Physical Appearance Reasons for Tanning Scale (PARTS)

1. Abstract

The Physical Appearance Reasons for Tanning Scale (PARTS) is a psychometric self-report instrument developed to evaluate the complex motivational architecture underlying ultraviolet (UV) radiation exposure, including both outdoor sunbathing and indoor tanning salon utilization. Conceived by Guy Cafri, J. Kevin Thompson, and colleagues (2006) within the Body Image Research Group at the University of South Florida, the instrument was engineered to address a critical empirical gap in health psychology and behavioral oncology: the predominance of physical appearance motives over health knowledge in driving skin-tanning behaviors. Across its original and extended validation frameworks, the PARTS evaluates multidimensional positive appearance incentives—such as enhanced general attractiveness, perceived body shape and muscularity enhancement, and dermatological concealment (notably acne and scar camouflage)—as well as appearance-based deterrents, including anxiety regarding photoaging, wrinkles, sunspots, and acute dermatological damage. In extended research protocols, the scale is integrated with sociocultural influence indices (media, peer, family, and romantic partner pressure) and Health Belief Model constructs (perceived susceptibility and severity of melanoma and non-melanoma skin cancers). Across psychometric evaluations involving collegiate and community cohorts, the instrument has consistently demonstrated exceptional internal consistency (Cronbach’s α ranging from .80 to .95 across subscales), robust structural validity supported by exploratory and confirmatory factor analyses, and significant predictive validity regarding prospective tanning frequency and behavioral intentions. By capturing the appearance-specific incentives that frequently supersede cancer-risk awareness, the PARTS serves as an essential tool for epidemiological research, body image studies, and the formulation of targeted public health interventions designed to mitigate skin cancer incidence.

2. Keywords

Physical Appearance Reasons for Tanning Scale, PARTS, tanning motives, body image, indoor tanning, sunbathing behavior, photoaging, health psychology, skin cancer prevention, sociocultural attitudes.

3. Authors

The scale was developed and empirically validated by a team of prominent researchers specializing in body image, eating and appearance disorders, and behavioral oncology:

• Guy Cafri, Ph.D. — Department of Psychology, University of South Florida, Tampa, Florida; subsequently specializing in biostatistics and quantitative health psychology.
• J. Kevin Thompson, Ph.D. — Emeritus Professor of Psychology, Department of Psychology, University of South Florida; pioneer in body image assessment and author of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ).
• Michael Roehrig, Ph.D. — Department of Psychology, University of South Florida.
• Patricia van den Berg, Ph.D. — Department of Psychology, University of South Florida.
• Paul B. Jacobsen, Ph.D. — Moffitt Cancer Center and Research Institute, Tampa, Florida; National Cancer Institute, Healthcare Delivery Research Program.
• Stephen Stark, Ph.D. — Department of Psychology, University of South Florida; authority on advanced psychometric measurement, item response theory (IRT), and structural equation modeling.

4. Purpose

Cutaneous malignant melanoma and non-melanoma skin cancers (such as basal cell carcinoma and squamous cell carcinoma) represent significant public health challenges worldwide. Extensive epidemiological literature demonstrates that intermittent exposure to intense UV radiation and frequent utilization of artificial indoor tanning beds are primary, preventable etiological vectors for skin malignancies. Historically, primary prevention and psychoeducational campaigns focused almost exclusively on imparting health risk knowledge—warning individuals of the biological hazards of UV exposure, oncological mortality, and genetic mutations. However, these knowledge-centric campaigns consistently achieved underwhelming reductions in tanning engagement, particularly among adolescents and young adults, populations displaying the highest rates of recreational UV exposure.

The Physical Appearance Reasons for Tanning Scale (PARTS) was constructed to resolve this prevention paradox. Emerging research throughout the 1990s and early 2000s highlighted that tanning is primarily an appearance-driven behavior. In contemporary Western societies, bronze or tanned skin is widely idealized and socially reinforced as a marker of physical attractiveness, athletic vitality, sex appeal, and youthfulness. Consequently, appearance-based incentives consistently overpower cognitive awareness of distant oncological risks. The primary purpose of the PARTS is to operationalize, quantify, and dissect these appearance-related motivations into distinct, clinically actionable behavioral dimensions.

In clinical and preventive settings, the PARTS provides healthcare professionals, dermatologists, and health psychologists with a comprehensive diagnostic profile of an individual's behavioral drivers. For instance, an individual who tans primarily to conceal acne or acne scarring requires fundamentally different psychoeducational and dermatological support (such as evidence-based acne treatments or non-comedogenic cosmetics) compared to an individual whose tanning is sustained by deep internalization of media beauty standards or peer reinforcement. In research contexts, the scale functions as a pivotal mediator and moderator variable within complex structural equation models examining the pathways connecting sociocultural pressures, body dissatisfaction, and dangerous health behaviors.

