Australian primary school communities' understandings of SunSmart: a qualitative study

Current Utilization of Qualitative Methodologies in Dermatology: A Scoping Review

The focus of this review was to determine how qualitative methods are used in dermatology research and whether published manuscripts meet current standards for qualitative research. A scoping review of manuscripts published in English between January 1, 2016 and September 22, 2021 was conducted. A coding document was developed to collect information on authors, methodology, participants, research theme, and the presence of quality criteria as outlined by the Standards for Reporting Qualitative Research. Manuscripts were included if they described original qualitative research about dermatologic conditions or topics of primary interest to dermatology. An adjacency search yielded 372 manuscripts, and after screening, 134 met the inclusion criteria. Most studies utilized interviews or focus groups, and researchers predominantly selected participants on the basis of disease status, including over 30 common and rare dermatologic conditions. Research themes frequently included patient experience of disease, development of patient-reported outcomes, and descriptions of provider and caregiver experiences. Although most authors explained their analysis and sampling strategy and included empirical data, few referenced qualitative data reporting standards. Missed opportunities for qualitative methods in dermatology include examination of health disparities, exploration of surgical and cosmetic dermatology experiences, and determination of the lived experience of and provider attitudes toward diverse patient populations.

Developing an Online Tool to Promote Safe Sun Behaviors With Young Teenagers as Co-researchers

Despite education about the risks of excessive sun exposure, teenagers in Australia are sun-seeking, with sunburn common in summer. Conversely, some regular (time-limited) exposure to sunlight (that avoids sunburn) is necessary for vitamin D and healthy bones and other molecules important for immune and metabolic health. New interventions are thus required to better support teenagers to make healthy and balanced decisions about their sun behaviors. This paper describes the development of a prototype online tool—a smartphone app—that aimed to foster safe sun practices in teenagers. We recruited young adolescents (aged 12–13 years, n = 24) as “co-researchers” to provide ongoing input into the nature and design of the online tool. This age group was selected, as it is a critical time when young people transition from primary education, where “SunSmart” behaviors are entrenched in Australian schools, to high school, where risky behaviors emerge. Through a series of interviews and workshops, we codesigned an Apple iOS smartphone app with the co-researchers, leading health promotion professionals, researchers, and app designers. The developed app, Sun Safe, contains educational content relevant to teenagers about safe sun behaviors, complemented by other features requested by co-researchers and stakeholders to help engage young people, including gamified quizzes to test their sun health knowledge, real-time weather data on the UV Index and temperature, a sunscreen application timer, and reminders to check the UV Index. The developed prototype app was rated well by co-researchers, suggesting it is suitable for further feasibility and efficacy testing as an intervention tool to improve knowledge and promote safe sun behaviors by young adolescents.

Adolescents' Perceptions About Cancer and Preferences for Cancer Education

BACKGROUND

Cancer is one of the leading causes of death within the United States. Adolescence remains a critical stage of development in which new cognitive skills and lifestyle factors related to cancer are acquired. It is critical to understand adolescents' knowledge of cancer and preferences for receiving clear and easy-to-comprehend information about cancer and cancer prevention. The purpose of this study was to explore adolescents' perceptions of cancer and cancer risk factors and identify their preferences for receiving cancer prevention education.

METHODS

The survey used in this study was based on the Health Belief Model framework, the Youth Risk Behavior Survey, and the Cancer, Clear & Simple (CC&S) Curriculum. The survey evaluated adolescents' knowledge, attitudes, and health-related behaviors regarding cancer and cancer prevention among adolescents. Three Midwestern middle and high schools were recruited, and 235 students completed the survey. Survey responses were analyzed using descriptive statistics.

RESULTS

Study participants had some basic knowledge of cancer; however, only 66% recognized that individuals have control over their risk of developing cancer. Participants (95%) reported that cancer prevention was important, yet only 37.3% stated they knew how to lower their risk of getting cancer and 50% indicated that they currently try to make decisions that lower their chances of getting cancer. About 82% stated that an educational game would be a useful tool to learn about cancer and prevention.

CONCLUSION

Study findings indicate the need for an increase in adolescent knowledge of cancer, specifically how they can control their cancer risk, and prevention strategies through development of game-based education to teach adolescents about cancer-related topics.

Investigating primary preservice teachers' ultraviolet radiation awareness and perceived ability to teach sun safety

Issue addressed

Sun protection practices in Australian primary schools remain inconsistent. Therefore, this study investigates primary PSTs sun protective sun behaviours, ultraviolet (UV) radiation awareness and perceived ability to teach sun safety.

Methods

A convenience sample of undergraduate PSTs (N = 275; mean age = 23.13 years) enrolled at one Western Australian university completed an online survey. Descriptive analyses provided features of the data. Factors associated with sun protection behaviours and perceived knowledge and skill to teach sun safety were explored using multivariable logistic regression models.

Results

Lesser than 10% of participants reported using sun protective measures daily (midday shade use: 6.5%; sunscreen: 7.6%; hat: 4.4%). Only 56.3% reported they understand the UV index, with 68.0% rarely/never using it to aid sun protection. Under half the participants reported they felt they had the knowledge (38.5%) or skills (40%) to effectively teach sun safety in primary schools. Regression analysis revealed gender, undergraduate, year and skin sensitivity were not predictors of UV index use (P > .05) or perceived knowledge of sun safety (P > .05). Skin sensitivity was the strongest predictor for shade usage (P = .02), hat usage (P = .05) and perceived skill to teach sun safety (P = .02).

Conclusions

Survey data indicate UV radiation is inconsistently understood by PSTs. Many felt that they did not have the required knowledge or skill to teach sun safety effectively.

So what?

Improving PSTs UV radiation knowledge while at university is a potential opportunity to improve sun safety delivery in primary schools. A targeted intervention for PSTs is warranted.

The National SunSmart Schools Program: Impact on sun protection policies and practices in Australian primary schools

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.

Protect your skin and let the fun begin: The results of an intervention to improve NSW primary schools' implementation of the SunSmart Program

ISSUE ADDRESSED

The SunSmart Policy Support and Intervention Study (SSPSIS) (ACTRN12614000926639) investigated the feasibility of improving schools' implementation of the SunSmart Program, which is a resource for primary school communities to support their development of a comprehensive sun protection policy.

METHODS

A cluster randomised controlled trial (RCT) was used to evaluate the SSPSIS, which was conducted in NSW SunSmart schools (n = 20). Objective measurements of students' sun-safe hat-wearing behaviours and sunscreen application, and teachers' role-modelling behaviours, were collected for baseline, post-test and follow-up data. Interviews with school community stakeholders, including students (n = 103), parents (n = 31), teachers (n = 11) and executive staff (n = 4), were conducted to inform the intervention design, which was implemented following baseline data collection.

RESULTS

The results of baseline observations and interviews have been published previously. The intervention design aimed to combat negative perceptions of hat-wearing policy and create a trigger for sunscreen application by rewarding students practising these sun protection behaviours with play-based incentives. Although this intervention had no significant effect on the wearing of sun-safe hats among students or teachers, it did have a large effect on the consumption of sunscreen.

CONCLUSIONS

Associating sunscreen and play-based incentives can create an effective trigger for students' sunscreen application behaviours. However, further evidence is needed to investigate how students' and teacher role models' hat-wearing behaviours could be increased. SO WHAT?: While combining a play-based incentive with a trigger for behaviour can promptly increase students' sunscreen application, it was unable to increase students' or teacher role models' hat-wearing behaviours.