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García-Harana C, Blázquez-Sánchez N, Rodríguez-Martínez A, Rivas-Ruiz F, Aguilar-Ortega D, Rodríguez-Martínez AG, Cambil-Martín J, de Gálvez MV, de Troya-Martín M. Positive impact of Distintivo Soludable on implementation of sun protection policies and practices in schools of Andalusia, Spain. J Public Health Policy 2024; 45:471-483. [PMID: 38858538 DOI: 10.1057/s41271-024-00495-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 06/12/2024]
Abstract
The incidence of skin cancer is increasing worldwide even though its main risk factor is preventable. This study evaluated the impact of the Distintivo Soludable pilot intervention on implementation of photoprotection policies and practices in preschool and primary schools in Andalusia, Spain. We completed two rounds of a Sun Protection Policies and Practices Survey (SPPPS) nine months apart. At baseline, 67 Andalusian schools earned a median score of 3/12 points (range 0-8; IQR: 2). Ten schools involved in Distintivo Soludable intervention group significantly increased their scores from 4 to 7.5/12 points (p = 0.014). We also detected a modest positive effect in 57 control group schools, an increase from 2 to 3 points (p = 0.002). This pilot study demonstrated that the main achievement of the Distintivo Soludable intervention was implementation of organizational policies regarding sun protection, an essential starting point for establishing positive attitudes toward sun protection in school communities.
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Affiliation(s)
- C García-Harana
- Dermatology Department, Hospital Universitario Costa del Sol, Marbella, Spain
- Department of Medicine, University of Málaga, Málaga, Spain
| | - N Blázquez-Sánchez
- Dermatology Department, Hospital Universitario Costa del Sol, Marbella, Spain.
- Hospital Costa del Sol, Autovía A7, KM 187, 29603, Marbella, Spain.
| | - A Rodríguez-Martínez
- Research and Innovation Unit, Hospital Universitario Costa del Sol, Marbella, Spain
| | - F Rivas-Ruiz
- Research and Innovation Unit, Hospital Universitario Costa del Sol, Marbella, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
| | - D Aguilar-Ortega
- Research and Innovation Unit, Hospital Universitario Costa del Sol, Marbella, Spain
| | | | - J Cambil-Martín
- Nursing Department, Faculty of Health Science, University of Granada, Granada, Spain
| | - M V de Gálvez
- Photobiological Dermatology Laboratory Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - M de Troya-Martín
- Dermatology Department, Hospital Universitario Costa del Sol, Marbella, Spain
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2
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Peconi J, Lanyon K, Tod D, Driscoll T, Prathap S, Watkins A, Abbott RA. Are Welsh primary schools Sunproofed? Results of a national survey, part 1: scoping the landscape of sun safety policies in Wales. Clin Exp Dermatol 2024; 49:566-572. [PMID: 38173274 DOI: 10.1093/ced/llad458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Schools with formal sun safety polices generally show better sun safety practices than schools without. OBJECTIVES To understand the extent to which Welsh primary schools have sun safety policies; to identify the key characteristics of policies; to assess whether policy adoption varies by school characteristics; and to consider what support schools need to develop sun safety policies. METHODS An online multiple-choice survey on sun safety was distributed to all 1241 primary schools in Wales. RESULTS In total, 471 (38.0%) schools responded. Of these, 183 (39.0%) reported having a formal sun safety policy. Welsh medium schools (P = 0.036) and schools in North Wales (P = 0.008) were more likely to report having a policy. Schools with a higher percentage of pupils receiving free school meals (P = 0.046) and with lower attendance rates (P = 0.008) were less likely to report having a sun safety policy. The primary reasons for schools not having a policy included being 'not aware of the need' (34.6%); 'need assistance with policy or procedure development' (30.3%); and 'not got around to it just yet' (26.8%). CONCLUSIONS With less than half of schools reporting a sun safety policy and variation in the presence/absence of a policy by school characteristics, our survey revealed inconsistency in formal sun safety provision in Welsh schools. The findings also suggest that schools are unaware of the importance of sun safety and need support to develop and implement policies. This snapshot of the current situation in primary schools in Wales provides a basis upon which the comprehensiveness, effectiveness and implementation of sun safety policies can be further evaluated.