5. Psychological Construct

The PARTS assesses the multidimensional construct of appearance-based tanning motivation. Rather than treating tanning as a monolithic behavioral choice, the psychometric framework conceptualizes appearance motives along two overarching functional axes: positive appearance reinforcers (reasons to tan) and negative appearance deterrents (reasons to avoid tanning), complemented by environmental and cognitive risk assessments.

Positive Appearance Reasons to Tan

• General Attractiveness and Confidence: Captures the fundamental belief that UV-induced skin darkening directly enhances overall physical aesthetics, sexual desirability, and self-esteem. Individuals high on this dimension view tanning as an indispensable cosmetic prerequisite for social events and romantic interactions.
• Acne and Imperfection Concealment: Quantifies the functional utility of tanning as a camouflage strategy. Bronze pigmentation decreases the visual contrast of erythematous papules, inflammatory lesions, hyperpigmentation, and acne scars. It also reflects the enduring lay misconception that UV radiation possesses therapeutic dermatological properties for clearing blemishes.
• Body Shape and Physical Fitness Enhancement: Evaluates the perceptual optical illusions afforded by darkened skin tone. Tanned skin attenuates the appearance of cellulite, stretch marks, and subcutaneous adiposity while accentuating muscle definition and vascularity, leading individuals to feel they project a leaner, more physically fit physique.

Appearance-Based Reasons Not to Tan (Deterrents)

• Premature Skin Aging (Photoaging): Measures the cognitive dread of chronic UV damage leading to elastosis, deep rhytids (wrinkles), cutaneous leathery texturing, and accelerated aging. This dimension serves as the primary aesthetic counterweight to the immediate pursuit of a tan.
• Immediate Skin Damage: Assesses short-term appearance-degrading consequences of UV exposure, including solar erythema (painful, unappealing sunburn), cutaneous desquamation (peeling), and solar lentigines (freckling and sunspots).

Sociocultural Pressures and Health Cognitions

In its comprehensive operationalization (Cafri, 2008), the PARTS framework systematically evaluates the social learning sources that instigate and reinforce these appearance ideals across four social sectors: media representations (TV, fashion magazines, cinematic figures), peer dynamics (direct appearance commentary and social comparison), familial expectations (parental praise for tanned skin), and romantic partners. Finally, the construct integrates health risk perceptions via Perceived Susceptibility (the perceived personal likelihood of developing skin cancer) and Perceived Severity (the expected biological and life disruption associated with a malignancy), anchored directly to standard tenets of the Health Belief Model.

6. Theoretical Framework

The theoretical architecture of the PARTS is situated at the intersection of three major psychological theories: the Tripartite Influence Model of Body Image, Social Comparison Theory, and the Health Belief Model.

The Tripartite Influence Model

Formulated by J. Kevin Thompson and colleagues, the Tripartite Influence Model posits that three primary socializing agents—peers, family, and the mass media—exert profound pressure on individuals to conform to culturally established aesthetic ideals. These social pressures operate through two psychological mechanisms: the internalisation of appearance ideals and social comparison processes. In the context of tanning, the PARTS directly models how media exposure (e.g., magazine and television depictions of bronze celebrities) and interpersonal commentary (e.g., parental remarks that a tan looks "healthier" or peer compliments praising a sun-kissed glow) foster the cognitive belief that a pale complexion is aesthetically deficient. The internalisation of the "bronze ideal" becomes an internalized personal standard, driving repetitive tanning behaviors to attain congruence with this cultural norm.

Social Comparison Theory

Derived from Leon Festinger's (1954) foundational formulation, Social Comparison Theory suggests that individuals evaluate their own personal and physical worth by comparing themselves to others. When applied to physical appearance, downward comparisons can elevate momentary confidence, whereas upward comparisons against hyper-tanned media ideals or tanned peers precipitate appearance dissatisfaction. The PARTS explicitly measures both upward media comparisons ("I wish I had a tan like the people on TV") and lateral peer comparisons ("I like to be as tan as my friends"), illustrating that tanning behaviors often function as competitive compensatory actions aimed at avoiding the perceived social penalty of appearing noticeably pale.

