EasyEdit
Edit tags
(what's this?What are these tools?
People just like you can add or edit the content on this site. If you want to try editing, but aren't ready to add to this site, try our demo area.
Read more about editing pages at Wetpaint Central.
)
Report page
Share this

Toolbox of Research & Resources on Sun Safety

This collection or research references, reports and resources has been done as part of a national project funded by the Canadian Partnership Against Cancer. Visitors to and members of this wiki-based web site are welcome to add references (using the Easy Edit" tool found at the top of the page or to comment on the collection by using the "thread" tool found at the bottom of the page. (All previous versions of this page are automatically saved by the system, so don't hesitate to edit this page.

List of Research References, Reports and Resources

The list represents the findings of a preliminary scan of the research literature as well as the Internet. In the list of web-linked research references found below, we have identified major case studies and research reviews. In the listing of web-linked reports and resources (educational, planning, policy and training tools), we have tried to provide a time-saving and convenient resources for the school health community. While much further examination and further searching is required,m we hope that this listing provides a quick start for program planning and development. The listing is presented under these headings:

Prevalence and nature of the problem among young people
Specific Risks, Behaviours and Conditions
Impact of School's Social and Physical Environment
Holistic, Contextual and Comprehensive Approaches
Effectiveness of Coordinated Programs and Services
Evidence-based Single Interventions/Programs (Policy, Intruction, Services, Social Support, Physical Environment)
Use of Evidenced-based Implementation Strategies (Diffusion theory, Capacity Building, Sustainability, Community Context, Future Research)

Prevalence & Nature of the Problem Among Young People
This sub-section lists items that explain the problem of skin cancer among young people and approaches that seem to be more effective or efficient. A holistic approach to behaviour change is often suggested by the research evidence.

Preliminary Findings:

A number of studies of adolescent and adult behaviours indicate that substantial numbers of young people do not follow basic health advice about risky prolonged exposure to the sun. These include minimizing exposure at mid-day, accessing shade, wearing protective clothing, using an effective sunscreen, wearing sunglasses and avoiding sunlamps and tanning beds
The Canadian studies located in this preliminary search (Rhainds et al, 1999; Purdue, 2002; Lovato et al, 1998) show that Canadian behaviours are similar to those in other countries.
It would appear that younger children are more apt to follow health advice about exposure than teens and young adults who are less likely to do so because of media, peer, and other social influences (Hoerster et al, 2007; Myers & Horswill, 2006).
Our preliminary searching located several good explanations of sun-related behaviours among young people that were founded on well-recognized behaviour theories (Myers & Horswill, 2006; Dadlani & Orlow, 2008; Stanton et al, 2005; De Vries et al, 2006; Olsen et al, 2007; Pagota et al, 2004).
Students and staff that were more likely to practice safer sun-related behaviours were also more likely to follow good health advice about other health behaviours such as smoking, diet and activity.

Research	Reports & Resources
Andreeva VA, Reynolds KD, Buller DB, Chou CP, Yaroch AL.(2008) Concurrent psychosocial predictors of sun safety among middle school youth. J Sch Health. 2008 Jul;78(7):374-81 Cokkinides V, Weinstock M, Glanz K, Albano J, Ward E, Thun M.(2006) Trends in sunburns, sun protection practices, and attitudes toward sun exposure protection and tanning among US adolescents, 1998-2004. Pediatrics. 2006 Sep;118(3):853-64 Cokkinides, V.E., Johnston-Davis, K., Weinstock, M., O'Connell, M.C., Kalsbeek, W., Thun , M.J., & Wingo, P.A. (2001). Sun exposure and sun-protection behaviors and attitudes among U.S. youth, 11 to 18 years of age. Prev Med, 33(3), 141-51. de Vries, H., Lezwijn, J., Hol, M., & Honing, C. (2005). Skin cancer prevention: behaviour and motives of Dutch adolescents. Eur J Cancer Prev,14(1), 39-50. Diffey, B.L. Human exposure to solar ultraviolet radiation. J Cosmet Dermatol ,1(3), 124-30. Review. Dixon, H., Borland, R., & Hill, D. (1999). Sun protection and sunburn in primary school children: the influence of age, gender, and coloring. Prev Med, 28(2),119-30. El Sayed, F., Ammoury, A., Nakhle, F., Dhaybi ,R., & Marguery, M.C. (2006). Photoprotection in teenagers. Photodermatol Photoimmunol Photomed, 22(1), 18-21. Gefeller, O., & Pfahlberg, A. (2002). Sunscreen use and melanoma: a case of evidence-based prevention? Photodermatol Photoimmunol Photomed, 18(3), 153-6; discussion 156. Guy, C., Diab, M. R., & Martincigh, B. (2003). Ultraviolet radiation exposure of children and adolescents in Durban, South Africa. Photochem Photobiol, 77(3), 265-70. Hall, H.I., Saraiya, M., Thompson, T., Hartman, A., Glanz, K., & Rimer, B. (2003). Correlates of sunburn experiences among U.S. adults: results of the 2000 National Health Interview Survey. Public Health RE , 118(6), 540-9. Livingston, P.M., White, V., Hayman, J., & Dobbinson, S. (2003). Sun exposure and sun protection behaviours among Australian adolescents: trends over time. Prev Med, 37(6 Pt 1), 577-84. Livingston, P.M., White, V.M., Ugoni , A.M., & Borland, R. (2001). Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia. Health Educ Res, 16(3), 269-78. Lowe, J.B., Borland, R., Stanton, W.R., Baade, P., White, V., & Balanda, K.P. (2000). Sun-safe behaviour among secondary school students in Australia. Health Educ Res. 15(3), 271-81. McGee, R., Reeder, A., Williams, S., Bandaranayake, M., & Tan A.H. (2002). Observations of summer sun protection among children in New Zealand: 1998-2000. N Z Med J, 8;115(1149), 103-6. Moise, A.F., & Aynsley, R. (1999). Ambient ultraviolet radiation levels in public shade settings. Int J Biometeorol, 43(3), 128-38. O'Riordan, D.L., Steffen, A.D., Lunde, K.B., & Gies, P. (2008). A day at the beach while on tropical vacation: sun protection practices in a high-risk setting for UV radiation exposure. Arch Dermatol. 144(11), 1449-55. Purdue, M.P. (2002). Predictors of sun protection in Canadian adults. Can J Public Health, 93(6), 470-4. Purdue, M.P., Marrett, L.D., Peters, L.,& Rivers, J.K. (2001). Predictors of sunburn among Canadian adults. Prev Med. 33(4), 305-12. Ramirez, R., & Schneider, J.(2003). Practical guide to sun protection. Surg Clin North Am. 83(1), 97-107, vi. Robinson, J.K., Rigel, D.S., & Amonette, R.A. (2000). Summertime sun protection used by adults for their children. J Am Acad Dermatol, 42(5 Pt 1), 746-53. Santmyire, B.R., Feldman, S.R., & Fleischer, A.B. Jr. (2001). Lifestyle high-risk behaviors and demographics may predict the level of participation in sun-protection behaviors and skin cancer primary prevention in the United States: results of the 1998 National Health Interview Survey. Cancer. 92(5), 1315-24. Shoveller, J.A., Savoy, J.A., & Roberts, R.E. (2002). Sun protection among parents and children at freshwater beaches. Can J Public Health. 93(2), 146-8. Solomon, C.C., White, E., Kristal, A.R., & Vaughan, T. (2004). Melanoma and lifetime UV radiation. Cancer Causes Control, 15(9), 893-902. Threlfall, T.J., & English, D.R. (1999). Sun exposure and pterygium of the eye: a dose-response curve. Am J Ophthalmol, 128(3), 280-7. Whiteman, D.C., Whiteman, C.A., & Green, A.C. (2001). Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies. Cancer Causes Control, 12(1), 69-82. Review. Dixon H, Dobbinson S, Wakefield M, Jamsen K, McLeod K (2008) Portrayal of tanning, clothing fashion and shade use in Australian women's magazines, 1987–2005 Health Education Research 2008 23(5):791-802 Vergnes C, Daures JP, Sancho-Garnier H, Bousquet J, Pourin-Bourdonneau C, Grabar S, Picot E, Meynadier J.(1999) Sun exposure behavior of children between 3-15 years of age living in Montpellier Ann Dermatol Venereol. 1999 Jun-Jul;126(6-7):505-12 Rhainds M, De Guire L, Claveau J. (1999) A population-based survey on the use of artificial tanning devices in the Province of Québec, Canada. J Am Acad Dermatol. 1999 Apr;40(4):572-6 Myers LB and Mark S. Horswill (2006) Social Cognitive Predictors of Sun Protection Intention and Behavior. Volume 32, Number 2 / Summer 2006 57-63 Dadlani C, Orlow SJ. (2008) Planning for a brighter future: a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online J. 2008 Sep 15;14(9):1 Stanton WR, Jenny Moffatt A2, Alexandra Clavarino (2005) Community Perceptions of Adequate Levels and Reasons for Skin Protection Behavioral Medicine Volume 31, Number 1 / Spring 2005 5-17 de Vries, H., Lezwijn, J., Hol, M., & Honing, C. (2005). Skin cancer prevention: behaviour and motives of Dutch adolescents. Eur J Cancer Prev,14(1), 39-50 Purdue, M.P. (2002). Predictors of sun protection in Canadian adults. Can J Public Health, 93(6), 470-4.	Sunsense Summary (Canadian Cancer Society) describes the risk factors for skin cancer, the need for sunscreens, proper clothing for protection from the sun, how tanning salons are not safe and suspicious changes on skin to look for when we monitor our own health. Canadian Dermatology Association This bilingual site provides practical information on sun protection, including the role of sunscreen in an overall sun protection program; a list of CDA recognized sunscreens in alphabetical order by brand name; and sun safety tips for athletes and spectators. The site also provides advice for parents and daycare personnel on how to integrate safe sun practices into children's programs. Environment Canada – UV Index and Sun Protection This bilingual site provides information on the UV Index, North American and Caribbean forecasts, sun protection and the UV Index Sun Awareness Program for students.

