Can a scary movie improve sun protection behaviours?

Queensland Health have just released a new campaign targeting 18-34 year olds utilising the horror movie genre to motivate them to be more vigilant about sun protection. The campaign line ‘You do the 5. You survive’ is referencing the well known campaign slogan - Slip Slop Slap Seek Slide. The creative draws on familiar horror movie scenes - creepy old lady, child appearing out of the ether, objects disappearing... you get the gist. The music track is as you would expect, creating suspense and drama. All in all, it’s a novel and entertaining way to get the message out there and a genre that the age group will relate to. But will the message land? Is scaring someone into sun protection the best approach?

If my personal experience is anything to go by, I’d have to say no.

Five years ago, I was diagnosed with Stage IV Melanoma and was told the historic prognosis of that diagnosis was 12-24 months to live. I sat my 17 and 21 year old sons down and told them that I had an incurable disease and any treatment I received was just to buy me more time. I made no secret of my prognosis so it was known to all my family and my circle of friends. I, however, was incredibly lucky and had a complete response to immunotherapy treatment, in only 97 days I was clear of cancer and have been ever since. Just a couple of months after receiving this amazing news though, both my sons came home sunburnt and members of my family, in their teens and 20’s, were still sunbaking.

I wondered what the hell was going on. Wasn’t knowing that their Mum or Aunt could have died from sun exposure enough of a scare to stop them from putting their own lives at risk? As you can imagine, this triggered me and set me on a path of secondary research and ultimately writing my memoir about my Melanoma journey and the cultural norms that impacted my own sun exposure, which still exist today.

In my review of research papers, I discovered Trauma Management Theory, it's a psychological theory that argues that we all know that we are going to die, but to live with this existential threat everyday would be too difficult to bear, so in order to defend ourselves against it we strive to create meaning by building our self-esteem. It also states that people’s behaviour changes in relation to how prominent thoughts of death are in their consciousness. If they are prominent, people will behave in a way that protects them from the threat of death. However, when thoughts of death have been activated but move to the back of consciousness people will behave in a way that helps defend them from the existential threat ie. they will seek to build their self-esteem.

So, here’s the kicker, by highlighting the danger of the sun, like it does so dramatically in this campaign, you could actually be driving sun tanning behaviour. This is because, for many, sun tanning is a way of building self-esteem, and when the message from this campaign and others, moves to the back of their consciousness, they will act in a way to defend themselves from the existential threat of death.

Research interventions confirm, rather ironically or perhaps sadly, that some of the behaviours people engage in to defend themselves from the worry of death can actually increase the probability of succumbing to disease and death by engaging in risky behaviour like sun exposure, smoking and driving too fast. Also, if an individual believed themself to be vulnerable to the risk, this increased the threat and led them to engage in even more of the defensive behaviour. Maybe that’s what was playing out in my own family.

All is not lost though, research suggests that the required behaviours can be stimulated if performing the behaviours adds to one’s self esteem. For instance, in the case of sun protection this could be positioned as increasing autonomy or empowerment at a time when young people are finding their identity.

What is also at play, are the cultural beliefs and norms of our society which created and reinforced the underlying meaning of having a tan in Australia. If having a tan didn’t add to self-esteem or indeed in Australia’s case, our national identity, then tanning behaviour would reduce. In my upcoming memoir Sunburnt I discuss this issue and suggest some ways to start changing these cultural norms.

Government advertising campaigns are always well informed by research throughout the campaign development process, which I’m sure this one has been. Of course, not all the academics agree with Terror Management Theory, but I still wonder whether intentions expressed during research to adopt sun protection will change to risky defensive behaviour after time lapses and thoughts of mortality move to the back of consciousness.

I'm for anything that helps to reduce skin cancer so I’ll be interested to see the results of this campaign and whether it too, survives.

Routledge et al 2004. A Time to Tan: Proximal and Distal Effects of Mortality Salience on Sun Exposure Intentions.
Goldenberg et al 2008. The Implications of Death for Health: A Terror Management Health Model for Behavioral Health Promotion