A Conversation Surrounding Sun Safety and Healthy Behaviors with Dr. Sherry Pagoto

When it comes to making healthy choices, sometimes the short-term benefit of an unhealthy choice outweighs the long-termbenefit of a healthy choice. In the following conversation, we sat down with Dr. Sherry Pagoto, a licensed clinical psychologistwhose research focuses on behavioral science and public health approaches to skin cancer prevention, to share the latestresearch and advice behind maintaining healthy routines and sun safe behaviors.

How did you get into your field of study?

I am a clinical health psychologist, which is a sub-specialty field of psychology that focuses on behavior relevant to yourphysical health. I have always been interested in the phenomenon of why we make unhealthy choices when we know they're unhealthy,and how to inspire people to make healthy choices.

Can you describe an unhealthy behavior choice?

Unhealthy choices, in the short term, feel good. This outweighs our concerns about disease in the future. A great example has to do with skin cancer prevention. We like to be out in the sun, it feels good, and some people think it looks good to be tanned. These immediate ‘rewards’ compete with our concern about cancer. Most people are aware that these choices can increase their risk for cancer, but what they're getting in the immediate time is more worth it in the moment.

In times of stress and disruption, do you have advice for maintaining healthy habits?

Sometimes, we can’t get stress to disappear no matter how hard we try, such as now during the pandemic. Our only choice is to find ways to cope with it so that it doesn't impact us negatively. One method is avoiding things that trigger stress, like watching or reading the news. My biggest piece of advice would be to prioritize decreasing stress, so the body and mind have more time to focus on healthier behaviors.

Do you have any pieces of advice from your research that would help get someone back on track?

To get back on track, you want to put conscious effort into developing that new routine sooner rather than later. The longer that somebody is off track, the harder it can be to get back on track. One thing you may want to think about is, "how do I create the infrastructure around this routine to help it succeed". That might involve bringing other people into it or rearranging your environment, so you're reminded to engage in the behavior.

Do you have any examples of a flawed routine?

One thing that I've noticed in my studies is that people will use sun protection in nonbeneficial ways. A lot of people say, "I use sunscreen, but it's really to just control how much I'm going to burn so I can get a tan", rather than using it to prevent tanning altogether. In this case, sunscreen becomes their tool for damage control as opposed to following the guidelines of reapplying every two hours to get adequate coverage.

Does positive reinforcement affect behavior change as much as negative reinforcement?

Definitely. Instead of saying, "Oh, you're going to develop wrinkles later," you could flip that around and say, "Don't you want to look youthful when you're 50 years old or 60 years old?". Focusing more on the benefits of preserving your youth rather than aging can inspire the same behavior changes. It’s important to strive for something positive as opposed to avoid something negative.

Could you expand on how habits are linked to diseases and illnesses?

It certainly depends on the disease, but top causes of death are cancer and heart disease, and there are several lifestyle choices and habits that are associated with one's risk. In the example of skin cancer prevention, there can be a genetic factor in your risk, but genetics rarely operate by themselves, and your environmental exposures have a lot to do with your risk in terms of UV exposure, how much time you spend tanning, and so on.