title: Rationale, design, and baseline data of a cross-national randomized trial on the effect of built shade in public parks for sun protection.
abstract: Environments can be structured to reduce solar ultraviolet radiation (UV) exposure to prevent skin cancer. A prospective randomized trial is being conducted to test whether introducing shade sails in passive recreation areas (PRAs) in public parks will increase use and decrease UV exposure in the shaded compared to unshaded PRAs. Shade effects will be compared between Melbourne, Australia and Denver, USA. The trial enrolled 145 public parks with PRAs suitable for shade construction and randomized parks to intervention or control in a 1:3 ratio. Use of PRAs and UV levels were recorded at each park by trained observers during 30-minute periods on four weekend days in each of two summers (pretest and posttest). Shade sails were constructed between the summers. Given low numbers of users at pretest, the outcome measure was modified to use of the PRA (use vs. no use) and unit of analysis to the individual observation. Observations (n=580) occurred on average 29days from the summer solstice and 55min from solar noon in warm weather (mean=26.2°C) with some cloud cover but only slight or no wind. Typically, PRAs had benches and picnic tables and were located near playgrounds. PRAs were in use during 13.3% of observations (mean=0.41 users). UV over 30-minutes at the PRA boundary (mean=3.2 standard erythemal dose [SED]) and center (mean=3.3 SED) was high. Shade for skin cancer prevention has been understudied. This study will address this gap by determining whether purpose-built shade structures promote greater use of shaded areas within public parks.
authors.affiliation: Klein Buendel, Inc., Golden, CO, USA. Electronic address: dbuller@kleinbuendel.com.
authors.forename: David B
authors.initials: DB
authors.lastname: Buller
authors.affiliation: Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Dobbinson
authors.affiliation: Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.affiliation: Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia.
authors.forename: Melanie
authors.initials: M
authors.lastname: Wakefield
authors.affiliation: Klein Buendel, Inc., Golden, CO, USA.
authors.forename: Mary Klein
authors.initials: MK
authors.lastname: Buller
mesh_terms: D001315:Australia; D006801:Humans; D000068316:Parks, Recreational; D011446:Prospective Studies; D012107:Research Design; D012878:Skin Neoplasms / Q000517:prevention & control*; D013472:Sunlight; D014481:United States
keywords: Public parks; Randomized trial; Shade; Sun protection