Determinants of Skin Cancer Prevention Behaviors Among Iranian People Aged Over 20 Years Old in Northeast Iran: An Application of the Extended Parallel Process Model

Background: Understanding factors that influence the adoption of preventive measures to reduce the risk of skin cancer is essential for creating effective educational programs. This study aimed to identify key factors contributing to the adoption of skin cancer prevention behaviors among Iranians in the northeast region of Iran over 20 years, utilizing the extended parallel process model (EPPM). Methods: Overall, 500 participants were selected using stratified random sampling and included in this cross-sectional study. The data were collected through a researcher-made questionnaire based on the EPPM and a demographic questionnaire. The collected data were analyzed using hierarchical linear regression models in SPSS 16.0. Results: The median age of the participants was 29.00 years (1st quartile: 22.00 years, 3rd quartile: 41.00 years), with 317 individuals (63.4%) identifying as female. Only 21.8% of participants (95% confidence interval: 18.3%–25.7%) reported consistently adhering to all recommended skin cancer preventive behaviors. Pearson’s correlation coefficient indicated a positive and significant correlation between all the EPPM and preventive behavior, except for defensive avoidance constructs. Furthermore, regression analysis identified gender and four components of the EPPM—perceived response efficacy, fear, perceived self-efficacy, and perceived severity—as the most significant predictors of intentions and behaviors related to skin cancer prevention. Conclusion: The findings showed a low level of preventive behaviors among the participants and the determinant role of four constructs of the EPPM in adhering to skin cancer preventive behaviors. Therefore, educational interventions based on the EPPM model are suitable frameworks for designing interventions and training programs to improve preventive behaviors against skin cancer.