Research

Reports & Resources

Andreeva VA, Reynolds KD, Buller DB, Chou CP, Yaroch AL.(2008) Concurrent psychosocial predictors of sun safety among middle school youth. J Sch Health. 2008 Jul;78(7):374-81
Cokkinides V, Weinstock M, Glanz K, Albano J, Ward E, Thun M.(2006) Trends in sunburns, sun protection practices, and attitudes toward sun exposure protection and tanning among US adolescents, 1998-2004. Pediatrics. 2006 Sep;118(3):853-64
Cokkinides, V.E., Johnston-Davis, K., Weinstock, M., O'Connell, M.C., Kalsbeek, W., Thun , M.J., & Wingo, P.A. (2001). Sun exposure and sun-protection behaviors and attitudes among U.S. youth, 11 to 18 years of age. Prev Med, 33(3), 141-51.
de Vries, H., Lezwijn, J., Hol, M., & Honing, C. (2005). Skin cancer prevention: behaviour and motives of Dutch adolescents. Eur J Cancer Prev,14(1), 39-50.
Diffey, B.L. Human exposure to solar ultraviolet radiation. J Cosmet Dermatol ,1(3), 124-30. Review.
Dixon, H., Borland, R., & Hill, D. (1999). Sun protection and sunburn in primary school children: the influence of age, gender, and coloring. Prev Med, 28(2),119-30.
El Sayed, F., Ammoury, A., Nakhle, F., Dhaybi ,R., & Marguery, M.C. (2006). Photoprotection in teenagers. Photodermatol Photoimmunol Photomed, 22(1), 18-21.
Gefeller, O., & Pfahlberg, A. (2002). Sunscreen use and melanoma: a case of evidence-based prevention? Photodermatol Photoimmunol Photomed, 18(3), 153-6; discussion 156.
Guy, C., Diab, M. R., & Martincigh, B. (2003). Ultraviolet radiation exposure of children and adolescents in Durban, South Africa. Photochem Photobiol, 77(3), 265-70.
Hall, H.I., Saraiya, M., Thompson, T., Hartman, A., Glanz, K., & Rimer, B. (2003). Correlates of sunburn experiences among U.S. adults: results of the 2000 National Health Interview Survey. Public Health RE , 118(6), 540-9.
Livingston, P.M., White, V., Hayman, J., & Dobbinson, S. (2003). Sun exposure and sun protection behaviours among Australian adolescents: trends over time. Prev Med, 37(6 Pt 1), 577-84.
Livingston, P.M., White, V.M., Ugoni , A.M., & Borland, R. (2001). Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia. Health Educ Res, 16(3), 269-78.
Lowe, J.B., Borland, R., Stanton, W.R., Baade, P., White, V., & Balanda, K.P. (2000). Sun-safe behaviour among secondary school students in Australia. Health Educ Res. 15(3), 271-81.
McGee, R., Reeder, A., Williams, S., Bandaranayake, M., & Tan A.H. (2002). Observations of summer sun protection among children in New Zealand: 1998-2000. N Z Med J, 8;115(1149), 103-6.
Moise, A.F., & Aynsley, R. (1999). Ambient ultraviolet radiation levels in public shade settings. Int J Biometeorol, 43(3), 128-38.
O'Riordan, D.L., Steffen, A.D., Lunde, K.B., & Gies, P. (2008). A day at the beach while on tropical vacation: sun protection practices in a high-risk setting for UV radiation exposure. Arch Dermatol. 144(11), 1449-55.
Purdue, M.P. (2002). Predictors of sun protection in Canadian adults. Can J Public Health, 93(6), 470-4.
Purdue, M.P., Marrett, L.D., Peters, L.,& Rivers, J.K. (2001). Predictors of sunburn among Canadian adults. Prev Med. 33(4), 305-12.
Ramirez, R., & Schneider, J.(2003). Practical guide to sun protection. Surg Clin North Am. 83(1), 97-107, vi.
Robinson, J.K., Rigel, D.S., & Amonette, R.A. (2000). Summertime sun protection used by adults for their children. J Am Acad Dermatol, 42(5 Pt 1), 746-53.
Santmyire, B.R., Feldman, S.R., & Fleischer, A.B. Jr. (2001). Lifestyle high-risk behaviors and demographics may predict the level of participation in sun-protection behaviors and skin cancer primary prevention in the United States: results of the 1998 National Health Interview Survey. Cancer. 92(5), 1315-24.
Shoveller, J.A., Savoy, J.A., & Roberts, R.E. (2002). Sun protection among parents and children at freshwater beaches. Can J Public Health. 93(2), 146-8.
Solomon, C.C., White, E., Kristal, A.R., & Vaughan, T. (2004). Melanoma and lifetime UV radiation. Cancer Causes Control, 15(9), 893-902.
Threlfall, T.J., & English, D.R. (1999). Sun exposure and pterygium of the eye: a dose-response curve. Am J Ophthalmol, 128(3), 280-7.
Whiteman, D.C., Whiteman, C.A., & Green, A.C. (2001). Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies. Cancer Causes Control, 12(1), 69-82. Review.
Dixon H, Dobbinson S, Wakefield M, Jamsen K, McLeod K (2008) Portrayal of tanning, clothing fashion and shade use in Australian women's magazines, 1987–2005 Health Education Research 2008 23(5):791-802
Vergnes C, Daures JP, Sancho-Garnier H, Bousquet J, Pourin-Bourdonneau C, Grabar S, Picot E, Meynadier J.(1999) Sun exposure behavior of children between 3-15 years of age living in Montpellier Ann Dermatol Venereol. 1999 Jun-Jul;126(6-7):505-12
Rhainds M, De Guire L, Claveau J. (1999) A population-based survey on the use of artificial tanning devices in the Province of Québec, Canada. J Am Acad Dermatol. 1999 Apr;40(4):572-6
Myers LB and Mark S. Horswill (2006) Social Cognitive Predictors of Sun Protection Intention and Behavior. Volume 32, Number 2 / Summer 2006 57-63
Dadlani C, Orlow SJ. (2008) Planning for a brighter future: a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online J. 2008 Sep 15;14(9):1
Stanton WR, Jenny Moffatt A2, Alexandra Clavarino (2005) Community Perceptions of Adequate Levels and Reasons for Skin Protection Behavioral Medicine Volume 31, Number 1 / Spring 2005 5-17
de Vries, H., Lezwijn, J., Hol, M., & Honing, C. (2005). Skin cancer prevention: behaviour and motives of Dutch adolescents. Eur J Cancer Prev,14(1), 39-50
Purdue, M.P. (2002). Predictors of sun protection in Canadian adults. Can J Public Health, 93(6), 470-4.

Sunsense Summary (Canadian Cancer Society) describes the risk factors for skin cancer, the need for sunscreens, proper clothing for protection from the sun, how tanning salons are not safe and suspicious changes on skin to look for when we monitor our own health.
Canadian Dermatology Association This bilingual site provides practical information on sun protection, including the role of sunscreen in an overall sun protection program; a list of CDA recognized sunscreens in alphabetical order by brand name; and sun safety tips for athletes and spectators. The site also provides advice for parents and daycare personnel on how to integrate safe sun practices into children's programs.
Environment Canada – UV Index and Sun Protection This bilingual site provides information on the UV Index, North American and Caribbean forecasts, sun protection and the UV Index Sun Awareness Program for students.

Specific Risks, Behaviours and Conditions
This sub-section examines specific risks and behaviours related to sun safety. These include fair skin, exposure to sunlight at mid-day and other factors and conditions.

Preliminary Findings:

Similar to other broad health issues, it appears that programs and interventions are more likely to be effective if they are target specific behaviours or conditions. These include the proper use of sun screens, wearing protective clothing, de-normalizing tanning and the use of tanning beds, creating and accessing shade, educating students or staff, awareness campaigns just prior to specific events such as graduation dances and so on.

