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• W2903876103 abstract "To the Editor: Traditional gender roles have been shown to influence health-related behaviors. Masculinity is often linked with health-harming behaviors, whereas femininity is often linked with health-promoting behaviors.1Griffith D.M. Gilbert K.L. Bruce M.A. Thorpe R.J. Masculinity in men's health: barrier or portal to healthcare?.in: Heidelbaugh J. Men's Health in Primary Care. Current Clinical Practice. Humana Press, New York2016Crossref Google Scholar, 2Galdas P.M. Cheater F. Marshall P. Men and health help-seeking behaviour: literature review.J Adv Nurs. 2005; 49: 616-623Crossref PubMed Scopus (1044) Google Scholar Focus groups suggest that men avoid sunscreen because of its association with beauty products and have difficulty asking male peers to help apply sunscreen because it violates male-to-male body contact norms.3Abroms L. Jorgensen C.M. Southwell B.G. Geller A.C. Emmons K.M. Gender differences in young adults' beliefs about sunscreen use.Health Educ Behav. 2003; 30: 29-43Crossref PubMed Scopus (69) Google Scholar Despite these findings and men's higher incidence of melanoma,4National Cancer Institute. SEER Surveillance Epidemiology and End Results. 2011-2015. Cancer Stat Facts: Melanoma of the Skin. Available from: https://seer.cancer.gov/statfacts/html/melan.html. Accessed July 1, 2018.Google Scholar sun protection interventions rarely focus on men. We hypothesized that men strongly adhering to masculine norms have poor sun safety compared with men moderately adhering to masculine norms. We used cross-sectional questionnaire data from 961 adult men recruited through ResearchMatch, a national recruitment tool. The study sample consisted primarily of older (range, 18-92 years; mean, 51.8), heterosexual, white, and educated men (Table I). The questions captured information regarding demographics, masculine ideologies, and sun safety. The Male Role Norms Inventory–Short Form's Avoidance of Femininity subscale was used to classify men as displaying less adherence (Less-M), medium adherence (Med-M), or more adherence (More-M) to masculine norms. Previous studies have provided evidence for this scale's construct validity.5Levant R.F. Hall R.J. Rankin T.J. Male Role Norms Inventory-Short Form (MRNI-SF): development, confirmatory factor analytic investigation of structure, and measurement invariance across gender.J Couns Psychol. 2013; 60: 228-238Crossref PubMed Scopus (137) Google Scholar Stratification was determined before data collection. For each variable, a multivariate logistic regression generalized logit model was constructed. The dependent variable was the degree of adherence to masculine norms, and the independent variables were related to sun safety. Med-M was selected as the reference category so that More-M and Less-M could be compared with Med-M. Because our hypothesis compares men moderately and strongly adhering to masculine norms, the More-M–to–Med-M odds ratios are reported. The multivariate models included age, race, education, and sexual orientation. The study was approved by Northwestern Institutional Review Board. Statistical analysis was performed with SAS software (SAS OnlineDoc 9.4, SAS Institute Inc, Cary, NC).Table IParticipant characteristicsVariableValueAge, y Mean51.8 Median55 Range (SD)18-92 (17.00)Masculinity, (%) Less-M277 (28.8) Med-M514 (53.5) More-M170 (17.7)Race, (%) White860 (89.5) Nonwhite101 (10.5)Education, (%) High school or less42 (4.4) Some college or more919 (95.6)Sexual orientation, (%) Bisexual66 (6.9) Heterosexual/straight792 (82.4) Homosexual/gay103 (10.7)Geographic region, (%) Northeast142 (14.8) West193 (20.1) Midwest318 (33.1) South308 (32.0)Skin type, (%) I or II255 (26.5) III or IV654 (68.1) V or VI52 (5.4)Less-M, Less adherence to masculine norms; Med-M, medium adherence to masculine norms; More-M, more adherence to masculine norms; SD, standard