How do you counsel patients with AKs such that they are motivated to improve or optimize sun protection behaviors?   

Some thoughts and approaches that may help: It is very challenging (possibly close to impossible!) to induce behavior change in anyone, much less someone not motivated to change, so recognize your role as being a teacher/provider of information and do not assume a sense of personal responsibility...

In addition to what Dr. @Nicholas wrote, there are patients who won't use a sunscreen, but who will take vitamins. Suggest Nicotinamide 500 mg bid to decrease the incidence of actinic keratoses and non-melanoma skin cancers. Diana D. Parnell, MD