Research	Reports/Resources
Azzarello, L.M., Dessureault, S.,& Jacobsen, P.B.(2006). Sun-protective behavior among individuals with a family history of melanoma. Cancer Epidemiol Biomarkers Prev,15(1), 142-5. Geller AC, Brooks DR, Colditz GA, Koh HK, Frazier AL. (2006) Sun protection practices among offspring of women with personal or family history of skin cancer.Pediatrics. 2006 Apr;117(4):e688-94 Boyett, T., Davy, L., Weathers, L., Campbell, R., Van Durme, D., & Roetzheim, R.G. (2002).Sun protection of children at the beach. J Am Board Fam Pract.15(2), 112-7. Das, G., Crocombe, S., McGrath, M., Berry, J.L.,& Mughal, M.Z. (2006). Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child. 91(7), 569-72. Epub 2005 Sep 20. Dixon, H., Dobbinson, S., Wakefield, M., Jamsen, K.,& McLeon, K. (nd). Portrayal of tanning, clothing fashion and shade use in Australian women's magazines, 1987–2005. Victoria, Australia: Centre for Behavioural Research in Cancer, The Cancer Council Victoria. Dobbinson, S., Wakefield, M., Hill, D., Girgis, A., Aitken, J.F., Beckmann, K., Reeder, A.I., Herd, N., Fairthorne, A., & Bowles, K.A. (2008). Prevalence and determinants of Australian adolescents' and adults' weekend sun protection and sunburn, summer 2003-2004. J Am Acad Dermatol, 59(4), 602-14. Epub 2008 Aug 8. Glanz, K., Geller, A.C., Shigaki, D., Maddock, J.E.,& Isnec, M.R. (2002). A randomized trial of skin cancer prevention in aquatics settings: the Pool Cool program. Glanz, K., Lew, R.A., Song, V., Cook, V.A. (1999). Factors associated with skin cancer prevention practices in a multiethnic population. Health Educ Behav, 26(3), 344-59. Lagerlund, M., Dixon, H.G., Simpson, J.A., Spittal, M., Taylor, H.R., & Dobbinson, S.J. (2002). Observed use of sunglasses in public outdoor settings around Melbourne, Australia: 1993 to 2002. Prev Med, 42(4), 291-6. Epub 2006 Feb 20. Lawler, S., Spathonis, K., Eakin, E., Gallois, C., Leslie, E., & Owen N. (2007). Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health, 31(3),230-4. Lund, P.M., & Taylor, J.S. (2008). Lack of adequate sun protection for children with oculocutaneous albinism in South Africa. BMC Public Health, 30(8), 225. Maddock, J.E., O'Riordan, D.L., Lunde, K.B., & Steffen, A. (2007). Sun protection practices of beachgoers using a reliable observational measure. Ann Behav Med, 34(1), 100-3. Livingston, P., White, V., Ugoni, A., & Borland, R. (2001). Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia. Health Education Research, 16, 269–278. Whiteman, D., Whiteman C., & Green, A. (2001). Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic. Cancer Causes andControl, 12(1), 69–82.

Research

Reports/Resources

Azzarello, L.M., Dessureault, S.,& Jacobsen, P.B.(2006). Sun-protective behavior among individuals with a family history of melanoma. Cancer Epidemiol Biomarkers Prev,15(1), 142-5.
Geller AC, Brooks DR, Colditz GA, Koh HK, Frazier AL. (2006) Sun protection practices among offspring of women with personal or family history of skin cancer.Pediatrics. 2006 Apr;117(4):e688-94
Boyett, T., Davy, L., Weathers, L., Campbell, R., Van Durme, D., & Roetzheim, R.G. (2002).Sun protection of children at the beach. J Am Board Fam Pract.15(2), 112-7.
Das, G., Crocombe, S., McGrath, M., Berry, J.L.,& Mughal, M.Z. (2006). Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child. 91(7), 569-72. Epub 2005 Sep 20.
Dixon, H., Dobbinson, S., Wakefield, M., Jamsen, K.,& McLeon, K. (nd). Portrayal of tanning, clothing fashion and shade use in Australian women's magazines, 1987–2005. Victoria, Australia: Centre for Behavioural Research in Cancer, The Cancer Council Victoria.
Dobbinson, S., Wakefield, M., Hill, D., Girgis, A., Aitken, J.F., Beckmann, K., Reeder, A.I., Herd, N., Fairthorne, A., & Bowles, K.A. (2008). Prevalence and determinants of Australian adolescents' and adults' weekend sun protection and sunburn, summer 2003-2004. J Am Acad Dermatol, 59(4), 602-14. Epub 2008 Aug 8.
Glanz, K., Geller, A.C., Shigaki, D., Maddock, J.E.,& Isnec, M.R. (2002). A randomized trial of skin cancer prevention in aquatics settings: the Pool Cool program.
Glanz, K., Lew, R.A., Song, V., Cook, V.A. (1999). Factors associated with skin cancer prevention practices in a multiethnic population. Health Educ Behav, 26(3), 344-59.
Lagerlund, M., Dixon, H.G., Simpson, J.A., Spittal, M., Taylor, H.R., & Dobbinson, S.J. (2002). Observed use of sunglasses in public outdoor settings around Melbourne, Australia: 1993 to 2002. Prev Med, 42(4), 291-6. Epub 2006 Feb 20.
Lawler, S., Spathonis, K., Eakin, E., Gallois, C., Leslie, E., & Owen N. (2007). Sun exposure and sun protection behaviours among young adult sport competitors. Aust N Z J Public Health, 31(3),230-4.
Lund, P.M., & Taylor, J.S. (2008). Lack of adequate sun protection for children with oculocutaneous albinism in South Africa. BMC Public Health, 30(8), 225.
Maddock, J.E., O'Riordan, D.L., Lunde, K.B., & Steffen, A. (2007). Sun protection practices of beachgoers using a reliable observational measure. Ann Behav Med, 34(1), 100-3.
Livingston, P., White, V., Ugoni, A., & Borland, R. (2001). Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia. Health Education Research, 16, 269–278.
Whiteman, D., Whiteman C., & Green, A. (2001). Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic. Cancer Causes andControl, 12(1), 69–82.

Impact of School's Social and Physical Environment
This sub-section examines the impact of the social and physical environment of the school as a place in which students and staff spend considerable time. Physical conditions and facilities in the school can contribute to health. As well, prevailing social norms, beliefs and misconceptions from the media and the community can be either reproduced or debunked in the school social environment.

Preliminary Findings:

Shade structures or the lack of shade on school grounds can contribute to skin cancer
The social norm that tanned skin is "healthier" or better looking can either be reproduced in activities such as visits to tanning stores prior to student social events or they can be addressed through peer and school awareness programs.

Research	Reports & Resources
Boldemann, C., Blennow, M., Dal, H., Mårtensson, F., Raustorp, A., Yuen, K., & Wester, U. (2006). Impact of preschool environment upon children's physical activity and sun exposure. Prev Med, 42(4), 301-8. Epub 2006 Jan 30. Moise, A.F., Büttner, P.G., & Harrison, S.L. (1999). Sun exposure at school. Photochem Photobiol, 70(2), 269-74. Stanton, W.R., Saleheen, H.N., O'Riordan, D., & Roy, C.R. (2003). Environmental conditions and variation in levels of sun exposure among children in child care. Int J Behav Med. 10(4), 285-98.

Research

Reports & Resources

Boldemann, C., Blennow, M., Dal, H., Mårtensson, F., Raustorp, A., Yuen, K., & Wester, U. (2006). Impact of preschool environment upon children's physical activity and sun exposure. Prev Med, 42(4), 301-8. Epub 2006 Jan 30.
Moise, A.F., Büttner, P.G., & Harrison, S.L. (1999). Sun exposure at school. Photochem Photobiol, 70(2), 269-74.
Stanton, W.R., Saleheen, H.N., O'Riordan, D., & Roy, C.R. (2003). Environmental conditions and variation in levels of sun exposure among children in child care. Int J Behav Med. 10(4), 285-98.

Holistic, Contextual and Comprehensive Approaches

This sub-section examines holistic, contextual and comprehensive approaches include the whole child, all children (especially vulnerable), developmental stages/life course, clusters of behaviours and conditions(eg mental health, crime, tobacco, sexual risk-taking, dropouts), community and systems context analysis, synergistic combinations of strategies and initiatives (e.g. police officers, safe schools, character education, early childhood programs), multi-level , intersectorial strategies, programs and policies).

Preliminary Findings:

There are two broad sets of related health issues to which sun safety can be successfully linked. The connection to other cancers and hence to other chronic diseases such as obesity, heart disease and other conditions can lead to a focus on promoting healthier lifestyle choices (healthy eating, not smoking, being active, staying out of the sun, etc). Another broad set of issues are in the environmental health arena, where sub safety proponents can partner with other promoting ecological sustainability and changes to the physical environment and our consumption patterns.We found some programs that did the latter.