deviation. Open table in a new tab Less-M, Less adherence to masculine norms; Med-M, medium adherence to masculine norms; More-M, more adherence to masculine norms; SD, standard deviation. Logistic regression models revealed that men who did not use sunscreen regularly (adjusted odds ratio [aOR], 1.44; 95% confidence interval [CI], 1.00-2.07) or believed that tanning protects them from skin damage (aOR, 1.74; 95% CI, 1.10-2.76) had increased odds of strongly adhering to traditional masculine norms. Men who viewed young-looking skin as not at all important (aOR, 0.39; 95% CI, 0.22-0.70), slightly important (aOR, 0.40; 95% CI, 0.24-0.67), or important (aOR, 0.47; 95% CI, 0.28-0.81) compared with very important had decreased odds of strongly adhering to traditional masculine norms (Table II).Table IIMore adherence to masculine norms and related outcomesVariableDegree of masculinity, n (%)Odds of More-M compared with Med-MMed-MMore-MaOR∗aOR includes age, race, education, and sexual orientation. (95% CI)P valueDo you use sunscreen regularly? No277 (53.9)107 (62.9)1.44 (1.00-2.07).05 Yes237 (46.1)63 (37.1)1 (ref)How concerned are you about ultraviolet rays that can cause skin damage? Not at all concerned56 (10.9)27 (15.9)1.29 (0.68-2.43).44 Slightly concerned206 (40.1)70 (41.2)0.93 (0.57-1.54).79 Fairly concerned168 (32.7)42 (24.7)0.68 (0.40-1.16).16 Very concerned84 (16.3)31 (18.2)1 (ref)How important to you is young-looking skin? Not at all important105 (20.4)29 (17.1)0.39 (0.22-0.70).002 Slightly important212 (41.2)59 (34.7)0.40 (0.24-0.67)<.001 Important137 (26.7)43 (25.3)0.47 (0.28-0.81).006 Very important60 (11.7)39 (22.9)1 (ref)Do you think that you can protect yourself from skin damage by getting a tan? True, I don't know (incorrect)67 (13.0)35 (20.6)1.74 (1.10-2.76).019 False (correct)447 (87.0)135 (79.4)1 (ref)Do you think that a sunscreen with SPF 30 offers twice as much skin protection as an SPF 15 sunscreen? True, I don't know (incorrect)335 (65.2)118 (69.4)1.19 (0.81-1.73).37 False (correct)179 (34.8)52 (30.6)1 (ref)Do you think that when skin cancer is detected early it can be effectively treated? True (correct)491 (95.5)168 (98.8)4.02 (0.93-17.34).063 False, I don't know (incorrect)23 (4.5)2 (1.2)1 (ref)Boldface indicates statistical significance (P ≤ .05).aOR, Adjusted odds ratio; CI, confidence interval; Med-M, medium adherence to masculine norms; More-M, more adherence to masculine norms; ref, reference; SPF, sun protection factor.∗ aOR includes age, race, education, and sexual orientation. Open table in a new tab Boldface indicates statistical significance (P ≤ .05). aOR, Adjusted odds ratio; CI, confidence interval; Med-M, medium adherence to masculine norms; More-M, more adherence to masculine norms; ref, reference; SPF, sun protection factor. These findings suggest that men strictly adhering to masculine norms are less likely to use sunscreen regularly or demonstrate tanning knowledge, despite valuing young-looking skin. One proposed explanation is that sun safety is a feminine concern that is at odds with traditional male roles. This study's large sample size lent power to statistical models and controlled for potentially confounding variables. Limitations include self-reported data, inclusion of men with a history of skin cancer, and over-representation of white, educated men. Despite these limitations, this study suggests that adherence to masculine norms can serve as a barrier to sun safety and thus, can increase skin cancer risk. Future sun safety interventions could use these findings to address the impact of gender norms when targeting men. Further studies are needed to elucidate the mechanisms underlying these associations." @default.
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• W2903876103 title "Masculine norms and sunscreen use among adult men in the United States: A cross-sectional study" @default.
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