Sunproofed study protocol: A mixed-methods scoping study of sun safety policies in primary schools in Wales

Are Welsh primary schools Sunproofed? Results of a national survey, part 2: sun protection practices in primary schools in Wales

BACKGROUND

Skin cancer rates are on the rise globally. School sun safety programmes are recommended by the World Health Organization to reduce the risk of future skin cancer at the population level; however, these are encouraged but not mandated in Wales.

OBJECTIVES

To explore current sun protection practices and sun safety education in primary schools in Wales and whether these are linked to the existence of a formal sun safety policy.

METHODS

An online survey to all 1241 Welsh primary schools asking about sun safety practices, education and formal policies was undertaken.

RESULTS

In total, 471 (38.0%) schools responded. A minority (22/469, 4.7%) of responding schools reported they had sufficient shade for most activities. In the spring and summer terms, almost two-thirds of schools encourage hat wearing (304/469, 64.8%) and sunscreen (296/468, 63.2%). Although nearly all schools reported that parents were encouraged to apply sunscreen to students before school (449/469, 95.7%), there was wide variation in other sunscreen application practices. Less than one-third of schools (129/445, 29.0%) reported that they include sun protection education in the curriculum in every year group, with 11.7% (52/445) including this in certain years only. Schools with a formal policy were more likely to report more comprehensive sun protection practices, including having sufficient shade [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.04-2.19; P = 0.03], having spare hats for pupils to wear (OR 1.59, 95% CI 1.07-2.37; P = 0.02), providing guidance for staff (OR 5.87, 95% CI 3.05-11.28; P < 0.001), encouraging them to model sun safe behaviours (OR 1.82, 95% CI 1.18-2.80; P = 0.007) and teaching sun protection education as part of the curriculum in every year group (OR 2.56, 95% CI 1.76-3.71; P < 0.001). With respect to sunscreen, the existence of a formal policy did not seem to affect a school's practice.

CONCLUSIONS

Although in most cases, the existence of a formal policy suggests more comprehensive sun protection practices and education in schools, sun protection measures and education need improvement across the primary school sector in Wales to reverse rising skin cancer rates.

Are Welsh primary schools Sunproofed? Results of a national survey, part 1: scoping the landscape of sun safety policies in Wales

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.