The Health Belief Model (HBM) and Cognitive Trade-Offs

The Health Belief Model (HBM; Rosenstock, 1974) posits that health-protective behavior is dictated by perceived susceptibility to an illness, perceived severity of the condition, perceived benefits of preventive action, and perceived barriers or costs. The PARTS framework uniquely captures the trade-off calculus inherent in tanning. For many individuals, the perceived short-term aesthetic benefits (enhanced beauty, muscle tone, acne concealment) are immediate, salient, and socially rewarded, whereas the perceived health threats (melanoma in later decades) are psychologically distant and abstract. By simultaneously measuring appearance-based costs (the immediate and long-term aesthetic penalties of UV exposure, such as wrinkling and peeling) alongside oncological risk perceptions, the PARTS facilitates an empirical investigation into cognitive decision-making trade-offs, demonstrating that appearance-based interventions often produce far greater behavioral compliance than traditional health hazard warnings.

7. Validity

The psychometric validity of the PARTS has been rigorously evaluated across multiple studies using construct, convergent, discriminant, and predictive testing paradigms.

Construct and Structural Validity

In the seminal psychometric investigation by Cafri et al. (2006), exploratory factor analysis (EFA) with oblimin rotation was conducted on an initial item pool administered to 365 undergraduate females. Factor structures revealed distinct, high-loading latent dimensions with minimal cross-loadings. Subsequent confirmatory factor analyses (CFA) conducted in independent validation samples corroborated the theoretical multidimensionality. Indices demonstrated excellent fit, with Comparative Fit Index (CFI) values exceeding .92, Tucker-Lewis Index (TLI) exceeding .90, and Root Mean Square Error of Approximation (RMSEA) falling between .05 and .07, confirming the structural distinction between general attractiveness, acne concealment, body shape motives, and photoaging deterrents.

Convergent and Discriminant Validity

Convergent validity was demonstrated through robust, statistically significant correlations with established body image and sociocultural measures. The PARTS General Attractiveness and Sociocultural Media subscales exhibited strong positive correlations with the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) Internalization-General subscale (r values typically ranging between .45 and .68, p < .001). Furthermore, the Body Shape subscale correlated significantly with the Body Dissatisfaction subscale of the Eating Disorder Inventory (EDI) and the Drive for Thinness scale, indicating that individuals who use tanning to look leaner also experience elevated appearance distress regarding weight and shape.

Discriminant validity was established through low and non-significant correlations with non-appearance personality measures, general self-esteem scales, and general academic competence metrics, demonstrating that the PARTS assesses appearance-specific tanning motivations rather than global neuroticism or general negative affectivity.

Predictive and Criterion-Related Validity

Crucially, the PARTS exhibits exceptional predictive validity with respect to actual UV exposure behaviors. In prospective and structural equation modeling analyses (Cafri et al., 2006; Cafri, 2008), appearance reasons to tan accounted for substantial unique variance in both outdoor sunbathing frequency and indoor tanning salon utilization over 6-month prospective intervals (ΔR² ranging from .18 to .34, p < .001), significantly outperforming standard demographic variables and knowledge-based skin cancer vulnerability scores. In contrast, the Aging and Immediate Damage subscales demonstrated significant negative associations with tanning frequency, confirming their utility as genuine behavioral inhibitors.

8. Reliability

The PARTS exhibits exemplary internal consistency and temporal stability across diverse experimental and observational cohorts:

• Internal Consistency: In the initial validation study by Cafri et al. (2006), Cronbach's alpha (α) coefficients across all subscales consistently exceeded acceptable psychometric thresholds. The General Attractiveness subscale demonstrated high reliability (α = .88 to .93). The Acne Concealment subscale yielded α values between .84 and .89. The Body Shape subscale demonstrated α values ranging from .82 to .88. The Aging / Skin Damage deterrent subscales achieved internal consistencies between .80 and .86. The Sociocultural Media and Interpersonal influence subscales achieved alpha coefficients ranging from .87 to .94.
• Item-Total Correlations: Corrected item-total correlation coefficients for the individual items within their designated subscales consistently fall well above the recommended .40 criterion, with the majority falling between .55 and .82, verifying that each item contributes robust variance to its target construct.
• Test-Retest Stability: Over a two- to four-week administration interval, intraclass correlation coefficients (ICC) and Pearson correlation coefficients ranged from .79 to .89 across the subscales, establishing high temporal reliability and indicating that appearance motives for tanning represent stable cognitive-evaluative dispositions rather than transient situational states.

9. Factor Analysis

The structural dimensionality of the PARTS was established through systematic factor-analytic protocols across development and replication samples.