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Affiliation(s)
- Julie Peconi
- Swansea Trials Unit, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Kirsty Lanyon
- Swansea Trials Unit, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Daniel Tod
- Swansea Trials Unit, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Timothy Driscoll
- Swansea Trials Unit, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Swetha Prathap
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - Alan Watkins
- Swansea Trials Unit, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, UK
| | - Rachel A Abbott
- Dermatology Department, Cardiff and Vale University Health Board, Cardiff, UK
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Challapalli SD, Shetty KR, Bui Q, Osazuwa-Peters N, Adjei Boakye E. Sun protective behaviors among adolescents and young adults in the United States. J Natl Med Assoc 2023; 115:353-361. [PMID: 37142483 DOI: 10.1016/j.jnma.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE We described sun protective behaviors in adolescents and young adults (AYA) compared to older adults. METHODS We used data from the 2013-2018 National Health and Nutrition Examination Survey, a nationally representative samples of the civilian, noninstitutionalized US population (10,710 respondents aged between 20 and 59 and without a history of skin cancer diagnoses). The primary exposure for the study was age group: aged 20-39 defined as AYA and aged 40-59 as adults. The outcome variable was sun protective behaviors: stay in the shade, wear a long-sleeved shirt, use sunscreen, at least one of the three; and all three measures. Multivariable logistic regression models were used to assess association between age group and sun protective behaviors adjusting for sociodemographic factors. RESULTS Overall, 51.3% of respondents were AYA, 76.1% reported staying in the shade, 50.9% using sunscreen, 33.3% wearing long-sleeved clothes, 88.1% engaging in one of the three behaviors, and 17.1% engaging in all three behaviors. In the adjusted models, the odds of engaging in all three behaviors among AYAs was 28% (aOR: 0.72, 95% CI: 0.62-0.83) lower than adult respondents. Compared to adults, AYAs were 22% less likely to wear long sleeved clothes (aOR: 0.78, 95% CI: 0.70-0.87). There were no significant differences in the odds of engaging in at least one sun protective behavior, using sunscreen, and staying in the shade between AYAs and adults. CONCLUSIONS More targeted interventions need to be implemented to decrease the risk of skin cancer in the AYA population.
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Affiliation(s)
- Sai D Challapalli
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, Houston, Texas, USA
| | - Kunal R Shetty
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, Houston, Texas, USA
| | - Quoc Bui
- Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA; Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA; Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA.
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Scott JJ, Johnston RS, Darby J, Blane S, Strickland M, McNoe BM. A novel skin cancer prevention strategy: Preservice teachers' perceptions of a sun safety intervention and experiences in schools. Health Promot J Austr 2023; 34:255-263. [PMID: 35833309 PMCID: PMC10084111 DOI: 10.1002/hpja.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/20/2022] [Indexed: 01/27/2023] Open
Abstract
ISSUE ADDRESSED Teachers play a vital role in developing children's sun protection routines however upskilling preservice teachers (PSTs) while at university has not yet been trialled as a targeted skin cancer prevention strategy. Hence, this study investigated PSTs perceptions and experiences of sun safety following a brief pilot intervention and placement in primary schools in Western Australia. METHODS This study used a triangulation mixed methods design. Participants (n = 161) completed a post intervention survey which was analysed quantitatively. A random sub-sample was invited to participate in focus groups (three groups, n = 21) and one-on-one interviews (n = 4). This data was transcribed and uploaded in NVIVO software for thematic analysis. RESULTS Participants felt the intervention increased their awareness of the dangers of overexposure to ultraviolet radiation (UVR) with many feeling more knowledgeable, skilled and confident to teach sun safety in school settings. Most reported clear sun safety messages in their placement schools. However, only 34.4% reported they had been briefed on the school's sun safety procedures. There was consensus among PSTs that sun protection in primary schools needs to be improved to maximise the protection of children from harmful UVR overexposure. Participants supported a need for consistent sun protection messaging across primary schools with greater emphasis on education rather than compliance management to sun protection. CONCLUSION Enhancing existing teacher education programs to include more rigorous curriculum content and pedagogical approaches to sun protection education is a novel skin cancer prevention strategy and could feasibly support PSTs self-efficacy to effectively deliver sun safety curriculum in Australian schools.
