{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:05:18Z","timestamp":1781769918493,"version":"3.54.5"},"reference-count":60,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study examined Australian farmers\u2019 engagement with skin cancer prevention behaviours and explored what made it hard for them to be \u2018SunSmart\u2019 (barriers), and what could be done to make prevention easier (facilitators). In total, 498 farmers (83.1% male, 22\u201389 years, 50.8% grain, sheep, or cattle farmers) participated. The least frequently performed SunSmart behaviours (reported as never practiced during summer) were using SPF 30+ sunscreen (16.6%), wearing protective sunglasses (10.5%), and wearing protective clothing (8.6%). Greater engagement (i.e., higher scores on scale from Never to Always) with SunSmart behaviours was explained by gender (female), educational attainment (trade or technical college certificate vs. high school), personal skin cancer history, and skin sun sensitivity. Barriers reported by farmers related to personal preferences (e.g., short-sleeved rather than long-sleeved clothing), comfort, and perceived impracticality of sun protection. Farmers\u2019 solutions included making protective clothing and sunscreen more appropriate for farm work (e.g., by making clothing more breathable). A personal health scare was the most reported motivation for skin cancer prevention. Findings highlight the need for increased access to sun-protective clothing and sunscreen that is suitable for wearing when working on farms, complemented by culturally appropriate health education messaging, to encourage more farmers to perform SunSmart behaviours.<\/jats:p>","DOI":"10.3390\/ijerph19052940","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T22:53:25Z","timestamp":1646261605000},"page":"2940","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["\u201cShe\u2019ll Be Right, Mate\u201d: A Mixed Methods Analysis of Skin Cancer Prevention Practices among Australian Farmers\u2014An At-Risk Group"],"prefix":"10.3390","volume":"19","author":[{"given":"Camilla","family":"Trenerry","sequence":"first","affiliation":[{"name":"School of Psychology, The University of Adelaide, Adelaide, SA 5000, Australia"},{"name":"Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, SA 5000, Australia"},{"name":"Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3663-2451","authenticated-orcid":false,"given":"Chloe","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlene","family":"Wilson","sequence":"additional","affiliation":[{"name":"Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia"},{"name":"Olivia Newton John Cancer Wellness Research Centre, Austin Health, Heidelberg, VIC 3084, Australia"},{"name":"School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3083, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0837-6814","authenticated-orcid":false,"given":"Kate","family":"Gunn","sequence":"additional","affiliation":[{"name":"Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, SA 5000, Australia"},{"name":"Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia"},{"name":"Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/j.1751-1097.2004.tb09854.x","article-title":"Global Solar UV Index: Australian measurements, forecasts and comparison with the UK","volume":"79","author":"Gies","year":"2004","journal-title":"Photochem. Photobiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/1753-6405.12470","article-title":"Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use","volume":"39","author":"Olsen","year":"2015","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"12222","DOI":"10.3390\/ijms140612222","article-title":"UV Radiation and the Skin","volume":"14","author":"Jarrett","year":"2013","journal-title":"Int. J. Mol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1097\/00008390-199311000-00002","article-title":"How much melanoma is caused by sun exposure?","volume":"3","author":"Armstrong","year":"1993","journal-title":"Melanoma Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S1011-1344(01)00198-1","article-title":"The epidemiology of UV induced skin cancer","volume":"63","author":"Armstrong","year":"2001","journal-title":"J. Photochem. Photobiol. B Biol."},{"key":"ref_6","first-page":"778","article-title":"Cancer statistics for the year 2020: An overview","volume":"149","author":"Ferlay","year":"2021","journal-title":"Cancer Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_8","unstructured":"Australian Institute of Health and Welfare (2020). Cancer Data in Australia."},{"key":"ref_9","unstructured":"Australian Institute of Health and Welfare (2016). Skin Cancer in Australia."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6","DOI":"10.5694\/j.1326-5377.2006.tb00086.x","article-title":"Non-melanoma skin cancer in Australia: The 2002 national survey and trends since 1985","volume":"184","author":"Staples","year":"2006","journal-title":"Med. J. Aust."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.pmedr.2015.07.004","article-title":"Farmers sun exposure, skin protection and public health campaigns: An Australian perspective","volume":"2","author":"Brumby","year":"2015","journal-title":"Prev. Med. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.puhe.2008.12.007","article-title":"Patterns of real-time occupational ultraviolet radiation exposure among a sample of outdoor workers in New Zealand","volume":"123","author":"Hammond","year":"2009","journal-title":"Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.canep.2017.06.003","article-title":"Cancer incidence in the AGRICAN cohort study (2005\u20132011)","volume":"49","author":"Lemarchand","year":"2017","journal-title":"Cancer Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kachuri, L., Harris, M.A., MacLeod, J.S., Tjepkema, M., Peters, P.A., and Demers, P.A. (2017). Cancer risks in a population-based study of 70,570 agricultural workers: Results from the Canadian census health and Environment cohort (CanCHEC). BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3346-x"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1440-1584.2011.01209.x","article-title":"Mortality patterns of Australian male farmers and farm managers","volume":"19","author":"Fragar","year":"2011","journal-title":"Aust. J. Rural. Health"},{"key":"ref_16","unstructured":"National Rural Health Alliance (2014). Skin Cancer in Australia: Awareness, Early Diagnosis and Management. Submission to House of Representatives Standing Committee on Health, National Rural Health Alliance."