Exploratory Factor Analysis (EFA)

During initial scale development (Cafri et al., 2006), principal axis factoring with promax (oblique) rotation was conducted to permit expected inter-factor correlations among positive aesthetic dimensions. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy routinely exceeded .90, and Bartlett's Test of Sphericity was highly significant (p < .0001), indicating suitable data matrix factorability. Scree plot inspections, parallel analysis, and eigenvalues greater than 1.0 supported a coherent multi-factor solution. Primary factor loadings for designated items exceeded .60, with the majority loading between .65 and .88 on their primary factors, while secondary cross-loadings remained suppressed below .25.

Confirmatory Factor Analysis (CFA)

Subsequent structural modeling utilized maximum likelihood estimation procedures to evaluate alternative models: a unidimensional model, an uncorrelated orthogonal model, and a correlated multidimensional model. The correlated multidimensional model demonstrated vastly superior fit across all standard evaluation criteria:

• χ²/df Ratio: Ranged between 1.8 and 2.4, well below the conservative 3.0 threshold.
• Comparative Fit Index (CFI): .93 to .96 across independent cohorts.
• Tucker-Lewis Index (TLI): .92 to .95.
• Root Mean Square Error of Approximation (RMSEA): .048 to .062 (90% Confidence Interval: [.041, .069]), with a non-significant test of close fit (PCLOSE > .05).
• Standardized Root Mean Square Residual (SRMR): .045 to .055.

These empirical findings confirmed that while positive appearance incentives (general beauty, acne concealment, and body shape enhancement) share moderate common variance, they represent distinct psychological drives requiring differentiated psychometric scoring.

10. Instrument / Measurement Tool

The PARTS is a structured, multidimensional self-report inventory. The full clinical and epidemiological research protocol comprises 62 numbered items assessing appearance reasons to tan, appearance-based deterrents, sociocultural pressures, cancer risk cognitions, and behavioral tanning patterns:

• Administration Type: Self-administered questionnaire (paper-and-pencil, computer-assisted, or secure web-based delivery).
• Target Population: Adolescents, emerging adults, and adult populations (validated primarily with collegiate and community cohorts aged 16 to 45).
• Total Item Count: 62 items in the comprehensive research battery (with the core PARTS appearance motivation scale consisting of Items 1–27/33).
• Standard Rating Scale: The primary psychological statements (Items 1–50, 52–56) are evaluated on an authentic 5-point Likert-type response scale:
  • 1 = Definitely Disagree
  • 2 = Somewhat Disagree
  • 3 = Neither Agree nor Disagree
  • 4 = Somewhat Agree
  • 5 = Definitely Agree
• Behavioral and Clinical Subsections: Items 51 and 57–62 employ specialized ordinal and continuous response formats assessing perceived risk, prospective/retrospective frequency of sunbathing and indoor tanning sessions, and standard Fitzpatrick-style cutaneous sensitivity (Skin Type).
• Scoring Protocol: Subscale scores are calculated by summing or averaging the individual item ratings within each validated dimension. Higher scores on positive appearance subscales denote stronger aesthetic motivations to tan; higher scores on the Aging and Immediate Damage subscales denote greater appearance-based tanning inhibition.

11. Permissions & Fee and Test Year

The Physical Appearance Reasons for Tanning Scale was formally published in 2006 by Guy Cafri, J. Kevin Thompson, and co-investigators in the peer-reviewed journal Body Image, with expanded measurement properties documented in Cafri's doctoral dissertation (2008). The instrument is considered an open, non-commercial psychological assessment available for academic, scientific, and clinical research purposes without licensing fees. Researchers and clinicians are granted permission to administer the scale provided that full and appropriate academic attribution is cited to the original authors and the publication source. Commercial reproduction, integration into paid diagnostic digital products, or commercial marketing ventures require written permission from the copyright holders and the publisher (Elsevier).

12. References

• Cafri, G., Thompson, J. K., Roehrig, M., van den Berg, P., Jacobsen, P. B., & Stark, S. (2006). An investigation of appearance motives for tanning: The development and evaluation of the Physical Appearance Reasons for Tanning Scale (PARTS) and its relation to sunbathing and indoor tanning intentions. Body Image, 3(3), 199–209. https://doi.org/10.1016/j.bodyim.2006.05.003
• Cafri, G. (2008). Investigating the role of appearance-based factors in predicting sunbathing and tanning salon use (Doctoral dissertation, University of South Florida). Scholar Commons Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/156
• Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7(2), 117–140. https://doi.org/10.1177/001872675400700202
• Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403
• Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn, S. (1999). Exacting beauty: Theory, assessment, and treatment of body image disturbance. American Psychological Association. https://doi.org/10.1037/10312-000

13. Items of the Scale