Health education videos tell us what really matters to people.

Two videos both began by offering information about UV light and sun-protective behaviors but then one describes the increased skin cancer risk of UV exposure and the other
describes effects on appearance including wrinkles and premature aging.

Cancer is too remote, but wrinkles are real, for teenagers. 

A
University of Colorado Cancer Center study shows that while teens who watched both videos
learned and retained the same amount of knowledge about UV light and sun-protective behaviors,
only the teens who watched the appearance-based video (and not the health-based video) actually
changed these behaviors.

"We see this anecdotally in the clinic. The teens who come in,
often it's because their parents are dragging them. A lot have undergone tanning or never wear
sunscreen. You can tell that when we talk about the skin cancer risk, it doesn't faze them. But
when you talk about premature wrinkling and aging, they listen a little more closely," says
April W. Armstrong, MD MPH, investigator at the CU Cancer Center and vice chair of Clinical
Research at the CU School of Medicine Department of Dermatology.

The current study aimed
to quantify this observation. First, Armstrong and colleagues went to local high schools to
recruit 50 subjects. All subjects completed questionnaires demonstrating their baseline
knowledge about UV light and use of sun-protective behaviors. Then subjects were randomized into
two groups, one of which viewed the health-based video that emphasized skin cancer risk, and the
other of which viewed the appearance-based video that emphasized cosmetic changes due to UV
exposure. Six weeks later, all subjects again completed questionnaires that showed the knowledge
they retained and changes in sun-protective behaviors.

"Interestingly, we didn't see any
difference in teenagers' knowledge – no matter if they had watched the health-based or
appearance-based video, students learned and retained the same amount of information," Armstrong
says.

However, despite knowing the skin cancer risk from UV exposure, the group that had
watched the health-based video showed no statistically significant increase in their
sun-protective behaviors. On the other hand, the group that had been shown the appearance-based
video reported a dramatic increase in the use of sunscreen.

"For teenagers, telling them
UV exposure will lead to skin cancer is not as effective as we would hope. If our endgame is to
modify their behavior, we need to tailor our message in the right way and in this case the right
way is by highlighting consequences to appearance rather than health. It's important to address
now – if we can help them start this behavior when younger, it can affect skin cancer risk when
older," Armstrong says.