative model of intentional behavior change underlying numerous efective interventions. Empiri- cally based tailoring is especially relevant in population-based interventions when not everyone is prepared to immediately change their risk behavior(s). Decisional Balance is one of the core constructs integrated within the TTM framework. Based initially on the work of Janis and Mann [14], Decisional Balance relects the cognitive and motivational shits in deci- sion making as an individual weighs the relative importance of the Pros and Cons of changing the behavior in question [15]. he theoretical relationship between Decisional Balance and transitions across the stages of change (i.e., readiness to change the problem behavior) has been well documented across a variety of health behaviors [16, 17], and there- fore incorporated into intervention programs. Appropriately operationalizing theoretical constructs into psychometrically sound measures is critical for testing and implementing a theoretical model. he Decisional Balance for sun protection inventory has been used in a number of applications [7–9]; however, no published study has evaluated the psychometric properties of this measure. Hindawi Publishing Corporation Journal of Skin Cancer Volume 2014, Article ID 190541, 7 pages http://dx.doi.org/10.1155/2014/190541