Research	Reports & Resources
Boe, K., & Tillotson, E.A. (2006). Encouraging sun safety for children and adolescents. J Sch Nurs. 22(3), 136-41. Review.Geller, A.C., Zwirn, J., Rutsch, L., Gorham, S.A., Viswanath, V.,& Emmons, K.M. (2008). Multiple levels of influence in the adoption of sun protection policies in elementary schools in Massachusetts. Arch Dermatol, 144(4), 491-6. Reynolds, K.D., Buller, D.B., Yaroch, A.L., Maloy, J., Geno, C.R., & Cutter, G.R. (2008). Effects of program exposure and engagement with tailored prevention communication on sun protection by young adolescents. Saraiya, M., Glanz, K., Briss, P.A., Nichols, P., White, C., Das, D., Smith, S.J., Tannor, B., Hutchinson, A.B., Wilson, K.M., Gandhi, N., Lee, N.C., Rimer, B., Coates, R.C., Kerner, J.F., Hiatt, R.A., Buffler, P., & Rochester, P. (2004). Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med, 27(5),,422-66. Review. Stanton, W.R., Janda, M., Baade, P.D., & Anderson, P. (2004). Primary prevention of skin cancer: a review of sun protection in Australia and internationally. Health Promot Int. 19(3), 369-78. Review.	Healthy Living Schools Initiative (BC Cancer Society) Cancer Prevention Coordinators offer customized support, materials, tips, tools and ideas for educators at all levels. We are actively seeking to increase participation in Healthy Living Schools both through our individual CPCs and through a province-wide mailout in spring 2008 Guidelines to Prevent Skin Cancer (US Centers for Disease Control & Prevention) These guidelines were designed to provide schools with a comprehensive approach to preventing skin cancer among adolescents and young people. CDC worked with specialists in dermatology, pediatrics, public health, and education from universities; national, federal, state, and voluntary agencies; schools; and other organizations to develop these guidelines. SunSafe in the Middle School Years Community-wide multi-component programs, Education & policy interventions in secondary schools

Research

Reports & Resources

Boe, K., & Tillotson, E.A. (2006). Encouraging sun safety for children and adolescents. J Sch Nurs. 22(3), 136-41. Review.Geller, A.C., Zwirn, J., Rutsch, L., Gorham, S.A., Viswanath, V.,& Emmons, K.M. (2008). Multiple levels of influence in the adoption of sun protection policies in elementary schools in Massachusetts. Arch Dermatol, 144(4), 491-6.
Reynolds, K.D., Buller, D.B., Yaroch, A.L., Maloy, J., Geno, C.R., & Cutter, G.R. (2008). Effects of program exposure and engagement with tailored prevention communication on sun protection by young adolescents.
Saraiya, M., Glanz, K., Briss, P.A., Nichols, P., White, C., Das, D., Smith, S.J., Tannor, B., Hutchinson, A.B., Wilson, K.M., Gandhi, N., Lee, N.C., Rimer, B., Coates, R.C., Kerner, J.F., Hiatt, R.A., Buffler, P., & Rochester, P. (2004). Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med, 27(5),,422-66. Review.
Stanton, W.R., Janda, M., Baade, P.D., & Anderson, P. (2004). Primary prevention of skin cancer: a review of sun protection in Australia and internationally. Health Promot Int. 19(3), 369-78. Review.

Healthy Living Schools Initiative (BC Cancer Society)
Cancer Prevention Coordinators offer customized support, materials, tips, tools and ideas for educators at all levels. We are actively seeking to increase participation in Healthy Living Schools both through our individual CPCs and through a province-wide mailout in spring 2008
Guidelines to Prevent Skin Cancer (US Centers for Disease Control & Prevention) These guidelines were designed to provide schools with a comprehensive approach to preventing skin cancer among adolescents and young people. CDC worked with specialists in dermatology, pediatrics, public health, and education from universities; national, federal, state, and voluntary agencies; schools; and other organizations to develop these guidelines.
SunSafe in the Middle School Years
Community-wide multi-component programs, Education & policy interventions in secondary schools

Effectiveness of Coordinated Programs and Services
This sub-section examines coordinated, multi-intervention programs. Where possible, we differentiate between Coordinated School-Community Programs (CSHP) and Whole-School Programs (HPS) involving only school-based personnel.

Preliminary Findings:

While some reviews of the evidence have indicated that school, pre-school, college and workplace, recreation and other settings-based multi-intervention programs can be effective (Knowledge Exchange Network, 2008, Primary Prevention Action Group, 2009) there are other reviews stating that there is insufficient evidence available for high school and college/university programs ( Centers for Disease Control, 2003).
The impact of school-based programs on sun-related health appears to be concentrated in significant changes to awareness, knowledge, and behaviour change among younger students. We did not locate any longitudinal studies. no studies examining the relationship between sun safety and educational achievement were found. One study noted the economic benefits of prevention programs

Research	Reports & Resources
Coordinated SH Programs (School-Agency-Community) Saraiya M, Glanz K, Briss P, Nichols P, White C, Das D; (2003) Preventing skin cancer: findings of the Task Force on Community Preventive Services on reducing Exposure to Ultraviolet Light. The CDC Community Guide Cassel, K,D. (2005). Made for the shade: the Hawaii Skin Cancer Coalition celebrates its ten year history. Hawaii Med J, 64(9), 236-8. Dietrich, A.J., Olson, A.L., Sox, C.H., Tosteson, T.D., & Grant-Petersson, J. (2000). Persistent increase in children's sun protection in a randomized controlled community trial. Prev Med, 31(5), 569-74. Olson, A.L., Gaffney, C., Starr, P., Gibson, J.J., Cole, B.F., & Dietrich, A.J. (2007). SunSafe in the Middle School Years: a community-wide intervention to change early-adolescent sun protection. Pediatrics, 119(1), e247-56. Smith, B.J., Ferguson, C., McKenzie, .J., Bauman, A., & Vita, P.(2002). Impacts from repeated mass media campaigns to promote sun protection in Australia. Health Promot Int,17(1), 51-60. Knowledge Exchange Network (2008) Effective Sun Safety Interventions, Winnipeg, Manitoba, Author Knowledge Exchange Network (2008) Moderate-strength Sun Safety Interventions, Winnipeg, Manitoba, Author Primary Prevention Action Group (2009) Literature Review of Evidence-Based Strategies and Practices in Promoting Skin Cancer Prevention, Toronto, ON, Canadian Partnership Against Cancer Centers for Disease Control and Prevention (2003) Preventing skin cancer. Findings of the Task Force on Community Preventive Services on reducing exposure to ultraviolet light. MMWR 2003;52(RR-15):1–12 Whole School (HPS) involving only school personnel in delivery Geller, A.C., Cantor, M., Miller, D.R., Kenausis, K., Rosseel, K., Rutsch, L., Brooks, D.R., Zhang, Z., & Demierre, M.F. (2002). The Environmental Protection Agency's National SunWise School Program: sun protection education in US schools (1999-2000). J Am Acad Dermatol ,46(5), 683-9. Giles-Corti, B., English, D.R., Costa, C., Milne, E., Cross, D., & Johnston, R. (2004). Creating SunSmart schools. Health Educ Res,19(1), 98-109. Jones, S.B., Beckmann, K., & Rayner, J.(2008). Australian primary schools' sun protection policy and practice: evaluating the impact of the National SunSmart Schools Program. Health Promot J Austr, 19(2), 86-90. Milne, E., English, D.R., Johnston, R., Cross, D., Borland, R., Costa, C., & Giles-Corti, B. (2000). Improved sun protection behaviour in children after two years of the Kidskin intervention. Aust N Z J Public Health, 24(5), 481-7. Geller, A., Rutsch, L., Kenausis, K., & Zhang, Z. (2003). Evaluation of the SunWise school program. Journal of School Nursing, 19, 93-99. Gilaberte, Y., Alonso, J.P., Teruel, M.P., Granizo, C., & Gallego, J. (2008). Evaluation of a health promotion intervention for skin cancer prevention in Spain: the SolSano program. Health Promotion International, 23(3), 209–219. Giles-Corti B., English, D, Costa, C., Milne, E., Cross, D., & Johnston, R. (2004). Creating SunSmart schools. Health Education Research, 19(1), 98–109. Milne E, Jacoby P, Giles-Corti B, Cross D, Johnston R, English DR.(2006) The impact of the kidskin sun protection intervention on summer suntan and reported sun exposure: was it sustained? Prev Med. Jan;42(1):14-20. Epub 2005 Dec 5. Milne E, English DR, Johnston R, Cross D, Borland R, Giles-Corti B, Costa C. (2001) Reduced sun exposure and tanning in children after 2 years of a school-based intervention (Australia). Cancer Causes Control. 2001 Jun;12(5):387-93. Kyle JW, Hammitt JK, Lim HW, Geller AC, Hall-Jordan LH, Maibach EW, De Fabo EC, Wagner MC.(2008) Economic evaluation of the US Environmental Protection Agency's SunWise program: sun protection education for young children.Pediatrics. May;121(5):e1074-84	Sun Safe Community & School Program (Canadian Best Practices Portal) The program aims to enhance and promote sun protection of children ages 2 -9 years through the delivery of a multicomponent intervention in three settings: elementary schools and daycare centers, town beach areas, and primary care practices. Toyota Evergreen Learning Grounds Toyota Evergreen Learning Grounds helps schools create outdoor classrooms to provide students with a healthy place to play, learn and develop a genuine respect for nature. Ontario EcoSchools Eco-schools is an environmental education program for grades 1-12 that helps students develop ecological literacy while engaged in practices to become environmentally responsible citizens. Developed and run by school boards, Ontario EcoSchools also helps improve school building operations to reduce environmental impacts. écoles vertes Brundtland Le programme des écoles vertes Brundtland a été lancé en 1992 par la CEQ aujourd’hui devenue la Centrale des syndicats du Québec.