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Affiliation(s)
- Joseph J Scott
- School of Education and Tertiary Access, University of Sunshine Coast, QLD, Australia.,School of Education, Edith Cowan University, WA, Australia
| | - Robyn S Johnston
- Telethon Kids Institute and University of Western Australia, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, WA, Australia
| | - Jill Darby
- School of Medical and Health Sciences, Edith Cowan University, WA, Australia
| | - Sally Blane
- Cancer Council Western Australia, WA, Australia
| | | | - Bronwen M McNoe
- Social and Behavioural Research Unit, University of Otago, New Zealand
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García-Harana C, de Gálvez Aranda MV, Blazquez-Sanchez N, Rivas-Ruiz F, Rodriguez-Martinez A, de Troya-Martín M. Sun Protection Policies and Practices in Preschool and Elementary Schools in Andalusia (Spain). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:819-828. [PMID: 33025452 DOI: 10.1007/s13187-020-01889-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
Sun exposure in childhood is a major risk factor for the development of skin cancer as an adult. School children spend much of their time outdoors exposed to ultraviolet radiation during recreational and sports activities. Skin cancer incidence tripled from 1978 to 2002 in Spain. Andalusia, the largest and sunniest region of Spain, lacks data on the sun protection measures taken in schools. To address this deficit, the aim of this study was to determine photoprotection practices and policies in preschools and primary schools in Andalusia. This descriptive study involved the administration of an online questionnaire completed by principals regarding school sun protection policies and practices. Preschool and primary schools were selected from the database of the Ministry of Education of the Andalusian Regional Government. Information of interest included photoprotection policies, students' sun protection knowledge, sun protection measures, relevant curricular content, and availability of shade at the school. A total of 2425 schools were contacted. Of them, 420 schools responded (17.31%), with the highest number of responses received from Malaga (23.8%) and Seville (19.5%) provinces. Of those responding, 67.1% of the schools did not have written sun protection policies. The photoprotection measures reported included mandatory use of a cap or hat (3.3%), use of sunglasses in outdoor areas (30%), and active encouragement of students to use sunscreen (50.7%). Roughly 24% of schools evaluated their shaded areas, with 52.9% reporting insufficient protection for most activities. The study results showed that photoprotection policies and practices in Andalusian schools were mostly insufficient. Given that skin cancer incidence has increased considerably over the last decade, it is important to concentrate on improving primary prevention practices. Additionally, photoprotection programs in schools have been shown to improve children's knowledge, attitudes, and habits regarding photoprotection. Thus, it is essential for Andalusian preschools and primary schools to develop policies and strategies to help reduce children's sun exposure while at school.
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Affiliation(s)
- Cristina García-Harana
- Dermatology Department, Hospital Costal del Sol, Marbella, Spain.
- Medicine Department, University of Málaga, Málaga, Spain.
| | | | | | - Francisco Rivas-Ruiz
- Research Unit, Hospital Costal del Sol, Marbella, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain
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Boothby-Shoemaker WT, Mohammad TF, Ozog DM, Lim HW. Photoprotection by clothing: A review. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:478-488. [PMID: 35073443 DOI: 10.1111/phpp.12776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 12/19/2021] [Accepted: 01/13/2022] [Indexed: 12/18/2022]
Abstract
Clothing is recognized by leading health agencies as a primary method to protect against the harmful effects of photodamage caused by ultraviolet (UV) radiation and visible light. The photoprotective capacity of clothing is commonly measured as the ultraviolet protective factor (UPF). While the technology driving photoprotective clothing has been well-established, there continues to be efforts to discover new materials to improve the UPF of clothing. Here, we show increased Google searches for photoprotective clothing over the last decade, suggesting a high level of public interest in photoprotective clothing. In addition, we investigate the frequency of UPF-graded photoprotective clothing sold by large retail stores featured in Fortune 1000. We review factors that alter the UPF of clothing and describe emerging textile technologies used to increase clothing's photoprotective capacity. Finally, we compare how photoprotective clothing is regulated among different countries, the importance of photoprotective clothing in occupational health, and research in visible light and clothing photoprotection.
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Affiliation(s)
- Wyatt T Boothby-Shoemaker
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA.,Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Tasneem F Mohammad
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA
| | - David M Ozog
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA
| | - Henry W Lim
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA
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7
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Heckman CJ, Riley M, Coups EJ, Niu Z, Stapleton JL. Society of Behavioral Medicine Position Statement: promote sun-safety policies and practices for youth in educational, childcare, and recreational settings. Transl Behav Med 2021; 10:498-501. [PMID: 31504986 DOI: 10.1093/tbm/ibz120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Youth should be allowed and encouraged to engage in sun-safe behaviors in educational, childcare, and recreational settings, including use of sunscreen, wide-brimmed hats, other sun-protective clothing, and shade.
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Affiliation(s)
- Carolyn J Heckman
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Mary Riley
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Elliot J Coups
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Zhaomeng Niu
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jerod L Stapleton
- Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Keratinocyte skin cancer risks for working school teachers: Scenarios and implications of the timing of scheduled duty periods in Queensland, Australia. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 213:112046. [PMID: 33074139 DOI: 10.1016/j.jphotobiol.2020.112046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/20/2020] [Accepted: 09/29/2020] [Indexed: 01/01/2023]
Abstract
Relative keratinocyte skin cancer risks attributable to lifetime occupational and casual sunlight exposures of working school teachers are assessed across the state of Queensland for 1578 schools. Relative risk modeling utilizing annual ultraviolet exposure assessments of teachers working in different geographic locations and exposed during periods of measured daily playground duty times for each school were made for local administrative education districts by considering traditional school opening and closing hours, and playground lunchtime schedules. State-wide, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) relative risk estimates varied by 24% for BCC and 45% for SCC. The highest relative risk was calculated for the state's north (sunshine) coast education district which showed that risk could increase by as much as 32% for BCC and 64% for SCC due to differences in teacher duty schedules. These results highlight the importance of playground duty scheduling as a significant risk factor contributing to the overall burden of preventable keratinocyte skin cancers in Queensland.
