Are Environmental Interventions Targeting Skin Cancer Prevention among Children and Adolescents Effective? A Systematic Review

Abstract

Skin cancer, which is increasing exceedingly worldwide, is substantially preventable by reducing unprotected exposure to ultraviolet radiation (UVR). Several comprehensive interventions targeting sun protection behaviors among children and adolescents in various outdoor settings have been developed; however, there is a lack of insight on stand-alone effectiveness of environmental elements. To compose future skin cancer prevention interventions optimally, identification of effective environmental components is necessary. Hence, an extensive systematic literature search was conducted, using four scientific databases and one academic search engine. Seven relevant studies were evaluated based on stand-alone effects of various types of environmental sun safety interventions on socio-cognitive determinants, sun protection behaviors, UVR exposure, and incidence of sunburns and nevi. Free provision of sunscreen was most often the environmental component of interest, however showing inconsistent results in terms of effectiveness. Evidence regarding shade provision on shade-seeking behavior was most apparent. Even though more research is necessary to consolidate the findings, this review accentuates the promising role of environmental components in skin cancer prevention interventions and provides directions for future multi-component sun safety interventions targeted at children and adolescents in various outdoor settings.

A Qualitative Exploration of Parental Perceptions Regarding Children's Sun Exposure, Sun Protection, and Sunburn

“…Second, characteristics in the physical environment, such as situations in which limited shade was available, and especially at public venues involving water, were perceived as particularly burdensome in adequately protecting children ( 22 ). Since the availability of shady areas increases the likelihood of shade-seeking behavior ( 49 , 50 ), the importance of shade at recreational areas should be recognized. Moreover, warning signs involving the current UV index, along with specific advice for sun protection measures at public venues, could be beneficial.…”

“…Moreover, as the Environmental Research Framework for Weight Gain prevention (EnRG) states, different environmental levels of influence are distinguished as well, such as micro- (i.e., family, school) and macro- (government) settings ( 48 ). With regard to sun safety interventions, adaptations in the physical environment (e.g., provision of shady areas) can trigger sun protection behavior ( 49 , 50 ). Especially since the dosage of received UVR by children is highly dependent on characteristics in the physical environment ( 51 – 53 ), insight into the environmental context affecting parental sun protection behaviors is needed.…”

A qualitative exploration of parental perceptions regarding children’s sun exposure, sun protection, and sunburn

“…Second, characteristics in the physical environment, such as situations in which limited shade was available, and especially at public venues involving water, were perceived as particularly burdensome in adequately protecting children (22). Since the availability of shady areas increases the likelihood of shade-seeking behavior (49,50), the importance of shade at recreational areas should be recognized. Moreover, warning signs involving the current UV index, along with specific advice for sun protection measures at public venues, could be beneficial.…”

“…With regard to sun safety interventions, adaptations in the physical environment (e.g. provision of shady areas) can trigger sun protection behavior (49,50). Especially since the dosage of received UVR by children is highly dependent on characteristics in the physical environment (51-53), insight into the environmental context affecting parental sun protection behaviors is needed.…”

Ação contra o câncer de pele em cidade com alto índice ultravioleta

“…Há evidência de que campanhas de conscientização sobre o tema causam impacto da infância à idade adulta nos hábitos de exposição à radiação ultravioleta (UV) e também na incidência do câncer de pele (9)(10)(11) .…”