Research

Reports & Resources

Coordinated SH Programs (School-Agency-Community)

Saraiya M, Glanz K, Briss P, Nichols P, White C, Das D; (2003) Preventing skin cancer: findings of the Task Force on Community Preventive Services on reducing Exposure to Ultraviolet Light. The CDC Community Guide
Cassel, K,D. (2005). Made for the shade: the Hawaii Skin Cancer Coalition celebrates its ten year history. Hawaii Med J, 64(9), 236-8.
Dietrich, A.J., Olson, A.L., Sox, C.H., Tosteson, T.D., & Grant-Petersson, J. (2000). Persistent increase in children's sun protection in a randomized controlled community trial. Prev Med, 31(5), 569-74.
Olson, A.L., Gaffney, C., Starr, P., Gibson, J.J., Cole, B.F., & Dietrich, A.J. (2007). SunSafe in the Middle School Years: a community-wide intervention to change early-adolescent sun protection. Pediatrics, 119(1), e247-56.
Smith, B.J., Ferguson, C., McKenzie, .J., Bauman, A., & Vita, P.(2002). Impacts from repeated mass media campaigns to promote sun protection in Australia. Health Promot Int,17(1), 51-60.
Knowledge Exchange Network (2008) Effective Sun Safety Interventions, Winnipeg, Manitoba, Author
Knowledge Exchange Network (2008) Moderate-strength Sun Safety Interventions, Winnipeg, Manitoba, Author
Primary Prevention Action Group (2009) Literature Review of Evidence-Based Strategies and Practices in Promoting Skin Cancer Prevention, Toronto, ON, Canadian Partnership Against Cancer
Centers for Disease Control and Prevention (2003) Preventing skin cancer. Findings of the Task Force on Community Preventive Services on reducing exposure to ultraviolet light. MMWR 2003;52(RR-15):1–12

Whole School (HPS) involving only school personnel in delivery

Geller, A.C., Cantor, M., Miller, D.R., Kenausis, K., Rosseel, K., Rutsch, L., Brooks, D.R., Zhang, Z., & Demierre, M.F. (2002). The Environmental Protection Agency's National SunWise School Program: sun protection education in US schools (1999-2000). J Am Acad Dermatol ,46(5), 683-9.
Giles-Corti, B., English, D.R., Costa, C., Milne, E., Cross, D., & Johnston, R. (2004). Creating SunSmart schools. Health Educ Res,19(1), 98-109.
Jones, S.B., Beckmann, K., & Rayner, J.(2008). Australian primary schools' sun protection policy and practice: evaluating the impact of the National SunSmart Schools Program. Health Promot J Austr, 19(2), 86-90.
Milne, E., English, D.R., Johnston, R., Cross, D., Borland, R., Costa, C., & Giles-Corti, B. (2000). Improved sun protection behaviour in children after two years of the Kidskin intervention. Aust N Z J Public Health, 24(5), 481-7.
Geller, A., Rutsch, L., Kenausis, K., & Zhang, Z. (2003). Evaluation of the SunWise school program. Journal of School Nursing, 19, 93-99.
Gilaberte, Y., Alonso, J.P., Teruel, M.P., Granizo, C., & Gallego, J. (2008). Evaluation of a health promotion intervention for skin cancer prevention in Spain: the SolSano program. Health Promotion International, 23(3), 209–219.
Giles-Corti B., English, D, Costa, C., Milne, E., Cross, D., & Johnston, R. (2004). Creating SunSmart schools. Health Education Research, 19(1), 98–109.
Milne E, Jacoby P, Giles-Corti B, Cross D, Johnston R, English DR.(2006) The impact of the kidskin sun protection intervention on summer suntan and reported sun exposure: was it sustained? Prev Med. Jan;42(1):14-20. Epub 2005 Dec 5.
Milne E, English DR, Johnston R, Cross D, Borland R, Giles-Corti B, Costa C. (2001) Reduced sun exposure and tanning in children after 2 years of a school-based intervention (Australia). Cancer Causes Control. 2001 Jun;12(5):387-93.
Kyle JW, Hammitt JK, Lim HW, Geller AC, Hall-Jordan LH, Maibach EW, De Fabo EC, Wagner MC.(2008) Economic evaluation of the US Environmental Protection Agency's SunWise program: sun protection education for young children.Pediatrics. May;121(5):e1074-84

Sun Safe Community & School Program (Canadian Best Practices Portal) The program aims to enhance and promote sun protection of children ages 2 -9 years through the delivery of a multicomponent intervention in three settings: elementary schools and daycare centers, town beach areas, and primary care practices.
Toyota Evergreen Learning Grounds
Toyota Evergreen Learning Grounds helps schools create outdoor classrooms to provide students with a healthy place to play, learn and develop a genuine respect for nature.
Ontario EcoSchools
Eco-schools is an environmental education program for grades 1-12 that helps students develop ecological literacy while engaged in practices to become environmentally responsible citizens. Developed and run by school boards, Ontario EcoSchools also helps improve school building operations to reduce environmental impacts.
écoles vertes Brundtland
Le programme des écoles vertes Brundtland a été lancé en 1992 par la CEQ aujourd’hui devenue la Centrale des syndicats du Québec.

Evidence-based Single Interventions/Programs

This sub-section examines single intervention programs in five areas with various aspects; policy (school board, other agencies), instruction (curriculum, educational materials and methods, teacher training, etc), health and other services (screening, early identification, school clinics, access to youth friendly services, case coordination and referrals etc); social support (parent involvement, peer programs, working with local media, working with social media etc), phtsical environment (school grounds, facilities, transportation etc)

Preliminary Findings:

Multi-intervention programs that influence several aspects of the school setting are likely to be more effective. However, they are also more time-consuming, complicated or costly to implement, more difficult to sustain and more difficult to evaluate.
Several specific intervention programs, particularly sun safety education for primary students and staff awareness programs, have been reported to be effective in large scale random controlled trials
Comprehensive guidelines and examples of evaluated comprehensive, multi-intervention programs are readily available from other countries. Canadian materials and adaptations are available on some of the interventions.