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Reynolds KD, Buller DB, Buller MK, Massie K, Berteletti J, Ashley J, Meenan R. Randomized controlled trial evaluating an intervention supporting implementation of sun safety policies in California public elementary schools. Prev Med 2020; 137:106125. [PMID: 32389679 PMCID: PMC7495886 DOI: 10.1016/j.ypmed.2020.106125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
Solar ultraviolet radiation (UV) exposure is the primary risk factor for skin cancer and children receive about one-quarter of lifetime UV exposure before age 18. Thus, skin cancer prevention is essential for children. The objective of this study was to test an intervention to facilitate implementation of district sun safety policies. Elementary schools (N = 118) from 40 California public school districts with a school board-approved policy for sun safety were recruited along with one principal and teacher from each school. Elementary schools were randomly assigned to receive the 20-month Sun Safe Schools intervention (N = 58) or to a minimal informational control condition (N = 60). Principals were 47.8 and teachers 44.3 years of age and were predominately female (principals 72.7%; teachers 86.7%) and White (principals 72.0%; teachers 68.2%). The 20-month Sun Safe Schools intervention was delivered to principals and included a coaching session, telephone and email contacts, provision of resources for practice implementation, and a small grant program. The principal (N = 118) and a teacher (N = 113) at each school reported on school sun protection practices 20-months post-baseline. The schools were diverse in student characteristics (M = 64.1% free/reduced price meals; M = 54.5% Hispanic). Intervention principals reported implementing more sun safety practices overall (control M = 2.7, intervention M = 4.2, p < .005) and more practices not present in the district's policy (control M = 0.4, intervention M = 0.9, p = .005). Principals and teachers combined replicated these findings and also reported implementing more practices present in the district policy (control M = 0.9, intervention M = 1.3, p = .005). In sum, the intervention increased sun safety practices in public elementary schools. Trial Registration. This study is registered in ClinicalTrials.gov, www.clinicaltrials.gov, with the identification number of NCT03243929.
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Affiliation(s)
- Kim D Reynolds
- School of Community & Global Health, Claremont Graduate University, 675 W, Foothill Blvd., Ste. 200, Claremont, CA 91711, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Mary K Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Kim Massie
- School of Community & Global Health, Claremont Graduate University, 675 W, Foothill Blvd., Ste. 200, Claremont, CA 91711, USA
| | - Julia Berteletti
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Jeff Ashley
- Sun Safety for Kids, 2625 W. Alameda Ave., Suite 517, Burbank, CA 91505, USA
| | - Richard Meenan
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR 97227, USA
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de Troya Martín M, Blázquez Sánchez N, García Harana C, Fernández Morano T, Toribio Montero J, Jabalera Mesa L, Rivas Ruiz F, Delgado Sánchez N, Rodríguez Martínez A, Santana López V, de Gálvez Aranda M. Creation of the «soludable» sun protection accreditation program for schools. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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11
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Hunkin H, Pollock K, Scupham R. The National SunSmart Schools Program: Impact on sun protection policies and practices in Australian primary schools. Health Promot J Austr 2019; 31:251-257. [PMID: 31466123 DOI: 10.1002/hpja.291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Overexposure to ultraviolet radiation during childhood is a significant determinant of lifetime skin cancer risk, but can be mitigated through primary schools' adoption of appropriate sun protection policies and practices. The present study aimed to evaluate the changes in these policies and practices in Australia, and to assess the impact of the National SunSmart Schools Program. METHODS A random sample of primary schools were selected in 2011 and 2016 (N = 1577, 1533), and asked to complete a survey describing their current sun protection policies and practices. Significant changes across the study period, and relative to previously reported data from 2005, were identified. RESULTS Sun protection policies and practices remained relatively stable over the period, although there was a notable decrease in incorporating sun protection material into the curriculum. SunSmart membership was associated with a significantly greater likelihood of several policies and practices being employed. The launch of the SunSmart program in New South Wales was linked with significant improvements to sun protection practices, relative to other states and territories. CONCLUSION The National SunSmart Schools program continues to have a substantial impact in supporting the adoption of appropriate sun protection policies and their practical implementation. SO WHAT?: Even small changes to sun protection practices in Australian primary schools can have a major positive impact on long-term health outcomes. SunSmart membership can be leveraged to broaden existing policies and practices, targeting priority areas such as shade provision and the incorporation of sun protection into school curriculum.
