Skin Cancer Prevention: Psychosocial Predictors of Sunscreen Use in University Students Mehdi Mirzaei-Alavijeh 1 & Hassan Gharibnavaz 1 & Farzad Jalilian 1 # The Author(s) 2019 Abstract Skin cancer has the most prevention potential among all cancers. Sunscreen use is an effective method in reducing the risk prevalence of skin cancer. The aim of this study was to determine the cognitive determinants of sunscreen use among university students based on the health belief model (HBM). This cross-sectional study was conducted among 301 university students in the west of Iran. Students were randomly selected to participate voluntarily in the study. Participants filled out a self-administered questionnaire. Data were analyzed by SPSS version 16 using appropriate statistical tests including correlation and logistic regression at 95% significance level. Our results indicated 44.2% of participants reported had always sunscreen use. Among the HBM constructs, cues to action with odds ratio estimate of 1.146 (95% CI 1.061, 1.239) and perceived self-efficacy with odds ratio estimate of 1.131 (95% CI 1.036, 1.234) were the more influential predictors on always sunscreen use. Female students and high levels of mother’ s education were significant predictors of sunscreen use. It seems these findings are useful in planning health promotion programs aimed at increasing self-efficacy for sunscreen use. Keywords Self-efficacy . Mother’ s education . Female . Behavior change . Health education Background Cancer is one of the most important causes of mortality in the world at the global burden of diseases [1]. As well as, deaths from cancers in the world is now rising and is estimated to reach 13.1 million in 2030 [2]. Meanwhile, skin cancer is one of the most common of cancer, and studies indicated a high incidence of skin cancer [3]. The incidence rate of skin cancer is increasing in developed countries, and one in six people will suffer skin cancer in their lifetime [4]. Skin cancer is the most common cancer in Iran, and the prevalence of skin cancer in Iran is 16.1% reported [5]. Skin cancer has increased in the world and can be followed by several complications including mortality, morbidity, and financial cost associated with cancer treatment [6]. The most common skin cancer is basal cell carcinoma, whereas the mortality rate because of skin cancer is stable or decreasing [7]. However, skin cancer has the most potential prevention among all cancers [ 8]. The most important risk factor for this cancer is exposure to sunlight and ultraviolet radiation [9]. Sun protection agents are the early prevention of skin cancer [10]. In Iran, due to the intense sunlight exposure in most seasons and the lack of appropriate protective clothing such as outdoor clothing and hats, we should expect a high incidence of skin cancer [11]. Thus, the development of education programs is one of the most impor- tant approaches to cancer prevention [12]. In addition, identi- fying effective determinants of behavior can be useful in de- signing targeted interventions [13, 14]. It should be noted that the most effective educational programs are based on theory- driven approaches that are rooted in patterns of behavior change [15]. The health belief model (HBM) is one of the psychological models that was proposed by Hochbaum, Rosenstock, and Kegels; according to the HBM, behaviors are predicted by cognitive constructs including (a) perceived susceptibility which refers to one’ s perception of the risk, (b) perceived severity which refers to the degree people deem a particular disease or condition is serious, (c) perceived bene- fits which refer to the perception of the positive consequences that are caused by a specific action, (d) perceived barriers which refer to an individual’ s assessment of the obstacles to behavior change, (e) cause of action which may be internal or external, and (f) perceived self-efficacy which refers to the perception of one’ s own ability to reach a goal [16]. Several * Farzad Jalilian f_jalilian@yahoo.com 1 Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Journal of Cancer Education https://doi.org/10.1007/s13187-019-01579-2