Research	Reports & Resources
Policy Interventions Buller, D., Buller, M.K., & Reynolds, K. (2006). A survey of sun protection policy and education in secondary schools. Journal of the American Academy of Dermatology, 54(3), 427–432. Dobbinson, S., Peipers, A., Borland, R., & Nolan, K. (2000). Are Victorian primary schools Sunsmart? Health Promotion Journal of Australia, 10, 43–50 Eakin, P., Maddock, J., Techur-Pedro, A., Kaliko, R., & Derauf, C. (2004). Sun protection policy in elementary schools in Hawaii. Preventing Chronic Disease, 1, 1-10. Emmons, K., Geller, A., Viswanath, V., Rutsch, L., Zwirn, J., Gorham, S., & Puleo, E. (2008). The SunWise Policy Intervention for School-Based Sun Protection: A Pilot Study. Journal of School Nursing, 24(4), 215–221. Instructional Interventions Bastuji-Garin, S., Grob, J.J., Grognard, C., Grosjean, F., & Guillaume, J.C. (1999). Melanoma prevention: evaluation of a health education campaign for primary schools. Arch Dermatol, 135(8), 936-40. Collins, D.C., Kearns, R.A., Mitchell, H. (2006). "An integral part of the children's education": placing sun protection in Auckland primary schools. Health Place, 12(4):436-48. Epub 2005 Jul 1. de Vries, H., Mesters, I., Riet, J.V., Willems, K., & Reubsaet, A. (2006). Motives of Belgian adolescents for using sunscreen: the role of action plans. Cancer Epidemiol Biomarkers Prev, 15(7), 1360-6. Geller, A., Rutsch, L., Kenausis, K., Zhang, Z. (2003). Evaluation of the SunWise School Program. J Sch Nurs, 19(2), 93-9. Geller, A.C., Rutsch, L., Kenausis, K., Selzer, P., & Zhang, Z.(2003) Can an hour or two of sun protection education keep the sunburn away? Evaluation of the Environmental Protection Agency's Sunwise School Program. Environ Health. 3;2(1), 13. Harrison, S.L., Saunders, V.,& Nowak, M. (2007).Baseline survey of sun-protection knowledge, practices and policy in early childhood settings in Queensland, Australia. Health Educ Res, 22(2), 261-71. Epub 2006 Jul 31. Miles, A., Waller, J., Hiom, S., Swanston, D. (2005). SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample. Health Educ Res, 20(5), 579-85. Epub 2005 Jan 11. Olson AL, Gaffney CA, Starr P, Dietrich AJ (2008) The impact of an appearance-based educational intervention on adolescent intention to use sunscreen Health Education Research 2008 23(5):763-769 Stankeviciūte V, Zaborskis A, Petrauskiene A, Valiukeviciene S. (2004) Skin cancer prevention: children's health education on protection from sun exposure and assessment of its efficiency. Medicina (Kaunas). 2004;40(4):386-93 Buller DB, Reynolds KD, Yaroch A, Cutter GR, Hines JM, Geno CR, Maloy JA, Brown M, Woodall WG, Grandpre J.(2006) Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8. Am J Prev Med. Jan;30(1):13-22. Oncology Cooperative Group Of The Italian Group For Epidemiologic Research In Dermatology (GISED) (2003) Improving sun protection behaviour in children: study design and baseline results of a randomized trial in Italian elementary schools. The 'Sole Si Sole No GISED' project. Dermatology. 2003;207(3):291-7. Health and Other Services Interventions Crane, L.A., Schneider, L.S., Yohn, J.J., Morelli, J.G., Plomer, K.D. (1999). "Block the sun, not the fun": evaluation of a skin cancer prevention program for child care centers. Am J Prev Med, 17(1), 31-7. Gritz, E.R., Tripp, M.K., de Moor, C.A., Eicher, S.A., Mueller, N.H., & Spedale, J.H. Skin cancer prevention counseling and clinical practices of pediatricians. Pediatr Dermatol. 2003 Jan-Feb;20(1):16-24 U.S. Preventive Services Task Force. (2003) Counseling to prevent skin cancer: recommendations and rationale of the U.S. Preventive Services Task Force.MMWR Recomm Rep. 2003 Oct 17;52(RR-15):13-7 Social Support Interventions Glanz, K., Geller, A.C., Shigaki, D., Maddock, J.E., & Isnec, M.R. (2002). A randomized trial of skin cancer prevention in aquatics settings: the Pool Cool program. Health Psychol, 21(6), 579-87. Reding DJ, Fischer V, Gunderson P, Lappe K. (1995) Skin cancer prevention: a peer education model. Wis Med J. 1995 Feb;94(2):77-81. Physical Environment Interventions Coppa, K.R.,& Greenwood, J.S. (2006). Effective shade structures. Med J Aust, 184(8), 423. Turnbull, D.J., & Parisi, A.V. (2006). Effective shade structures. Med J Aust,184(1), 13-5. Cam Escoffery, Karen Glanz, and Tom Elliott (2008) Process evaluation of the Pool Cool Diffusion Trial for skin cancer prevention across 2 years Health Education Research Health Educ. Res. 2008 23: 732-743; doi:10.1093/her/cym060	Policy Resources Guidelines to Prevent Skin Cancer (US Centers for Disease Control & Prevention) These guidelines were designed to provide schools with a comprehensive approach to preventing skin cancer among adolescents and young people. CDC worked with specialists in dermatology, pediatrics, public health, and education from universities; national, federal, state, and voluntary agencies; schools; and other organizations to develop these guidelines. School Sun-Safety Policy Development Resources (California Dept of Health) One-page list of skin cancer prevention policy templates and background information for use in school settings. Sample School Board Policy on Sun Safety Sample policy from the Los Angeles Metropolitan Dermatological Society Instructional Resources Sunny Days Healthy Ways (Canadian Best Practices Portal) This skin cancer prevention curriculum is a comprehensive course for children in Grades 4, 5, and 6. The five-session curriculum presents material from science, history, social studies, health and geography in a comprehensive and cause-and-consequence presentation about the relationship between humans and the sun Sunsense Quiz (Canadian Cancer Society) How much do you really know about sun protection and skin cancer?Test your knowledge. Environment Canada – UV Index and Sun Protection This bilingual site provides information on the UV Index, North American and Caribbean forecasts, sun protection and the UV Index Sun Awareness Program for students. Fortune teller: A fun resource for primary school age children (BC Cancer Society) This resource provides general information for primary school age children on healthy sun-safe lifestyles and risk reduction, not skin cancer. Instruction for assembly of the resource is included. Sun Safety Learning Activity Package (Cancer Care Nova Scotia) This package is a compilation of learning activities developed by recognized leaders in sun safety and skin cancer prevention.They are intended to be used with students to raise awareness and educate on the importance of sun safety practices. Sun Safety Teaching Materials (California Dept of Health) Two-page list of skin cancer prevention curriculums, resource guides, videos, and UV-reactive promotional items designed for use to instruct pre-school children through age 12. Sunsmart Online Teacher Training (Western Australia) Professional development for early childhood, primary and secondary teachers and school health nurses. Sunsmart Online Student Module (Western Australia) Online interactive student education. Sunny Days Healthy Ways - Elementary School (Grades K-5) Designed to increase awareness and promote sun protection behavior and practices among K-5th grade students. Health and Other Services Interventions Educators Guide to Childhood Cancer Written by Curriculum Services Canada, and carrying their seal of approval, this is a very informative and well-crafted website for educators and parents of children with cancer. However, we wish for it to become well-known and used in Canadian schools. Statistics show that 1 in 400 children will have cancer before the age of 18, which is why we believe it is so important that teachers become educated about the many needs of a child suffering this disease, as well as how to support their siblings, classmates and other members of the community. Most teachers are unprepared for having children with cancer, and do not anticipate the changes in learning that they will face. For example, aggressive cancer treatment can often cause learning disabilities in children, which must be dealt with accordingly by teachers. Social Support Interventions Health Canada – Smart Summer Fun This bilingual site gives tips on how to be smart while having fun this summer in Canada. There are sections on air quality, sun safety and skin cancer, playing safe, food and drink and enjoying the great outdoors. The Summer Fun quiz tests your knowledge on smart summer fun. Pool Cool (Canadian Best Practices Portal) This pool-based program can be used with schools andf after school programs. It aims to increase sun-protection habits in parents, swimming instructors and children. Its main objective is to increase awareness, motivation, and sun protection practices among children ages 5-10 who take swimming lessons, their parents, aquatics staff, and other pool users Choose Your Cover The Choose Your Cover Campaign was a five–year skin cancer prevention and education campaign sponsored by the United States Department of Health and Human Services (DHHS) and the Centers for Disease Control and Prevention (CDC). Although campaign activities concluded in May 2003, some campaign materials are still available online. Successful School-Based Skin Cancer Prevention Activities (California Dept of Health) Discover what award winning schools do to integrate sun-safety activities. Together for Sun Safety Interventions oriented to children's parents and caregivers. Awareness building and Behavior Modification. Physical Environment Interventions Shade Planning for America's Schools* [pdf 1Mb]. This manual was created to support school communities in their implementation of CDC's Guidelines for School Programs to Prevent Skin Cancer, and can help district school health or wellness councils, and school health teams, ensure that school grounds have adequate shade. Healthy School Environments Assessment Tool (Environmental Protection Agency) The Healthy School Environments Assessment Tool (HealthySEATv2) is a fully customizable and easy to use software program designed to help school districts evaluate and manage ALL of their environmental, safety and health issues.

Research

Reports & Resources

Policy Interventions

Buller, D., Buller, M.K., & Reynolds, K. (2006). A survey of sun protection policy and education in secondary schools. Journal of the American Academy of Dermatology, 54(3), 427–432.
Dobbinson, S., Peipers, A., Borland, R., & Nolan, K. (2000). Are Victorian primary schools Sunsmart? Health Promotion Journal of Australia, 10, 43–50
Eakin, P., Maddock, J., Techur-Pedro, A., Kaliko, R., & Derauf, C. (2004). Sun protection policy in elementary schools in Hawaii. Preventing Chronic Disease, 1, 1-10.
Emmons, K., Geller, A., Viswanath, V., Rutsch, L., Zwirn, J., Gorham, S., & Puleo, E. (2008). The SunWise Policy Intervention for School-Based Sun Protection: A Pilot Study. Journal of School Nursing, 24(4), 215–221.