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Affiliation(s)
- Hugh Hunkin
- Behavioural Research and Evaluation Unit, Cancer Council SA, Eastwood, SA, Australia
| | - Kate Pollock
- Behavioural Research and Evaluation Unit, Cancer Council SA, Eastwood, SA, Australia
| | - Rebecca Scupham
- Behavioural Research and Evaluation Unit, Cancer Council SA, Eastwood, SA, Australia
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12
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de Troya Martín M, Blázquez Sánchez N, García Harana C, Fernández Morano T, Toribio Montero JC, Jabalera Mesa L, Rivas Ruiz F, Delgado Sánchez N, Rodríguez Martínez AG, Santana López V, de Gálvez Aranda MV. Creation Of The «Soludable» Sun Protection Accreditation Program For Schools. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:830-840. [PMID: 31399150 DOI: 10.1016/j.ad.2019.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Sun exposure during childhood is the main risk factor for skin cancer in later life. School-based sun protection policies and practices have proven to be the most effective and cost-effective strategies for preventing skin cancer. OBJECTIVE To develop a sun protection accreditation program known as «Soludable» (a play on the Spanish words sol [sun] and saludable [healthy]) to objectively identify schools that actively promote sun protection behaviors among students. METHODS The consensus method used was a 2-round Delphi technique with input from a panel of experts. We then calculated the median scores for the importance and feasibility of each of the recommendations proposed and the level of complexity assigned to each recommendation by counting the percentage of experts who chose each difficulty category. RESULTS The resulting accreditation model consists of 14 recommendations with corresponding evaluation criteria divided into 7 domains: 1) organizational leadership (5 recommendations), 2) effective communication (2 recommendations), 3) structural elements (2 recommendations), 4) training of professionals (1 recommendation), 5) school curriculum (1 recommendation), 6) behavioral models (2 recommendations), and 7) student habits (1 recommendation). A high level of agreement among experts was observed for all recommendations, in terms of both their perceived importance and feasibility and their categorization by levels of complexity. CONCLUSIONS This is the first sun protection accreditation program developed for Spanish schools. Studies are needed to evaluate how this program is received and how it affects students' sun protection behaviors.
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Affiliation(s)
- M de Troya Martín
- Servicio de Dermatología, Hospital Costa del Sol, Marbella (Málaga), España.
| | - N Blázquez Sánchez
- Servicio de Dermatología, Hospital Costa del Sol, Marbella (Málaga), España
| | - C García Harana
- Servicio de Dermatología, Hospital Costa del Sol, Marbella (Málaga), España; Universidad de Málaga, Málaga, España
| | - T Fernández Morano
- Servicio de Dermatología, Hospital Costa del Sol, Marbella (Málaga), España
| | - J C Toribio Montero
- Unidad de Enfermería, Hospital Costa del Sol de Marbella, Marbella (Málaga), España
| | - L Jabalera Mesa
- Unidad de Enfermería, Hospital Costa del Sol de Marbella, Marbella (Málaga), España
| | - F Rivas Ruiz
- Unidad de Investigación, Hospital Costa del Sol, Marbella (Málaga), España
| | - N Delgado Sánchez
- Unidad de Educación para la Salud, Distrito Sanitario Costa del Sol, Málaga, España
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13
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Lucas RM, Yazar S, Young AR, Norval M, de Gruijl FR, Takizawa Y, Rhodes LE, Sinclair CA, Neale RE. Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate. Photochem Photobiol Sci 2019; 18:641-680. [PMID: 30810559 DOI: 10.1039/c8pp90060d] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.
