title: Motivating public school districts to adopt sun protection policies: a randomized controlled trial.
abstract: BACKGROUND
  In 2002, CDC recommended that the nation's schools establish policies that reduce sun exposure to decrease students' risk of skin cancer.
  
  
  OBJECTIVE
  A program to convince public school districts to adopt such a policy was evaluated.
  
  
  METHODS
  RCT.
  
  
  METHODS
  Public school districts in Colorado (n=56) and Southern California (n=56).
  
  
  METHODS
  Policy information, tools, and technical assistance were provided through printed materials, a website, meetings with administrators, and presentations to school boards. An RCT enrolled public school districts from 2005 to 2010. Policy adoption was promoted over 2 years at districts randomized to the intervention.
  
  
  METHODS
  School board-approved policies were obtained from 106 districts and coded at baseline and 2-year follow-up. Analyses were conducted in 2010.
  
  
  RESULTS
  There was no difference in the percentage of districts adopting a policy (24% in intervention; 12% in control; p=0.142); however, intervention districts (adjusted M=3.10 of 21 total score) adopted stronger sun safety policies than control districts (adjusted M=1.79; p=0.035). Policy categories improved on sun safety education for students (intervention adjusted M=0.76; control adjusted M=0.43, p=0.048); provision of outdoor shade (intervention adjusted M=0.79; control adjusted M=0.28, p=0.029); and outreach to parents (intervention adjusted M=0.59; control adjusted M=0.20, p=0.027).
  
  
  CONCLUSIONS
  Multifaceted promotion can increase adoption of stronger policies for reducing sun exposure of students by public school districts. Future research should explore how policies are implemented by schools.
authors.affiliation: Research, Klein Buendel Inc., 1667 Cole Boulevard, Denver, CO 80401, USA. dbuller@kleinbuendel.com
authors.forename: David B
authors.initials: DB
authors.lastname: Buller
authors.forename: Kim D
authors.initials: KD
authors.lastname: Reynolds
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Ashley
authors.forename: Mary K
authors.initials: MK
authors.lastname: Buller
authors.forename: Ilima L
authors.initials: IL
authors.lastname: Kane
authors.forename: Cheri L
authors.initials: CL
authors.lastname: Stabell
authors.forename: Kim L
authors.initials: KL
authors.lastname: Massie
authors.forename: Xia
authors.initials: X
authors.lastname: Liu
authors.forename: Gary R
authors.initials: GR
authors.lastname: Cutter
mesh_terms: D002140:California; D003120:Colorado; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016134:Organizational Policy; D012574:Schools / Q000458:organization & administration; D012878:Skin Neoplasms / Q000517:prevention & control*; D013334:Students; D013471:Sunburn / Q000517:prevention & control*; D013472:Sunlight / Q000009:adverse effects*