Attitudes, Behaviors and Beliefs of Urban Adult Filipinos on Sunlight Exposure: A Qualitative Study
Keywords:sunlight exposure, adult Filipinos, urban health, community health, qualitative research
Abstract*Visual Abstracts prepared by Dr. Jerico Gutierrez
Objective. To explore the attitudes, behaviors, and beliefs of urban adult Filipinos on sunlight exposure as an initial step in the development and validation of a culturally-appropriate questionnaire.
Methodology. Focus groups were conducted among urban Filipinos 19 years old and above (n=38). The transcribed results underwent qualitative content and thematic analyses and were used to develop a conceptual framework.
Results. Qualitative analysis revealed four main themes of sunlight exposure: internal influences, external influences, perceived benefits, and perceived risks. Both internal and external influences lead to perceived risks and benefits. Consequently, the perceived benefits (or lack) of sunlight exposure influence an individual’s attitude towards vitamin D supplementation; whereas the perceived risks of sunlight exposure influence an individual’s attitude towards the need for sun protection.
Conclusion. The attitudes, behaviors and beliefs of urban adult Filipinos on sunlight exposure are influenced by both internal and external factors, that in turn lead to perceived risks and benefits. An increased awareness of these factors is necessary to establish future recommendations on proper sunlight exposure in this population. The study results will be used to develop and validate a culturally-appropriate sunlight exposure questionnaire.
Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080S-6S. PMID: 18400738. https://doi.org/10.1093/ajcn/87.4.1080S.
Maxwell JD. Seasonal variation in vitamin D. Proc Nutr Soc. 1994;53(3):533-43. PMID: 7886053.
Rapuri PB, Kinyamu HK, Gallagher JC, Haynatzka V. Seasonal changes in calciotropic hormones, bone markers and bone mineral density in elderly women. J Clin Endocrinol Metab 2002;87(5):2024-32. PMID: 11994336. https://doi.org/10.1210/jcem.87.5.8475.
Raso AA, Navarra SV, Li-Yu, J, Torralba TP. Survey of vitamin D levels among post-menopausal Filipino women with osteoporosis. Int J Rheum Dis. 2009;12(3): 225-9. PMID: 20374350. https://doi.org/10.1111/j.1756-185X.2009.01414.x.
Beadle PC. Sunlight, ozone and vitamin D. Br J Dermatol. 1977;97(5):585-91. PMID: 201266.
Creech LL, Mayer JA. Ultraviolet radiation exposure in children: A review of measurement strategies. Ann Behav Med. 1997;19(4):399-407. PMID: 9706367. https://doi.org/10.1007/BF02895159.
Wu S, Ho SC, Lam TP et al. Development and validation of a lifetime exposure questionnaire for use among Chinese populations. Sci Rep. 2013;3:2793. PMID: 24077356. PMCID: PMC3786302. https://doi.org/10.1038/srep02793.
Humayun Q, Iqbal RA, Azam I, Khan AH, Siddiqui AR, Baig-Ansari N. Development and validation of sunlight exposure measurement (SEM-Q) for use in adult population residing in Pakistan. BMC Public Health. 2012;12:421. PMID: 22682277. PMCID: PMC3436746. https://doi.org/10.1186/1471-2458-12-421.
Hanwell HE, Vieth R, Cole DE et al. Sun exposure questionnaire predicts circulating 25-hydroxyvitamin D concentrations in Caucasian hospital workers in southern Italy. J Steroid Biochemistry Mol Bio. 2010;121(1-2):334-7. PMID: 20298782. https://doi.org/10.1016/j.jsbmb.2010.03.023.
Cargill J, Lucas RM, Gies P et al. Validation of brief questionnaire measures of sun exposure and skin pigmentation against detailed and objective measures including vitamin D status. Photochem Photobiol. 2013;89(1):219-26. PMID: 22891914. https://doi.org/10.1111/j.1751-1097.2012.01221.x.
Adams A, Cox AL. Questionnaires, in-depth interviews and focus groups. In: Cairns P, Cox AL, eds. Research Methods for Human Computer Interaction. Cambridge, UK: Cambridge University Press, 2008. http://www.cambridge.org/catalogue/catalogue.asp?isbn=9780521870122&ss=toc.
Dawson S, Manderson L, Tallo VL, International Nutrition Foundation for Developing Countries & UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. A manual for the use of focus groups. Boston: International Nutrition Foundation for Developing Countries, 1993. http://www.who.int/iris/handle/10665/41795.
Roberts WE. Skin type classification systems old and new. Dermatol Clin. 2009;27(4):529-33. PMID: 19850202. https://doi.org/10.1016/j.det.2009.08.006.
Nimitphong H, Holick MF. Vitamin D status and sun exposure in southeast Asia. Dermatoendocrinol. 2013;5(1):34-7. PMID: 24494040. PMCID: PMC3897596. https://doi.org/10.4161/derm.24054.
Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B. Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health. 2011;11:853. PMID: 22074319. PMCID: PMC3247919. https://doi.org/10.1186/1471-2458-11-853.
Choi HS, OH HJ, Choi H et al. Vitamin D insufficiency in Korea—a greater threat to younger generation: The Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab. 2011;96(3):643-51. PMID: 21190984. https://doi.org/10.1210/jc.2010-2133.
Webb AR, Engelsen O. Calculated ultraviolet exposure levels for a healthy vitamin D status. Photochem Photobiol. 2006;82(6):1697-703. PMID: 16958558. https://doi.org/10.1562/2005-09-01-RA-670.
Whaley F. Strained infrastructure in Philippines erodes the nation’s growth prospects. The New York Times. August 3, 2014. https://www.nytimes.com/2014/08/04/business/international/strained-infrastructure-in-philippines-erodes-the-nations-growth-prospects.html.
Torres AT. A portrait of Filipino culture. Philipp Soc Sci Humanit Rev . 1985;47(1-4):243-64.
David R. The epidermalization of inferiority . Philippine Daily Inquirer. July 19, 2008.
Matsuoka LY, Ide L, Wortsman J, MacLaughlin JA, Holick MF. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab. 1987;64(6):1165-8. PMID: 3033008. https://doi.org/10.1210/jcem-64-6-1165.
Keown C. Focus group research: Tool for the retailer. In: Hayes TJ, Tathum CB, eds. Focus Group Interviews: A Reader. Chicago, USA: American Marketing Association, 1983.
Hinz A, Michalski D, Schwarz R, Herzberg PY. The acquiescence effect in responding to a questionnaire. Psychosoc Med. 2007;4:Doc07. PMID: 19742288. PMCID: PMC2736523.
Andres TQD. Filipino Behavior at Work: Human Relations and Organizational Behavior in the Philippine Setting. Quezon City, Philippines: Giraffe Books, 2001.
Barbour RS, Kitzinger J, eds. Developing Focus Group Research: Politics, Theory and Practice. London, UK: Sage, 1999.
Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8-14. https://doi.org/10.1016/j.npls.2016.01.001.
Moy FM. Vitamin D status and its associated factors of free living Malay adults in a tropical country, Malaysia. J Photochem Photobiol B. 2011;104(3):444-8. PMID: 21636288. https://doi.org10.1016/j.jphotobiol.2011.05.002.
Philippine Statistics Authority. Islam in Mindanao. PSA Fact Sheet. September 15, 2017. http://rsso11.psa.gov.ph/article/factsheet-islam-mindanao.
How to Cite
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to firstname.lastname@example.org or email@example.com.
A written agreement shall be emailed to the requester should permission be granted.