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Affiliation(s)
- R M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia. and Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - S Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia and MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - F R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Y Takizawa
- Akita University School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - L E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - R E Neale
- QIMR Berghofer Institute of Medical Research, Herston, Brisbane, Australia and School of Public Health, University of Queensland, Australia
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Wu YP, Mays D, Kohlmann W, Tercyak KP. Pediatric Predispositional Genetic Risk Communication: Potential Utility for Prevention and Control of Melanoma Risk as an Exemplar. J Genet Couns 2017; 26:887-893. [PMID: 28547663 PMCID: PMC5702278 DOI: 10.1007/s10897-017-0105-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 04/25/2017] [Indexed: 12/20/2022]
Abstract
Predispositional genetic testing among minor children is intensely debated due to the potential benefits and harms of providing this type of genetic information to children and their families. Existing guidelines on pediatric genetic testing state that predispositional testing could be appropriate for minors if preventive services exist that mitigate children's risk for or severity of the health condition in question. We use the example of hereditary melanoma to illustrate the rationale for and potential application of genetic risk communication for an adult-onset cancer to a pediatric population where childhood behaviors may reduce risk of disease later in life. We draw from the adult melanoma genetic risk communication and pediatric health behavior change literatures to suggest ways in which genetic test reporting and complementary education could be delivered to children who carry a hereditary risk for melanoma and their families in order to foster children's engagement in melanoma preventive behaviors. Genetic discoveries will continue to yield new opportunities to provide predispositional genetic risk information to unaffected individuals, including children, and could be delivered within programs that provide personalized and translational approaches to cancer prevention.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
| | | | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C, USA
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Winslade M, Wright B, Dudley D, Cotton W, Brown A. Australian primary school communities' understandings of SunSmart: a qualitative study. Aust N Z J Public Health 2017; 41:483-489. [PMID: 28664586 DOI: 10.1111/1753-6405.12677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 12/01/2016] [Accepted: 03/01/2017] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Skin cancer represents a major health issue for Australia. Childhood sun exposure is an important risk factor and evidence suggests the use of sun protection measures by Australian school children could be improved. This study examines how the SunSmart Program, a school-based skin cancer prevention resource, can be supported to further increase sun protection behaviours to assist in lowering skin cancer incidence. METHODS The Health Promoting Schools (HPS) framework was adopted to select key stakeholders from a convenience sample of five school communities. Students, teaching staff and parents participated in semi-structured focus group and individual interviews. A thematic analysis was used to extract key themes from the data. RESULTS Although these school communities were aware of sun protection practices and the risks associated with sun exposure, their understandings of the SunSmart Program were limited. Sun protection policy implementation was inconsistent and students were unlikely to engage in sun protection practices beyond the school setting. CONCLUSION AND IMPLICATIONS School communities require additional support and engagement to holistically enforce the principles of the SunSmart Program.
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Affiliation(s)
| | - Bradley Wright
- Faculty of Education, Charles Sturt University, New South Wales
| | - Dean Dudley
- School of Education, Macquarie University, New South Wales
| | - Wayne Cotton
- Faculty of Education and Social Work, University of Sydney, New South Wales
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16
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Dudley DA, Cotton WG, Winslade MJ, Wright BJ, Jackson KS, Brown AM, Rock V. An objective and cross-sectional examination of sun-safe behaviours in New South Wales primary schools. BMC Public Health 2017; 17:21. [PMID: 28056902 PMCID: PMC5217582 DOI: 10.1186/s12889-016-3917-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 12/08/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Previous evaluations have supported the link between sun protection policies and improved sun protection behaviours. However these evaluations have relied on self-reported data. METHODS A cross-sectional design as part of an ongoing 18-month cluster-controlled trial in primary schools (n = 20) was used. Researchers conducted direct observations to record students' hat use and teachers' use of sun protective measures during recess and lunch. Researchers also recorded the volume of sunscreen consumed in each school. RESULTS Only 60% of primary school children wear a sun-safe hat during their breaks when observed using objective measures. Weak correlations were observed between the wearing of a sun-safe hat and a school's socio-economic status (r = 0.26). All other independent variables measured had only very weak correlations (r < 0.19) with sun-safe hat wearing behaviour of students. Sunscreen consumption by school students during the school day is negligible. CONCLUSIONS A large percentage of NSW primary schools in this study wear sun-safe hats during the school day but this is well below what has been reported in previous national surveys. Given the finite resources of schools and the correlation, though small, with SES status for these behaviours, it behoves researchers to investigate low-cost solutions to these problems. Further qualitative data will also be needed to inform the enablers and barriers for sun-safe behaviour interventions to be adopted in NSW primary schools.
