First Evaluation of the Behavioral Addiction Indoor Tanning Screener (BAITS) in a nationwide representative sample K. Diehl, T. Görig, E.W. Breitbart, R. Greinert, J.J. Hillhouse, J.L. Stapleton, S. Schneider Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University British Journal of Dermatology, doi: 10.1111/bjd.15888

Dr Katharina Diehl

Introduction What’s already known? Ultraviolet (UV) radiation has been classified as carcinogenic to humans One important source of exposure to UV rays are indoor tanning (IT) facilities A growing body of research provides preliminarily support for viewing excessive tanning as a behaviour with addictive potential Different screening instruments for IT addiction exist but concerns about their internal consistency as well as the internal and external validity have been raised

Introduction Recently, a new instrument, the brief screener BAITS (Behavioral Addiction Indoor Tanning Screener), was developed based on the addiction disorder model published by the American Psychiatric Association BAITS is designed to capture the main features of addictive behaviours, such as experience of diminished control over a behaviour and temptations that lead to urges or craving for the behaviour BAITS was examined regarding its validity in a non-representative sample

Objective To use cognitive interviewing to check whether the BAITS items were understood and interpreted as intended To use the Germany-wide dataset to quantify the number of individuals reporting multiple symptoms on the BAITS using a representative sample for the first time To analyse validity and reliability of the instrument

Methods Cognitive interviews Interviews with 5 current and 5 past users of tanning beds Aim: to test if the seven BAITS items were intelligible and interpreted by the participants as intended Representative survey Nationwide telephone survey among 3,000 individuals Aim: to measure reliability (internal consistency), construct validity, and criterion validity of the BAITS

Results Cognitive interviews Most items were understood as intended Slight change of the wording of one item

Results Representative survey High internal consistency of the seven BAITS items All items load on one factor (construct validity) Usage parameters were significantly associated with BAITS (criterion validity)

Results Representative survey Among current users, 19.7% screened positive for symptoms of a potential IT addiction Among former users, 1.8% screened positive for symptoms of a potential IT addiction

Discussion What does this study add? Compared to other short instruments measuring symptoms of a potential indoor tanning addiction, the BAITS seems to be a valid and reliable tool With its short length and binary items the BAITS is easy to use in large surveys

Conclusions The multimethod approach showed that the BAITS is a valid and reliable tool that can be used in surveys The BAITS may also help physicians and healthcare providers to identify individuals in particular need of counselling to avoid the continuous use of sunbeds Further tests of the BAITS will show, how accurate it is in identifying IT addicted individuals

Team of the National Cancer Aid Monitoring (NCAM) on Sunbed Use Prof. Dr. phil. Sven Schneider, M.A. Dr. phil. Katharina Diehl, Dipl.-Soz. Dr. rer. pol. Tatiana Görig, M.A. Prof. Dr. med. Eckhard W. Breitbart Dr. Rüdiger Greinert

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