The 8-item Decisional Balance for sun protection inventory (SunDB) assesses the relative importance of the perceived advantages (Pros) and disadvantages (Cons) of sun protective behaviors. This study examined the psychometric properties of the SunDB measure, including invariance of the measurement model, in a population-based sample of adults. Confirmatory factor analyses supported the theoretically based 2-factor (Pros, Cons) model, with high internal consistencies for each subscale (). Multiple-sample CFA established that this factor pattern was invariant across multiple population subgroups, including gender, racial identity, age, education level, and stage of change subgroups. Multivariate analysis by stage of change replicated expected patterns for SunDB (Pros , Cons ). These results demonstrate the internal and external validity and measurement stability of the SunDB instrument in adults, supporting its use in research and intervention. 1. Introduction Skin cancer is a major public health concern. Melanoma is the most serious form of skin cancer and accounts for the majority of skin cancer deaths. The American Cancer Society estimates there will be more than 76,000 new cases of melanoma diagnosed in 2014 in the United States. Nonmelanoma skin cancers are typically nonfatal but much more prevalent; in 2006, approximately 3.5 million people in the United States were diagnosed with these malignancies, and more than 2 million were treated [1]. The incidence rates for both types of skin cancers have been increasing [1, 2]. Skin cancers lead to substantial direct medical care costs and significant indirect costs associated with premature mortality and morbidity [3, 4]. Preventing all skin cancers is both important and possible by adopting habitual sun protective behaviors such as reducing sun exposure and using sunscreen [5]. Interventions for increasing sun protection behaviors using tailored health communications based on the transtheoretical model of behavior change have been developed and implemented and have demonstrated significant impacts in numerous applications [6–9]. The transtheoretical model (TTM) [10–13] is an integrative model of intentional behavior change underlying numerous effective interventions. Empirically based tailoring is especially relevant in population-based interventions when not everyone is prepared to immediately change their risk behavior(s). Decisional Balance is one of the core constructs integrated within the TTM framework. Based initially on the work of Janis and Mann [14], Decisional Balance reflects the cognitive and
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