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Affiliation(s)
- Dean A. Dudley
- Department of Eduational Studies, Faculty of Human Sciences, Macquarie University, North Ryde, NSW 2109 Australia
| | - Wayne G. Cotton
- Faculty of Education and Social Work, University of Sydney, Sydney, NSW 2001 Australia
| | - Matthew J. Winslade
- School of Teacher Education, Faculty of Education, Charles Sturt University, Bathurst, NSW 2795 Australia
| | - Bradley J. Wright
- School of Teacher Education, Faculty of Education, Charles Sturt University, Bathurst, NSW 2795 Australia
| | - Kirsten S. Jackson
- Department of Eduational Studies, Faculty of Human Sciences, Macquarie University, North Ryde, NSW 2109 Australia
- Skin Cancer Prevention Unit, Cancer Council New South Wales, Woolloomooloo, NSW 2011 Australia
| | - Alexandra M. Brown
- Skin Cancer Prevention Unit, Cancer Council New South Wales, Woolloomooloo, NSW 2011 Australia
| | - Vanessa Rock
- Skin Cancer Prevention Unit, Cancer Council New South Wales, Woolloomooloo, NSW 2011 Australia
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Turner D, Harrison SL, Bates N. Sun-Protective Behaviors of Student Spectators at Inter-school Swimming Carnivals in a Tropical Region Experiencing High Ambient Solar Ultraviolet Radiation. Front Public Health 2016; 4:168. [PMID: 27579300 PMCID: PMC4985635 DOI: 10.3389/fpubh.2016.00168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 08/02/2016] [Indexed: 11/13/2022] Open
Abstract
Skin cancer is the most common cancer in humans and Australia (particularly in Queensland) has the highest incidence globally. Sunlight is a known skin carcinogen and reflects off water, exacerbating the risk of sunburn. In 1988, the "SunSmart Program" was developed to promote sun-protection to Australian children. Within a decade, it evolved to include a voluntary national accreditation program for schools, known as the SunSmart Schools (SSS) Program. Additionally, in 2008, it became compulsory for primary schoolchildren attending Queensland government-funded schools to wear a shirt during all water-based activities, except when competing. We observed the proportion of student spectators from 41 Townsville (latitude 19.3°S) primary schools (65.9% SSS) wearing hats at inter-school swimming carnivals in 2009-2011 and 2015 and the proportion wearing a shirt. Overall, a median of 30.7% student spectators from each school wore a hat [max 46.2% (2009); min 18% (2015)] and 77.3% wore a shirt [max 95.8% (2009); min 74.5% (2015)], suggesting that hats are under-utilized. Students from non-government (private) schools were twice as likely as students from government schools to wear a hat (41 vs. 18.2% p = 0.003). Neither the hat nor the shirt-wearing behaviors of student spectators were significantly influenced by their school's size (number of students), educational advantage, sun-protection policy score, or SunSmart status, indicating that other socioeconomic factors, not assessed here, may have influenced the results. Our findings suggest that the mandatory swim-shirt policy introduced in 2008 was very effective, especially initially. However, monitoring and feedback of results to schools may be needed to maintain high levels of compliance in the longer-term. Schoolchildren attending swimming carnivals should not rely on sunscreen or shade alone to protect against direct and reflected-sunlight, and need prompting to put a hat and shirt back on immediately after a race. This responsibility could be delegated to either a parent or a student prefect, if teachers are too busy to encourage and monitor sun-safety compliance among the students in their care.
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Affiliation(s)
- Denise Turner
- Skin Cancer Research Unit, Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University , Townsville, QLD , Australia
| | - Simone Lee Harrison
- Skin Cancer Research Unit, Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia; Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD, Australia
| | - Nicole Bates
- Skin Cancer Research Unit, Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia; Discipline of Pharmacy, Division of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
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18
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Harrison SL, Garzón-Chavez DR, Nikles CJ. Sun protection policies of Australian primary schools in a region of high sun exposure. HEALTH EDUCATION RESEARCH 2016; 31:416-428. [PMID: 27093982 DOI: 10.1093/her/cyw020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/17/2016] [Indexed: 06/05/2023]
Abstract
Queensland, Australia has the highest rates of skin cancer globally. Predetermined criteria were used to score the comprehensiveness of sun protection policies (SPP) of primary schools across Queensland. SPP were sought for schools in 10 regions (latitude range 16.3°S-28.1°S) from 2011 to 2014. Of the 723 schools sampled, 90.9% had a written SPP available publicly. Total SPP scores were low {mean 3.6 [95% CI: 3.4-3.9]; median 2 [interquartile range (IQR) 2, 4]}, with only 3.2% of schools achieving the maximum score of 12. Median SPP scores were higher in Northern and Central Queensland [both 2 (IQR 2, 6) and (IQR 2, 5), respectively] than in Southern Queensland [2 (IQR 2, 3); P = 0.004]. Clothing and hat-wearing were addressed in most policies (96% and 89%) while few schools used their SPP to plan outdoor events (5.2%) or reschedule activities to minimize sun exposure (11.7%). The SunSmart Schools program has been operating in Queensland for 17 years, and while most primary schools now have a written SPP, most are not comprehensive. Incentive-based approaches (5-star-rating award scheme and grants) may assist in addressing this issue, to reduce sun exposure of students and teachers. These data provide a baseline from which improvements in the comprehensiveness of school SPPs can be evaluated.
