Sun protection intervention effective at schools, not at home

A sun-protection intervention program aimed at increasing wide-brimmed hat use among fourth-grade students was successful while students were at school; however, the intervention had no effect on self-reported use of hats outside of school or on measures of skin pigmentation, according to data from the Sun Protection of Florida’s Children study.

Twenty-two schools in Hillsborough County, Fla., were randomly assigned to one of two groups: an intervention (n=1,029) or control group (n=1,366). Intervention schools were assigned classroom sessions that targeted sun protection attitudes and social norms. Students at the intervention schools received two wide-brimmed hats.

Researchers measured hat use during school by direct observation; hat use outside of school was measured by self-report. Primary outcome measure was to promote hat use both during school and outside of school between August 2006 and May 2007.

The researchers also examined the possible physiological effects of hat use in a subgroup of 378 students (178 in the intervention group and 200 in the control group) who underwent serial measurements of skin pigmentation.

When compared with students observed wearing hats at control schools (2% at baseline; none during fall; and 1% during spring), the number of students wearing hats at intervention schools increased significantly from 2% at baseline to 30% during the fall and 41% during the spring (P<.001). Yet, hat use varied among intervention schools. For example, during the spring, hat use ranged from 19.1% to 74.6%.

Neither self-reported use of hats outside of school nor measures of skin pigmentation significantly changed during the study period (control schools: 14% at baseline to 14% during the fall and 11% during the spring vs. intervention: 24% at baseline to 24% during the fall and 23% during the spring).

Hunter S. J Natl Cancer Inst. 2010;102:484-492.

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