Instructional Interventions

Bastuji-Garin, S., Grob, J.J., Grognard, C., Grosjean, F., & Guillaume, J.C. (1999). Melanoma prevention: evaluation of a health education campaign for primary schools. Arch Dermatol, 135(8), 936-40.
Collins, D.C., Kearns, R.A., Mitchell, H. (2006). "An integral part of the children's education": placing sun protection in Auckland primary schools. Health Place, 12(4):436-48. Epub 2005 Jul 1.
de Vries, H., Mesters, I., Riet, J.V., Willems, K., & Reubsaet, A. (2006). Motives of Belgian adolescents for using sunscreen: the role of action plans. Cancer Epidemiol Biomarkers Prev, 15(7), 1360-6.
Geller, A., Rutsch, L., Kenausis, K., Zhang, Z. (2003). Evaluation of the SunWise School Program. J Sch Nurs, 19(2), 93-9.
Geller, A.C., Rutsch, L., Kenausis, K., Selzer, P., & Zhang, Z.(2003) Can an hour or two of sun protection education keep the sunburn away? Evaluation of the Environmental Protection Agency's Sunwise School Program. Environ Health. 3;2(1), 13.
Harrison, S.L., Saunders, V.,& Nowak, M. (2007).Baseline survey of sun-protection knowledge, practices and policy in early childhood settings in Queensland, Australia. Health Educ Res, 22(2), 261-71. Epub 2006 Jul 31.
Miles, A., Waller, J., Hiom, S., Swanston, D. (2005). SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample. Health Educ Res, 20(5), 579-85. Epub 2005 Jan 11.
Olson AL, Gaffney CA, Starr P, Dietrich AJ (2008)
The impact of an appearance-based educational intervention on adolescent intention to use sunscreen Health Education Research 2008 23(5):763-769
Stankeviciūte V, Zaborskis A, Petrauskiene A, Valiukeviciene S. (2004) Skin cancer prevention: children's health education on protection from sun exposure and assessment of its efficiency. Medicina (Kaunas). 2004;40(4):386-93
Buller DB, Reynolds KD, Yaroch A, Cutter GR, Hines JM, Geno CR, Maloy JA, Brown M, Woodall WG, Grandpre J.(2006) Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8. Am J Prev Med. Jan;30(1):13-22.
Oncology Cooperative Group Of The Italian Group For Epidemiologic Research In Dermatology (GISED) (2003) Improving sun protection behaviour in children: study design and baseline results of a randomized trial in Italian elementary schools. The 'Sole Si Sole No GISED' project. Dermatology. 2003;207(3):291-7.

Health and Other Services Interventions

Crane, L.A., Schneider, L.S., Yohn, J.J., Morelli, J.G., Plomer, K.D. (1999). "Block the sun, not the fun": evaluation of a skin cancer prevention program for child care centers. Am J Prev Med, 17(1), 31-7.
Gritz, E.R., Tripp, M.K., de Moor, C.A., Eicher, S.A., Mueller, N.H., & Spedale, J.H. Skin cancer prevention counseling and clinical practices of pediatricians. Pediatr Dermatol. 2003 Jan-Feb;20(1):16-24
U.S. Preventive Services Task Force. (2003)
Counseling to prevent skin cancer: recommendations and rationale of the U.S. Preventive Services Task Force.MMWR Recomm Rep. 2003 Oct 17;52(RR-15):13-7

Social Support Interventions

Glanz, K., Geller, A.C., Shigaki, D., Maddock, J.E., & Isnec, M.R. (2002). A randomized trial of skin cancer prevention in aquatics settings: the Pool Cool program. Health Psychol, 21(6), 579-87.
Reding DJ, Fischer V, Gunderson P, Lappe K. (1995) Skin cancer prevention: a peer education model. Wis Med J. 1995 Feb;94(2):77-81.

Physical Environment Interventions

Coppa, K.R.,& Greenwood, J.S. (2006). Effective shade structures. Med J Aust, 184(8), 423.
Turnbull, D.J., & Parisi, A.V. (2006). Effective shade structures. Med J Aust,184(1), 13-5.
Cam Escoffery, Karen Glanz, and Tom Elliott (2008) Process evaluation of the Pool Cool Diffusion Trial for skin cancer prevention across 2 years Health Education Research Health Educ. Res. 2008 23: 732-743; doi:10.1093/her/cym060

Policy Resources

Guidelines to Prevent Skin Cancer (US Centers for Disease Control & Prevention) These guidelines were designed to provide schools with a comprehensive approach to preventing skin cancer among adolescents and young people. CDC worked with specialists in dermatology, pediatrics, public health, and education from universities; national, federal, state, and voluntary agencies; schools; and other organizations to develop these guidelines.
School Sun-Safety Policy Development Resources
(California Dept of Health) One-page list of skin cancer prevention policy templates and background information for use in school settings.
Sample School Board Policy on Sun Safety
Sample policy from the Los Angeles Metropolitan Dermatological Society

Instructional Resources

Sunny Days Healthy Ways (Canadian Best Practices Portal) This skin cancer prevention curriculum is a comprehensive course for children in Grades 4, 5, and 6. The five-session curriculum presents material from science, history, social studies, health and geography in a comprehensive and cause-and-consequence presentation about the relationship between humans and the sun
Sunsense Quiz (Canadian Cancer Society)
How much do you really know about sun protection and skin cancer?Test your knowledge.

Environment Canada – UV Index and Sun Protection This bilingual site provides information on the UV Index, North American and Caribbean forecasts, sun protection and the UV Index Sun Awareness Program for students.

Fortune teller: A fun resource for primary school age children (BC Cancer Society) This resource provides general information for primary school age children on healthy sun-safe lifestyles and risk reduction, not skin cancer. Instruction for assembly of the resource is included.

Sun Safety Learning Activity Package (Cancer Care Nova Scotia) This package is a compilation of learning activities developed by recognized leaders in sun safety and skin cancer prevention.They are intended to be used with students to raise awareness and educate on the importance of sun safety practices.

Sun Safety Teaching Materials (California Dept of Health) Two-page list of skin cancer prevention curriculums, resource guides, videos, and UV-reactive promotional items designed for use to instruct pre-school children through age 12.

Sunsmart Online Teacher Training (Western Australia)
Professional development for early childhood, primary and secondary teachers and school health nurses.

Sunsmart Online Student Module (Western Australia)
Online interactive student education.

Sunny Days Healthy Ways - Elementary School (Grades K-5) Designed to increase awareness and promote sun protection behavior and practices among K-5th grade students.

Health and Other Services Interventions

Educators Guide to Childhood Cancer
Written by Curriculum Services Canada, and carrying their seal of approval, this is a very informative and well-crafted website for educators and parents of children with cancer. However, we wish for it to become well-known and used in Canadian schools. Statistics show that 1 in 400 children will have cancer before the age of 18, which is why we believe it is so important that teachers become educated about the many needs of a child suffering this disease, as well as how to support their siblings, classmates and other members of the community. Most teachers are unprepared for having children with cancer, and do not anticipate the changes in learning that they will face. For example, aggressive cancer treatment can often cause learning disabilities in children, which must be dealt with accordingly by teachers.

Social Support Interventions

Health Canada – Smart Summer Fun This bilingual site gives tips on how to be smart while having fun this summer in Canada. There are sections on air quality, sun safety and skin cancer, playing safe, food and drink and enjoying the great outdoors. The Summer Fun quiz tests your knowledge on smart summer fun.
Pool Cool (Canadian Best Practices Portal)
This pool-based program can be used with schools andf after school programs. It aims to increase sun-protection habits in parents, swimming instructors and children. Its main objective is to increase awareness, motivation, and sun protection practices among children ages 5-10 who take swimming lessons, their parents, aquatics staff, and other pool users
Choose Your Cover The Choose Your Cover Campaign was a five–year skin cancer prevention and education campaign sponsored by the United States Department of Health and Human Services (DHHS) and the Centers for Disease Control and Prevention (CDC). Although campaign activities concluded in May 2003, some campaign materials are still available online.
Successful School-Based Skin Cancer Prevention Activities (California Dept of Health) Discover what award winning schools do to integrate sun-safety activities.
Together for Sun Safety Interventions oriented to children's parents and caregivers. Awareness building and Behavior Modification.

Physical Environment Interventions

Shade Planning for America's Schools* [pdf 1Mb]. This manual was created to support school communities in their implementation of CDC's Guidelines for School Programs to Prevent Skin Cancer, and can help district school health or wellness councils, and school health teams, ensure that school grounds have adequate shade.
Healthy School Environments Assessment Tool
(Environmental Protection Agency) The Healthy School Environments Assessment Tool (HealthySEATv2) is a fully customizable and easy to use software program designed to help school districts evaluate and manage ALL of their environmental, safety and health issues.

Use of Evidenced-based Implementation Strategies

This sub-section examines the use of research-based implementation strategies drawn from health promotion (eg PRECEDE planning model) or education (eg Concerns-based Adoption Model). We also looked for references and resources that described the use of "local mechanisms" such as training champions or truly engaging staff. As well, we looked to items that examined "local drivers" of change/resistance such provincial directives, local incidents or local personalities/relationships. This sub-section also examines system, agency, school and professional capacity in areas such as coordinated policy, mechanisms for cooperation, assigning staff to coordination, regular monitoring and reporting, workforce development, planning for sustainability and strategic management of issues. We also looked to adaptations to local community contexts or higher risk populations.

