A high level of photoprotection is required by people with xeroderma pigmentosum (XP), a rare skin disease, to reduce skin cancer and other risks.,However poor photoprotection is thought to be widespread.,This study examines the influences on photoprotection behaviours in adults with XP.,Inductive qualitative study with semistructured interviews.,Analysis employed a framework approach.,National sample recruited through a specialist XP centre in London.,Semistructured interviews at patients’ homes.,All transcripts were coded and themes charted for each participant.,Comparisons within and across cases identified common themes and differing motivations and approaches to photoprotection.,Credibility of interpretations assessed through patient/carer input and clinic adherence scores.,25 adults (17 male, eight female) aged 16-63 years with diagnosed XP attending a specialist centre. 18 lived outside London.,Awareness of risks of ultraviolet radiation (UVR) and photoprotection was high.,However, photoprotection behaviours varied according to perceived necessity and concerns.,Three behavioural responses were identified: (1) ‘dominated’ by planning and routines to achieve a high level of photoprotection with significant activity restrictions and psychosocial impacts. (2) ‘resistant’ to photoprotection with priority given to avoiding an illness identity and enjoying a normal life.,(3) Photoprotection’ integrated’ with an individual’s life with little psychosocial impact.,These responses were influenced by illness, personal and contextual factors including age, life stage and social support.,Only the ‘integrated’ group achieved an equilibrium between perceived ‘necessity’ and ‘concerns’.,The personal balance between perceived risks of UVR and social/psychological ‘concerns’ led to differing behavioural responses and contributes to an understanding of adaptation and normalisation in chronic illness.,The study will also inform a series of individualised behavioural interventions to reduce measured UVR exposure among people with XP that are potentially applicable to other conditions with high risks of skin cancer.
Excessive sun exposure and sunburn increase individuals’ risk of skin cancer.,It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life.,This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns.,Cross-sectional telephone surveys were conducted annually with Western Australians between 2005/06 and 2014/15.,The results from 4150 adolescents aged 14-17 years were used to conduct a path analysis of factors predicting various sun protection behaviours and sunburn.,Significant primary predictors of the sun protection behaviours included in the study were skin type (sun sensitivity), gender, tanning-related attitudes and behaviours, and perceived relevance of public service advertisements that advocate sun protection.,Of the four sun protection behaviours investigated, staying in the shade and staying indoors during the middle of the day were associated with a lower frequency of sunburn.,There is a particular need to target sun protection messages at adolescent males who are less likely to engage in the most effective sun protection behaviours and demonstrate an increased propensity to experience sunburn.,The results suggest that such future sun protection messages should include a focus on the importance of staying in the shade or indoors during periods of high UV radiation to increase awareness of the efficacy of these methods of avoiding skin cancer.