An objective and cross-sectional examination of sun-safe behaviours in New South Wales primary schools

Abstract

BackgroundPrevious evaluations have supported the link between sun protection policies and improved sun protection behaviours. However these evaluations have relied on self-reported data.MethodsA cross-sectional design as part of an ongoing 18-month cluster-controlled trial in primary schools (n = 20) was used. Researchers conducted direct observations to record students’ hat use and teachers’ use of sun protective measures during recess and lunch. Researchers also recorded the volume of sunscreen consumed in each school.ResultsOnly 60% of primary school children wear a sun-safe hat during their breaks when observed using objective measures. Weak correlations were observed between the wearing of a sun-safe hat and a school’s socio-economic status (r = 0.26). All other independent variables measured had only very weak correlations (r < 0.19) with sun-safe hat wearing behaviour of students. Sunscreen consumption by school students during the school day is negligible.ConclusionsA large percentage of NSW primary schools in this study wear sun-safe hats during the school day but this is well below what has been reported in previous national surveys. Given the finite resources of schools and the correlation, though small, with SES status for these behaviours, it behoves researchers to investigate low-cost solutions to these problems. Further qualitative data will also be needed to inform the enablers and barriers for sun-safe behaviour interventions to be adopted in NSW primary schools.

Australian primary school communities' understandings of SunSmart: a qualitative study

“…While Sharplin and Roth 12 found that NSW primary schools were 20% more likely to make sunscreen available at special occasions, i.e. sport excursions, than in all classrooms, the findings of this study and Dudley et al 18 indicate that sunscreen consumption in NSW SunSmart schools is minimal. These findings suggest that while triggers activate an intention to engage in sun protection behaviours, the basic provision of resources is not sufficient in facilitating sun protection behaviours for all individuals.…”

“…This finding aligns with previous research highlighting the strong link between sun protection policy and hat-wearing requirements, specifically students relocating to a shaded area if a school-assigned hat wasn't worn. 13,14,16,17 However, reviews of the SSP using objective measurements have found that hat-wearing behaviour in SunSmart schools is far less than had been self-reported in other studies 18 and was comparable to schools without a SunSmart membership. 19 The findings of this research identify a number of factors that may be influencing the division between hat-wearing policy and practice.…”

“…The inconsistency among adult role modelling is evident in other studies. While Turner et al (2014) found that 89% of adult role models wore hats while outside during school hours, Dudley et al (2017) found that only 46% of adult role models wore hats while outside during school hours 18 . These variations highlight the discrepancies among adult role modelling behaviour.…”

“…However, one observational study of students' hat‐wearing practices found the SSP does not necessarily provide a statistically significant difference in this area. Dudley et al 18 found that observed hat wearing was 20% lower than hat‐wearing practices in self‐reported studies, while observations of students' and adult role models' hat‐wearing behaviour in QLD schools before, during and after school hours 19 and during school swimming carnivals 20 found that SunSmart accreditation had little influence on hat‐wearing practices. Furthermore, measurements of sunscreen consumption in NSW SunSmart schools indicate that students use far less sunscreen than current health recommendations advise 18 …”

“…Furthermore, measurements of sunscreen consumption in NSW SunSmart schools indicate that students use far less sunscreen than current health recommendations advise. 18 Health promotion research has shown that the school setting is a complex context, and that practice within the setting is frequently adjusting depending on the priorities of the school community, the resources available, and the partnerships with other groups, agencies and services (such as parents and education sectors). 21,22 Thus, these influences can affect the implementation of the SSP in school settings.…”