Preliminary Findings:

The state of research on school sun safety is similar to other health issues in that it is just now that researchers are turning their attention to implementation and sustainability issues
Not surprisingly, and similar to other physical health issues and social behaviours, our preliminary search identified some research and measurement issues that are relevant to the school setting. Essentially, these issues revolve around the reliability of self-reporting of social behaviours and then technicalities related to measuring a physical change in health status

Research	Reports & Resources
Use of Diffusion and Education Change Knowledge/Theory Escoffery, C., Glanz, K., & Elliott, T. (2008). *Process evaluation of the Pool Cool* Diffusion Trial for skin cancer prevention across 2 years .Health Educ. Res, 23, 732-743 Use of Capacity-Building Knowledge/Theory and Sustainability** Milne E, Jacoby P, Giles-Corti B, Cross D, Johnston R, English DR.(2006) The impact of the kidskin sun protection intervention on summer suntan and reported sun exposure: was it sustained? Prev Med. Jan;42(1):14-20. Epub 2005 Dec 5. Buller, D.B., Geller, A.C., Cantor, M., Buller, M.K., Rosseel, K., Hufford, D., Benjes, L.,& Lew, R.A. (2002). Sun protection policies and environmental features in US elementary schools. Arch Dermatol, 138(6), 771-4. Gritz, E.R., Tripp, M.K., James, A.S., Harrist, R.B., Mueller, N.H., Chamberlain, R.M., & Parcel, G.S. Effects of a preschool staff intervention on children's sun protection: outcomes of sun protection is fun! Health Educ Behav, 34(4), 562-77. Epub 2006 May 31. Harrison, S.L., Saunders, V., & Nowak, M. (2007). Baseline survey of sun-protection knowledge, practices and policy in early childhood settings in Queensland, Australia. Health Educ Res, 22(2), 261-71. Epub 2006 Jul 31. Horsley, L., Charlton, A., & Waterman C. (2002). Current action for skin cancer risk reduction in English schools: pupils' behaviour in relation to sunburn. Health Educ Res, 17(6),715-31. Horsley, L., Charlton, A., Wiggett, C. (2000).Current action for skin cancer risk reduction in English schools: a report on a survey carried out for the Department of Health. Health Educ Res, 15(3), 249-59. Morris, J.M., Gould, D., Bennett, S., Bastin, J., Salter, L., & Watt, A. (2005). Sun protection initiatives in Cornwall. Clin Exp Dermatol. 30(4), 340-3. Nyiri PSun protection in Singapore's schools. Singapore Med J. 2005 Sep;46(9):471-5 Geller AC, Cantor M, Miller DR, Kenausis K, Rosseel K, Rutsch L, Brooks DR, Zhang Z, Demierre MF (2002) The Environmental Protection Agency's National SunWise School Program: sun protection education in US schools (1999-2000). J Am Acad Dermatol. 2002 May;46(5):683-9 Horsley L, Charlton A, Waterman C.(2002) Current action for skin cancer risk reduction in English schools: pupils' behaviour in relation to sunburn. Health Educ Res. 2002 Dec;17(6):715-31. Consideration of Ecology and System Characteristics Reynolds, K., Buller, D., Yaroch, A., Maloy, J., & Cutter, G. (2005). Mediation of a middle school skin cancer prevention program. Health Psychology, 5, 616-625 Consideration of Different Community, Cultural Contexts Questions related to Future and Current Research Dusza, S.W., Oliveria, S.A., Geller, A.C., Marghoob, A.A., & Halpern, A.C. (2005). Student-parent agreement in self-reported sun behaviors. J Am Acad Dermatol, 52(5), 896-900. Gies, P., & Mackay, C. (2004). Measurements of the solar UVR protection provided by shade structures in New Zealand primary schools. Photochem Photobiol, 80(2), 334-9. Milne, E., Corti, B., English, D.R., Cross, D., Costa, C.,& Johnston, R. (1999). The use of observational methods for monitoring sun-protection activities in schools. Health Educ Res, 14(2), 167-75. Milne, E., English, D.R., Corti, B., Cross, D., Borland, R., Gies, P., Costa, C.,& Johnston, R. (1999). Direct measurement of sun protection in primary schools. Prev Med. 29(1),45-52. Yaroch, A.L., Reynolds, K.D., Buller, D.B., Maloy, J.A.,& Geno, C.R. (2006). Validity of a sun safety diary using UV monitors in middle school children. Health Educ Behav, 33(3), 340-51. Milne, E., English, D., Corti, B., Cross, D., Borland, R., Gies, P., et al. (1999). Direct measurement of sun protection in primary schools. Preventive Medicine, 29, 45-52.

Research

Reports & Resources

Use of Diffusion and Education Change Knowledge/Theory

Escoffery, C., Glanz, K., & Elliott, T. (2008). Process evaluation of the Pool Cool Diffusion Trial for skin cancer prevention across 2 years .Health Educ. Res, 23, 732-743

Use of Capacity-Building Knowledge/Theory and Sustainability

Milne E, Jacoby P, Giles-Corti B, Cross D, Johnston R, English DR.(2006) The impact of the kidskin sun protection intervention on summer suntan and reported sun exposure: was it sustained? Prev Med. Jan;42(1):14-20. Epub 2005 Dec 5.
Buller, D.B., Geller, A.C., Cantor, M., Buller, M.K., Rosseel, K., Hufford, D., Benjes, L.,& Lew, R.A. (2002). Sun protection policies and environmental features in US elementary schools. Arch Dermatol, 138(6), 771-4.
Gritz, E.R., Tripp, M.K., James, A.S., Harrist, R.B., Mueller, N.H., Chamberlain, R.M., & Parcel, G.S. Effects of a preschool staff intervention on children's sun protection: outcomes of sun protection is fun! Health Educ Behav, 34(4), 562-77. Epub 2006 May 31.
Harrison, S.L., Saunders, V., & Nowak, M. (2007). Baseline survey of sun-protection knowledge, practices and policy in early childhood settings in Queensland, Australia. Health Educ Res, 22(2), 261-71. Epub 2006 Jul 31.
Horsley, L., Charlton, A., & Waterman C. (2002). Current action for skin cancer risk reduction in English schools: pupils' behaviour in relation to sunburn. Health Educ Res, 17(6),715-31.
Horsley, L., Charlton, A., Wiggett, C. (2000).Current action for skin cancer risk reduction in English schools: a report on a survey carried out for the Department of Health. Health Educ Res, 15(3), 249-59.
Morris, J.M., Gould, D., Bennett, S., Bastin, J., Salter, L., & Watt, A. (2005). Sun protection initiatives in Cornwall. Clin Exp Dermatol. 30(4), 340-3.
Nyiri PSun protection in Singapore's schools. Singapore Med J. 2005 Sep;46(9):471-5
Geller AC, Cantor M, Miller DR, Kenausis K, Rosseel K, Rutsch L, Brooks DR, Zhang Z, Demierre MF (2002) The Environmental Protection Agency's National SunWise School Program: sun protection education in US schools (1999-2000). J Am Acad Dermatol. 2002 May;46(5):683-9
Horsley L, Charlton A, Waterman C.(2002) Current action for skin cancer risk reduction in English schools: pupils' behaviour in relation to sunburn. Health Educ Res. 2002 Dec;17(6):715-31.

Consideration of Ecology and System Characteristics

Reynolds, K., Buller, D., Yaroch, A., Maloy, J., & Cutter, G. (2005). Mediation of a middle school skin cancer prevention program. Health Psychology, 5, 616-625

Consideration of Different Community, Cultural Contexts

Questions related to Future and Current Research

Dusza, S.W., Oliveria, S.A., Geller, A.C., Marghoob, A.A., & Halpern, A.C. (2005). Student-parent agreement in self-reported sun behaviors. J Am Acad Dermatol, 52(5), 896-900.
Gies, P., & Mackay, C. (2004). Measurements of the solar UVR protection provided by shade structures in New Zealand primary schools. Photochem Photobiol, 80(2), 334-9.
Milne, E., Corti, B., English, D.R., Cross, D., Costa, C.,& Johnston, R. (1999). The use of observational methods for monitoring sun-protection activities in schools. Health Educ Res, 14(2), 167-75.
Milne, E., English, D.R., Corti, B., Cross, D., Borland, R., Gies, P., Costa, C.,& Johnston, R. (1999). Direct measurement of sun protection in primary schools. Prev Med. 29(1),45-52.
Yaroch, A.L., Reynolds, K.D., Buller, D.B., Maloy, J.A.,& Geno, C.R. (2006). Validity of a sun safety diary using UV monitors in middle school children. Health Educ Behav, 33(3), 340-51.
Milne, E., English, D., Corti, B., Cross, D., Borland, R., Gies, P., et al. (1999). Direct measurement of sun protection in primary schools. Preventive Medicine, 29, 45-52.

dmccall	Latest page update: made by dmccall , Jun 2 2010, 1:49 PM EDT (about this update About This Update Edited by dmccall 139 words added view changes - complete history)
	Keyword tags: None (edit keyword tags) More Info: links to this page