title: Multiple levels of influence in the adoption of sun protection policies in elementary schools in Massachusetts.
abstract: OBJECTIVE
  To understand the factors that may influence sun protection policy development if the Centers for Disease Control and Prevention guidelines are to be realized.
  
  
  METHODS
  Qualitative research methodology incorporating a socioecological framework using individual or small-group interviews, surveys, and environmental assessments with school superintendents, elementary school principals, elementary school nurses, and parent-teacher organization presidents and co-chairs as well as coding of school documents.
  
  
  METHODS
  Elementary schools in Massachusetts.
  
  
  METHODS
  Nine school superintendents, 18 elementary school principals, 18 elementary school nurses, and 16 parent-teacher organization presidents or co-chairs.
  
  
  METHODS
  Presence of school sun protection policies, sun protection curriculum, and communication portals for sun protection information to parents.
  
  
  RESULTS
  None of the schools in the 9 districts had a sun protection policy, and only 1 had any type of sun protection curriculum. However, nearly all principals were receptive to developing sun protection policies and to making structural changes to increase the amount of accessible shade if funding were available.
  
  
  CONCLUSIONS
  The schools' communication infrastructure could provide a key portal for disseminating sun protection information to parents. Although there are other resources that could be brought to bear, many challenges must be surmounted to develop effective sun protection policies.
authors.affiliation: RN, Department of Dermatology, Boston University School of Medicine, 720 Harrison Ave, DOB801A, Boston MA 02118, USA. ageller@bu.edu
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.forename: Jodie
authors.initials: J
authors.lastname: Zwirn
authors.forename: Linda
authors.initials: L
authors.lastname: Rutsch
authors.forename: Sue A
authors.initials: SA
authors.lastname: Gorham
authors.forename: Vish
authors.initials: V
authors.lastname: Viswanath
authors.forename: Karen M
authors.initials: KM
authors.lastname: Emmons
mesh_terms: D002648:Child; D003479:Curriculum; D005260:Female; D005544:Forecasting; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006306:Health Surveys; D006801:Humans; D008297:Male; D008404:Massachusetts; D008545:Melanoma / Q000209:etiology / Q000517:prevention & control*; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control*; D010290:Parents / Q000193:education; D012572:School Health Services / Q000639:trends; D012878:Skin Neoplasms / Q000209:etiology / Q000517:prevention & control*; D013472:Sunlight / Q000009:adverse effects*