SunSafe

Categories

Categories associated with best practice:

  • Community
  • Individual
  • Organization
  • Young Adult (ages 19-24) icon
  • Adult (ages 25-64) icon
  • Community/ Neighbourhood
  • Health Care Setting
  • Recreation/ Fitness/ Sport Facilities

Determinants of Health: Personal health practices and coping skills, Education, literacy and life-long learning, Social environments

Overview

Objective: The SunSafe program aims to (1) educate and activate adults and peers to role model and actively promote sun-protection practices and (2) create a pro–sun protection community environment.

Population/Setting: This intervention targets school personnel, athletic coaches, lifeguards, and clinicians and enlisted teens as peer advocates.

Methods: A randomized, controlled trial was conducted in 10 communities to assess the impact of the SunSafe in the Middle School Years program. Annual observations of cross-sectional samples of teens at community beach/pool sites were used to assess the impact of 1 and 2 years of intervention exposure compared to grade-matched controls. The outcome was percent of body surface protected by sunscreen, clothing, or shade.

Key Results: Observers determined the sun protection level of 1927 adolescents entering 6th to 8th grades. After 2 years of intervention exposure, adolescents at the beach/pool in intervention communities were significantly better protected than those in control communities. Over 2 years, the percent of body surface area protected declined by 23% in the control arm but only 8% in intervention arm. After intervention, the average percent of body surface protected at intervention sites (66.1%) was significantly greater than control sites (56.8%). Teens in intervention communities reported sun-protection advice from more adult sources, were more likely to use sunscreen, and applied it more thoroughly than control- site teens.

Primary Source Document

A Olson, C Gaffney, P Starr, J Gibson, B Cole, A Dietrich, SunSafe in the middle school years: A community-wide intervention to change early-adolescent sun protection Pediatrics, 119(1), e247-e256

Contact information of developer(s) and/or implementer(s)

A Olson, MD, Department of Pediatrics, Dartmouth Hitchcock Medical Center, HB7450, 1 Medical Center Dr, Lebanon, NH 03756. E-mail: ardis. olson@dartmouth.edu

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Educate and activate adults and peers to role model and actively promote sun-protection practices
  • Community level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Create a pro-sun protection community environment
  • Community level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Sun Safety

Risk Reduction

    Specific Activities of the Intervention

    • Create a community coalition
    • Educational health information offered
    • Information sessions offered about a risk factor or condition
    • Community event/forum
    • Group process/program
    • Other training session
    • Modifying natural/built environments

    Priority/Target Population for Intervention Delivery

    Life Stage

    • Youth (age 13-18 years)
    • Adults (age 25-64 years)

    Settings

    Educational Settings

    • Secondary/Middle school

    Community Setting

    • Community/neighbourhood
    • Health care setting
    • Recreation/fitness/sport facilities

    Outcomes

    Outcomes and Impact Chart
    Level of ImpactDescription of OutcomeEquity Focus
    Community LevelEducation and activation of adults and peers to role model and actively promote sun-protection practices - After 2 years, 36.1% of intervention subjects were well protected versus 12.8% of controls (P ???? .001). It was found that sunscreens with an SPF of ????15 were widely used in the region. Use of a sunscreen with an SPF >15 increased from 75% to 84% over the project period without significant differences between the intervention and control communities. Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
    Community LevelCreation of a pro-sun protection community environment - The advice from adults in the school increased after 2 years of intervention exposure (baseline: 53%; year 1: 52%; year 2: 64.3%) but declined in control communities (baseline: 55.7%; year 1: 41.3%; year 2: 14.3%), with significant differences between study arms after 1 (P <. 01) and 2 (P <. 001) years. Recall of coach advice declined for control teens (baseline: 16%; year 1: 12%; year 2: 2%) but increased for intervention-site youth (baseline: 13%; year 1: 17.5%; year 2: 20%) (P < .05 [year 1] and P < .0001 [year 2]). Recall of clinician advice did not differ between study arms after 1 year but was more likely after 2 years for teens in the intervention communities (25.3% [intervention] vs 10.5% [control]; P < .001).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.

    Adaptability

    Implementation History

    • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

    Expertise Required for Implementation within the Context of the Intervention

    • Requires specialized skills that are easily available within the context - The intervention requires the participation of personnel with advanced skills (e.g. medical doctors, epidemiologists, social workers) but that are easily available within the intervention context.

    Are there supports available for implementation

    No.

    Are there resources and/or products associated with the interventions

    Yes. Training materials, promotion materials (bookmarks, posters), sunscreen, the Dermascan (a portable device that provides a darkened environment with a mirror to view skin changes not visible under normal light), the Environmental Protection Agency’s SunWise curriculum materials.