Objective: Skin cancer is the most frequently diagnosed cancer and rates are increasing because of global warming. This article reports a meta-analysis of randomized controlled trials of behavioral interventions to reduce exposure to ultraviolet radiation (UVR). The review aimed to (a) quantify the magnitude of intervention effects on indoor tanning, sun exposure, and sunscreen use, and (b) determine which intervention strategies maximize behavior change. Method: Out of 17,437 records identified via literature searches, 190 independent tests (N = 89,365) met the inclusion criteria. Sample, intervention, and methodological characteristics, and change techniques were coded, and random effects meta-analyses and metaregressions were conducted. Results: The sample-weighted average effect size across all studies was d+ = .193 (95% confidence interval, CI [.161, .226]), and there were significant effects on indoor tanning, sun exposure, and sunscreen use (d+ = .080, .149, and .196, respectively). However, there was evidence of publication bias, and trim and fill analyses indicated that the corrected effects for sun exposure and sunscreen use were of very small magnitude (d+ ~ .06) and were not significantly different from zero for indoor tanning (d+ = -.011, 95% CI [-.096, .074]). Metaregression analyses identified several intervention strategies that predicted effect sizes. For instance, interventions delivered individually that promoted alternatives to tanning were associated with larger effect sizes for indoor tanning. Conclusion: Interventions to date have had only a modest impact on behavioral exposure to UVR. The present findings offer new insights into how the effectiveness of future interventions can be improved. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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减少暴露在阳光下和室内晒黑的紫外线下的荟萃分析。

目的：皮肤癌是最常被诊断出的癌症，并且由于全球变暖，其发病率正在增加。本文报告了一项针对减少紫外线辐射（UVR）的行为干预随机对照试验的荟萃分析。该审查旨在（a）量化干预措施对室内晒黑，日晒和防晒霜使用的影响，以及（b）确定哪种干预策略可最大程度地改变行为。方法：在通过文献检索确定的17,437笔记录中，有190项独立测试（N = 89,365）符合纳入标准。对样本，干预措施和方法学特征以及变更技术进行了编码，并进行了随机效应的荟萃分析和荟萃回归。结果：所有研究中样本加权平均效应量为d + = .193（95％置信区间，CI [.161，.226]），并且对室内日光浴，日光照射和防晒霜使用有显着影响（分别为d + = .080，.149和.196）。但是，有证据表明出版物存在偏差，修整和填充分析表明，晒太阳和使用防晒霜的校正效果非常小（d +〜.06），并且室内晒黑的校正效果与零值无明显差异（d + =- .011，95％CI [-.096，.074]）。元回归分析确定了几种预测效应大小的干预策略。例如，单独实施的促进晒黑替代品的干预措施与室内晒黑的更大效果相关。结论：迄今为止，干预对行为暴露于UVR的影响很小。目前的发现为如何提高未来干预措施的有效性提供了新的见解。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。