title: Sun protection practices of beachgoers using a reliable observational measure.
abstract: BACKGROUND
  Skin cancer is the most prevalent form of cancer in the United States and is rising rapidly; however, most skin cancers are preventable. Compared to self-report, direct observational methodologies could be a more valid and reliable tool for assessing sun protective behaviors within a specific environment.
  
  
  OBJECTIVE
  The aim of the study is to assess the sun protection practices of beachgoers using a reliable observational measure.
  
  
  METHODS
  A systematic observation system for assessing sun protective behaviors among beachgoers was developed. Data were collected by 2 raters over 3 days using momentary ecological sampling methods. Individuals in a representative zone were assessed for head wear, upper body wear, sunglasses use, shade use, and gender.
  
  
  RESULTS
  Over the 3 days, Observers A and B made 1,678 and 1,725 observations, respectively. Interrater reliability ranged from 0.77 to 0.99. Hats, sunglasses, shirts, and shade were all used by less than 30% of the population. Sun protection behaviors varied by time of day and cloud cover.
  
  
  CONCLUSIONS
  A reliable, observational measure designed to assess population behavior at the setting level showed low use of sun protection practices among beachgoers. Test-retest reliability, the inclusion of low body protection, coding for age, and skin tone are recommended for future versions of this system.
authors: University of Hawaii at Manoa and Cancer Research Center of Hawaii, Department of Public Health Sciences and Epidemiology, Honolulu 96822, USA. jmaddock@hawaii.edu
authors: Jay E
authors: JE
authors: Maddock
authors: David L
authors: DL
authors: O'Riordan
authors: Kevin B
authors: KB
authors: Lunde
authors: Alana
authors: A
authors: Steffen
mesh_terms: D000328:Adult; D001493:Bathing Beaches / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006370:Heliotherapy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D013471:Sunburn / Q000517:prevention & control*; D011795:Surveys and Questionnaires