CONCLUSIONS
We have found that a new approach to delivering sunprotection
messages in early adolescence has an impact
on sun-protection behaviors at the community level.
Consistent messages across a number of venues and
involving teens, as well as adults, in the effort are needed
in early adolescence. We recommend that skin cancer
prevention programs for youth need to begin early in
middle school, when they are making independent
choices, and create a community-wide environment that
supports appropriate sun protection rather than focusing
on classroom health education alone. Support of a collaborative team that extends into the community from
the school is key to implementation. Implementation of
the national recommendations for school and recreational
environmental changes and formal sun-protection
policies11 would complement this intervention by
providing more shade and changing sun-protection expectations
of staff, parents, and teens at outdoor events
and sporting events.
Future research needs to address 2 types of adolescent
sun exposure: intentional and incidental sun-tanning.32
Girls are more likely than boys to be intentional tanners.
Tan seekers are also more likely to use artificial tanning
lights when they are older.33 Interventions and messages
may need to vary for these patterns of sun exposure
among boys and girls. Poor sun protection and tanseeking
are common in older adolescents. Evidencebased
interventions specific to the high school level are
lacking. Future interventions need to be developed that
are responsive to their activities, motivations, and developmental
stage.