},{"key":"ref_17","unstructured":"(2021, October 21). Slip, Slop, Slap, Seek, Slide. Available online: https:\/\/www.cancer.org.au\/cancer-information\/causes-and-prevention\/sun-safety\/campaigns-and-events\/slip-slop-slap-seek-slide."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1177\/109019810102800304","article-title":"Slip! Slop! Slap! and SunSmart, 1980\u20132000: Skin cancer control and 20 years of population-based campaigning","volume":"28","author":"Montague","year":"2001","journal-title":"Health Educ. Behav."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.amepre.2007.09.024","article-title":"Weekend sun protection and sunburn in Australia trends (1987\u20132002) and association with SunSmart television advertising","volume":"34","author":"Dobbinson","year":"2008","journal-title":"Am. J. Prev. Med."},{"key":"ref_20","unstructured":"(2021, October 21). SunSmart: National Position Statement. Available online: https:\/\/www.cancer.org.au\/about-us\/policy-and-advocacy\/position-statements\/sunsmart."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/j.1365-2133.2009.09459.x","article-title":"Skin cancer prevention in Australia","volume":"161","author":"Sinclair","year":"2009","journal-title":"Br. J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"D\u2019Souza, C., Kramadhari, N., Skalkos, E., Dutton, T., and Bailey, J. (2021). Sun safety knowledge, practices and attitudes in rural Australian farmers: A cross-sectional study in Western New South Wales. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10777-x"},{"key":"ref_23","first-page":"115","article-title":"Victorian farmers\u2019 and other rural outdoor workers\u2019 skin cancer prevention knowledge and practices","volume":"25","author":"Makin","year":"2009","journal-title":"J. Occup. Health Saf."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s10389-019-01089-x","article-title":"Occupational exposure: Rural Australian farmers\u2019 sun-protective behaviours","volume":"28","author":"Woods","year":"2020","journal-title":"J. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/ajr.12272","article-title":"Farmers\u2019 perceptions of health in the Riverland region of South Australia: \u2018If it\u2019s broke, fix it\u2019","volume":"24","author":"Rawolle","year":"2016","journal-title":"Aust. J. Rural. Health"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Fennell, K., Martin, K., Wilson, C., Trenerry, C., Sharplin, G., and Dollman, J. (2017). Barriers to Seeking Help for Skin Cancer Detection in Rural Australia. J. Clin. Med., 6.","DOI":"10.3390\/jcm6020019"},{"key":"ref_27","unstructured":"Dobbinson, S.J., Doyle, C.J., and Wakefield, M.A. (2005). Farmers\u2019 and Outdoor Workers\u2019 Beliefs about Skin Cancer and Protection from Summer Sun: A Brief Report, Centre for Behavioural Research in Cancer, Cancer Council Victoria."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1111\/bjd.17872","article-title":"\u2018Try to make good hay in the shade\u2014it won\u2019t work!\u2019 A qualitative interview study on the perspectives of Bavarian farmers regarding primary prevention of skin cancer","volume":"180","author":"Zink","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/1059924X.2015.1010059","article-title":"Skin cancer beliefs, knowledge, and prevention practices: A comparison of farmers and nonfarmers in a midwestern population","volume":"20","author":"Carley","year":"2015","journal-title":"J. Agromed."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e12083","DOI":"10.1002\/1348-9585.12083","article-title":"Outdoor workers\u2019 perceptions of skin cancer risk and attitudes to sun-protective measures: A qualitative study","volume":"62","author":"Rocholl","year":"2020","journal-title":"J. Occup. Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1111\/jdv.14281","article-title":"Do outdoor workers know their risk of NMSC? Perceptions, beliefs and preventive behaviour among farmers, roofers and gardeners","volume":"31","author":"Zink","year":"2017","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_32","first-page":"1","article-title":"Farmers\u2019 stress and coping in a time of drought","volume":"12","author":"Gunn","year":"2012","journal-title":"Rural Remote Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1080\/1389224X.2013.775954","article-title":"Adoption of Soil Health Improvement Strategies by Australian Farmers: I. Attitudes, Management and Extension Implications","volume":"19","author":"Bennett","year":"2013","journal-title":"J. Agric. Educ. Ext."},{"key":"ref_34","unstructured":"Binks, B., Stenekes, N., Kruger, H., and Kancans, R. (2018). Snapshot of Australia\u2019s Agricultural Workforce."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1001\/archderm.1988.01670060015008","article-title":"The validity and practicality of sun-reactive skin types I through VI","volume":"124","author":"Fitzpatrick","year":"1988","journal-title":"Arch. Dermatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ypmed.2014.12.025","article-title":"A randomised controlled trial of an online theory-based intervention to improve adult Australians\u2019 sun-protective behaviours","volume":"72","author":"White","year":"2015","journal-title":"Prev. