Crane, L.A., Schneider, L.S., Yohn, J.J., Morelli, J.G., & Plomer, K.D. (1999). Block the sun, not the fun: Evaluation of a skin cancer prevention program for child care centers. American Journal of Preventive Medicine, 17, 31-37.
Designed to enhance and promote sun protective behaviors at child care centers, this intervention provides child care staff with sun protection workshops and provides parents with brochures and learning activities they can do with their children. The study showed an increase in year-round sunscreen application and in distribution of sun protection materials to parents.
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Lifetime risk of squamous and basal cell carcinoma has increased steadily for over 70 years. The major risk factor for these diseases is chronic, cumulative sun exposure. The major risk factor for malignant melanoma is painful or blistering sunburns, in which a single severe, blistering sunburn during childhood or adolescence can double the lifetime risk for this disease. Skin cancer can be prevented by avoiding mid-day outdoor activities, wearing protective clothing, and using sunscreen with sun protection factor (SPF) of at least 15 on exposed skin. Targeting sun protection practices in preschool and day-care centers is likely to be an important approach to reducing the risk for skin cancer.
The program aims to improve sun protection of children through day care staff while at child care centers. Other goals include improving the sun protection of children by their parents and educating children about sun protection. The intervention consisted of two components:
1) Workshops with day care and preschool staff members which include the following:
- A dermatologist's presentation on the relationship between sun exposure and skin cancer
- A presentation and question-and-answer period with a Department of Social Services licensing administrator
- A session for developing a skin cancer prevention plan
- Participation in children's activities promoting sun protection
2) Parent packets that include brochures and learning activities to do with children
Community Preventive Services Task Force Finding
Day care staff attend a single 3-hour workshop.
The intervention aims to improve sun protection practices among day care and preschool staff at centers that do not already incorporate these practices in their daily care of the children. Parents are secondary targets for the intervention.
The intervention is designed for day care centers and preschools.
The intervention requires experts to present information on sun protection practices. Other resources include: 1) Preschool/Child Care Staff packet, and 2) Parent Materials packet.
About the Study
The intervention was evaluated in a randomized control trial of 27 preschools and day care centers. Thirteen centers participated in the intervention, while 14 were assigned to a wait-list control group.
- At pre-test, 23% of the directors in the intervention group reported they applied sunscreen year round while 50% of them reported doing so at post-test (p<0.004).
- At post-test, 100% of school directors in the intervention group vs. 57% in the control group (p<.05) reported sending sun protection materials home with parents.
- At post-test, 100% of school directors in the intervention group vs. 64% in the control group (p<0.05) reported they intended to apply sunscreen to children's exposed skin on sunny days when snow was on the ground.
- At post-test, school directors in the intervention group scored significantly (p<0.01) better on an assessment of sun protection knowledge and attitudes.
- At post-test, parents in the intervention and control groups did not differ in sun protective practices for their children or on sun protection knowledge and attitudes.
School Directors Reporting Year-Round Sunscreen Application
Directors Reporting Sending Sun Protection Materials Home With Parents