Persistent increase in children's sun protection in a randomized controlled community trial.
BACKGROUND
Reducing sun exposure during childhood may prevent skin cancer later in life. Sun protection increased immediately following implementation of the SunSafe multicomponent, community-based intervention delivered in 1996 through schools, day care centers, primary care offices, and beach recreation areas. Whether sun protection levels would remain higher than preintervention levels the following summer was unknown.


METHODS
A randomized controlled trial based in 10 New Hampshire towns addressed children's use of protective clothing, shade, and sunscreen at freshwater beach areas. The intervention was provided initially between March and May 1996. A brief project follow-up contact was provided to schools, day care centers, beaches, and primary care offices between March and May 1997 to restock intervention materials and to answer questions. Observations of 1490 children during June through August of 1997 were compared with observations made prior to any intervention between June and August of 1995.


RESULTS
In intervention towns, the proportion of children using at least some sun protection increased by 0.15 from 0.58 in 1995 to 0.73 in 1997 while the proportion in control towns increased by 0.03 (P = 0.033). This increase was due to more use of sunscreen, but not more use of protective clothing or shade. In 1997, care-givers of children in intervention towns reported receiving more sun protection information from school and health care sources than control town caregivers (62% versus 33%, P < 0.006).


CONCLUSIONS
In intervention communities, a higher proportion of children used sun protection in 1997 than at baseline. Increases from 1995 to 1997 were similar in magnitude to short-term increases between 1995 and 1996 that we have been previously reported.
Dietrich
A J
AJ
Department of Community and Family Medicine and Department of Pediatrics, Dartmouth Medical School, Hanover, New Hampshire 03755, USA. Allen.J.Dietrich@Dartmouth.EDU
Olson
A L
AL
Sox
C H
CH
Tosteson
T D
TD
Grant-Petersson
J
J
D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D008297:Male; D009513:New Hampshire; D011481:Protective Clothing / Q000706:statistics & numerical data; D011835:Radiation Protection; D012574:Schools; D013472:Sunlight / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000008:administration & dosage
D013473:Sunscreening Agents