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"Azjen","year":"1991","journal-title":"Organ. Behav. Hum. Decis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/hbe2.195","article-title":"The theory of planned behaviour: Frequently asked questions","volume":"2","author":"Azjen","year":"2020","journal-title":"Hum. Behav. Emerg. Technol."},{"key":"ref_39","unstructured":"QSR International Pty Ltd (2021, October 11). NVivo (Version 11). Available online: https:\/\/www.qsrinternational.com\/nvivo-qualitative-data-analysis-software\/home."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/nhs.12048","article-title":"Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study","volume":"15","author":"Vaismordai","year":"2013","journal-title":"Nurs. Health Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jdin.2020.10.013","article-title":"The global burden of skin cancer: A longitudinal analysis from the Global Burden of Disease Study, 1990\u20132017","volume":"2","author":"Urban","year":"2021","journal-title":"JAAD Int."},{"key":"ref_42","unstructured":"(2021, September 21). About Sunscreen: When to Use, How to Apply. Available online: https:\/\/www.cancer.org.au\/cancer-information\/causes-and-prevention\/sun-safety\/about-sunscreen."},{"key":"ref_43","unstructured":"Gies, P. (2013). Capital City Maximum UV Levels by Month."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1111\/jdv.15052","article-title":"Different outdoor professions have different risks\u2014A cross-sectional study comparing non-melanoma skin cancer risk among farmers, gardeners and mountain guides","volume":"32","author":"Zink","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/bjd.12160","article-title":"Outdoor workers\u2019 sun-related knowledge, attitudes and protective behaviours: A systematic review of cross-sectional and interventional studies","volume":"168","author":"Reinau","year":"2013","journal-title":"Br. J. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2526","DOI":"10.1111\/jdv.16560","article-title":"Skin cancer risk and shade: Comparing the risk of foresters with other outdoor workers","volume":"34","author":"Tizek","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1080\/1059924X.2013.855691","article-title":"Sun safety among farmers and farmworkers: A review","volume":"19","author":"Kearney","year":"2014","journal-title":"J. Agromed."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12995-021-00314-2","article-title":"New methods for assessing secondary performance attributes of sunscreens suitable for professional outdoor work","volume":"16","author":"Rocholl","year":"2021","journal-title":"J. Occup. Med. Toxicol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s13671-020-00284-4","article-title":"Sunscreen safety: A review of recent studies on humans and the environment","volume":"9","author":"Adler","year":"2020","journal-title":"Curr. Dermatol. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/1203475419856611","article-title":"Sunscreen application, safety, and sun protection: The evidence","volume":"23","author":"Li","year":"2019","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1001\/jama.2019.5528","article-title":"Filling in the evidence about sunscreen","volume":"321","author":"Califf","year":"2019","journal-title":"JAMA"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1001\/jama.2019.20143","article-title":"Systemic absorption of sunscreen: Balancing benefits with unknown harms","volume":"323","author":"Adamson","year":"2020","journal-title":"JAMA"},{"key":"ref_53","unstructured":"(2022, February 25). Be SunSmart. Available online: https:\/\/www.cancer.org.au\/cancer-information\/causes-and-prevention\/sun-safety\/be-sunsmart."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s13012-015-0347-5","article-title":"What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: A systematic review and meta-analyses","volume":"10","author":"Grudniewicz","year":"2015","journal-title":"Implement. Sci."},{"key":"ref_55","first-page":"CD004398","article-title":"Printed educational materials: Effects on professional practice and healthcare outcomes","volume":"8","author":"Zomahoun","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5130\/AJCEB.v2i2.2896","article-title":"Outdoor workers and sun protection: Knowledge and behaviour","volume":"2","author":"Cioffi","year":"2012","journal-title":"Constr. Econ. Build."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/1467-9566.12112","article-title":"Why behavioural health promotion endures despite its failure to reduce health inequities","volume":"36","author":"Baum","year":"2014","journal-title":"Sociol. Health Illn."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1108\/20426761111104419","article-title":"Regulation, public health and social marketing: A behaviour change trinity","volume":"1","author":"Hoek","year":"2011","journal-title":"J. Soc. Mark."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1080\/10410236.2014.974126","article-title":"Telling stories, saving lives: Creating narrative health messages","volume":"30","author":"Frank","year":"2015","journal-title":"Health Commun."},{"key":"ref_60","first-page":"4155","article-title":"A comparison of barriers to accessing services for mental and physical health conditions in a sample of rural Australian adults","volume":"18","author":"Fennell","year":"2018","journal-title":"Rural Remote Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2940\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:31:07Z","timestamp":1760135467000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2940"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,3]]},"references-count":60,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19052940"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19052940","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,3]]}}}