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Affiliation(s)
- S L Harrison
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia The Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD 4811, Australia
| | - D R Garzón-Chavez
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia
| | - C J Nikles
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia
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Whiteman DC, Green AC, Olsen CM. The Growing Burden of Invasive Melanoma: Projections of Incidence Rates and Numbers of New Cases in Six Susceptible Populations through 2031. J Invest Dermatol 2016; 136:1161-1171. [PMID: 26902923 DOI: 10.1016/j.jid.2016.01.035] [Citation(s) in RCA: 379] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/13/2016] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
Abstract
New melanoma therapies are being developed rapidly, complementing prevention and detection strategies for disease control. Estimating the future burden of melanoma is necessary for deciding how best to deploy limited resources to achieve effective melanoma control. Using three decades of cancer registry data (1982-2011) from six populations with moderate to high melanoma incidence (US whites and the populations of the United Kingdom, Sweden, Norway, Australia, New Zealand), we applied age-period-cohort models to describe current trends and project future incidence rates and numbers of melanomas out to 2031. Between 1982 and 2011, melanoma rates in US whites, and the populations of the United Kingdom, Sweden, and Norway increased at more than 3% annually and are projected to continue rising until at least 2022. Melanoma incidence in Australia has been declining since 2005 (-0.7% per year), and melanoma incidence in New Zealand is increasing but is projected to decline soon. The numbers of new melanoma cases will rise in all six populations because of aging populations and high age-specific rates in the elderly. In US whites, annual new cases will rise from around 70,000 in 2007-2011 to 116,000 in 2026-2031, with 79% of the increase attributable to rising age-specific rates and 21% to population growth and aging. The continued increases in case numbers in all six populations through 2031 will increase the challenges of melanoma control.
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Affiliation(s)
- David C Whiteman
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia.
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia; Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Catherine M Olsen
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia
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García-Romero MT, Geller AC, Kawachi I. Using behavioral economics to promote healthy behavior toward sun exposure in adolescents and young adults. Prev Med 2015; 81:184-8. [PMID: 26361753 DOI: 10.1016/j.ypmed.2015.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/17/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
Skin cancer represents an important public health problem, and it is associated with ultraviolet radiation exposure, particularly at early ages. Unhealthy sun exposure and intentional tanning continue to be the trend among young people. Multiple interventions to raise awareness of the risks of sun exposure have been implemented, without necessarily translating into decreased unhealthy behaviors or skin cancer incidence rates. Behavioral economics adds a set of concepts and tools to potentially boost the efficacy of existing approaches to decrease unhealthy sun exposure. This paper reviews public health interventions that have been based in behavioral economics concepts and their results, and provides examples of new and creative ways physicians and health professionals can actively apply insights from behavioral economics to counsel teenagers and young adults about skin cancer prevention.
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Affiliation(s)
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States; Melanoma Epidemiology, Massachusetts General Hospital, Boston, MA, United States
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States
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Rationale and study protocol to evaluate the SunSmart policy intervention: a cluster randomised controlled trial of a primary school-based health promotion program. BMC Public Health 2015; 15:42. [PMID: 25636822 PMCID: PMC4323015 DOI: 10.1186/s12889-015-1371-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 01/07/2015] [Indexed: 11/21/2022] Open
Abstract
Background Previous evaluations of the SunSmart Program have supported the link between a written sun protection policy and improved sun protection behaviours in New South Wales (NSW) primary schools. However these evaluations have relied on self-reported data and research suggests that direct observations are required to better represent schools’ usual sun protective practices. Methods/Design Data will be collected in the summer months of 2014, 2015, and 2016 as part of an 18-month cluster-controlled trial in NSW primary schools (n = 20). Researchers will conduct three direct observations to record students’ hat use and teachers’ use of sun protective measures during recess and lunch periods in each school. Researchers will also record the volume of sunscreen that the Year 6 classes in each school utilise over the term. At the conclusion of baseline data collection, five schools will be randomised into an intervention group that will work with researchers to develop a policy-driven intervention to improve sun safety behaviour in NSW primary schools. Discussion An initial review of relevant Australian and New Zealand literature suggests that provision of policy support is likely to improve school sun protection practices; however there is no suggested model for this support. This will be the first objective analysis of sun safe behaviours leading to a policy-driven intervention conducted in Australian primary schools since the 1990s, and will inform the future direction of sun safety in our schools. Trial registration Australian and New Zealand Clinical Trials Register ACTRN12614000926639 Registered 28th August 2014.
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Turner D, Harrison SL. Sun protection Provided by Regulation School Uniforms in Australian Schools: An Opportunity to Improve Personal Sun protection During Childhood. Photochem Photobiol 2014; 90:1439-45. [DOI: 10.1111/php.12312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 06/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Denise Turner
- Skin Cancer Research Group; School of Public Health, Tropical Medicine and Rehabilitation Sciences; Anton Breinl Centre for Health Systems Strengthening; Australian Institute of Tropical Health and Medicine (AITHM); James Cook University; Townsville Qld Australia
| | - Simone L. Harrison
- Skin Cancer Research Group; School of Public Health, Tropical Medicine and Rehabilitation Sciences; Anton Breinl Centre for Health Systems Strengthening; Australian Institute of Tropical Health and Medicine (AITHM); James Cook University; Townsville Qld Australia
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