OBJECTIVE. Rising rates of skin cancer associated with early-life sun exposure make it
important to improve adolescent sun-protection practices. Our study objective was
to determine if a multicomponent community-wide intervention could alter the
decline in sun protection that begins in early adolescence.
METHODS.A randomized, controlled trial was conducted in 10 communities to assess
the impact of the SunSafe in the Middle School Years program. The intervention
sought 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. It targeted school personnel, athletic coaches, lifeguards, and clinicians
and enlisted teens as peer advocates. 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.
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 controlsite
teens.
CONCLUSIONS. Our multicomponent model addressing adolescent sun protection
shows the power of engaging teens and adults from across the community as role
models and educators. This new ecological approach shows promise in changing
adolescent sun protection behaviors and reducing skin cancer risks.
OBJECTIVE. Rising rates of skin cancer associated with early-life sun exposure make itimportant to improve adolescent sun-protection practices. Our study objective wasto determine if a multicomponent community-wide intervention could alter thedecline in sun protection that begins in early adolescence.METHODS.A randomized, controlled trial was conducted in 10 communities to assessthe impact of the SunSafe in the Middle School Years program. The interventionsought to (1) educate and activate adults and peers to role model and activelypromote sun-protection practices and (2) create a pro–sun protection communityenvironment. It targeted school personnel, athletic coaches, lifeguards, and cliniciansand enlisted teens as peer advocates. Annual observations of cross-sectionalsamples of teens at community beach/pool sites were used to assess the impact of1 and 2 years of intervention exposure compared to grade-matched controls. Theoutcome was percent of body surface protected by sunscreen, clothing, or shade.RESULTS. Observers determined the sun protection level of 1927 adolescents entering6th to 8th grades. After 2 years of intervention exposure, adolescents at thebeach/pool in intervention communities were significantly better protected thanthose in control communities. Over 2 years, the percent of body surface areaprotected declined by 23% in the control arm but only 8% in intervention arm.After intervention, the average percent of body surface protected at interventionsites (66.1%) was significantly greater than control sites (56.8%). Teens in interventioncommunities reported sun-protection advice from more adult sources,were more likely to use sunscreen, and applied it more thoroughly than controlsiteteens.CONCLUSIONS. Our multicomponent model addressing adolescent sun protectionshows the power of engaging teens and adults from across the community as rolemodels and educators. This new ecological approach shows promise in changingadolescent sun protection behaviors and reducing skin cancer risks.
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