Can an hour or two of sun protection education keep the sunburn away? Evaluation of the Environmental Protection Agency's Sunwise School Program

Geller, Alan C.; Rutsch, Linda; Kenausis, Kristin; Selzer, Paula; Zhang, Zi

doi:10.1186/1476-069x-2-13

Cited by 52 publications

(64 citation statements)

References 21 publications

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“…89 The SunWise program, developed by the US Environmental Protection Agency, is a brief, standardized sun-protection education program for use in schools. 90 SunWise has been shown to promote improvement in knowledge, intentions to play in the shade and to use sunscreen, and attitudes regarding healthiness of a tan 91 ; SunWise also is cost-effective. 92 Multicomponent, community-wide approaches have been recommended by health education experts 93 and can be effective.…”

Section: Prevention Programsmentioning

confidence: 99%

Ultraviolet Radiation: A Hazard to Children and Adolescents

Balk¹,

Binns²,

Brumberg³

et al. 2011

Pediatrics

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Ultraviolet radiation (UVR) causes the 3 major forms of skin cancer: basal cell carcinoma; squamous cell carcinoma; and cutaneous malignant melanoma. Public awareness of the risk is not optimal, overall compliance with sun protection is inconsistent, and melanoma rates continue to rise. The risk of skin cancer increases when people overexpose themselves to sun and intentionally expose themselves to artificial sources of UVR. Yet, people continue to sunburn, and teenagers and adults alike remain frequent visitors to tanning parlors. Pediatricians should provide advice about UVR exposure during healthsupervision visits and at other relevant times. Advice includes avoiding sunburning, wearing clothing and hats, timing activities (when possible) before or after periods of peak sun exposure, wearing protective sunglasses, and applying and reapplying sunscreen. Advice should be framed in the context of promoting outdoor physical activity. Adolescents should be strongly discouraged from visiting tanning parlors. Sun exposure and vitamin D status are intertwined. Cutaneous vitamin D production requires sunlight exposure, and many factors, such as skin pigmentation, season, and time of day, complicate efficiency of cutaneous vitamin D production that results from sun exposure. Adequate vitamin D is needed for bone health. Accumulating information suggests a beneficial influence of vitamin D on many health conditions. Although vitamin D is available through the diet, supplements, and incidental sun exposure, many children have low vitamin D concentrations. Ensuring vitamin D adequacy while promoting sun-protection strategies will require renewed attention to children's use of dietary and supplemental vitamin D. Pediatrics 2011;127:588-597 BACKGROUND Sunlight sustains life on earth. The sun provides warmth, is needed for photosynthesis, drives biorhythms, and promotes feelings of wellbeing, and sunlight is essential for vitamin D synthesis in skin.The sun emits ultraviolet ("above violet") radiation (UVR) waves that range from 200 to 400 nm. UVB (290 -320 nm) and UVA (320 -400 nm) rays penetrate the atmosphere and have the greatest biological significance. Solar radiation that reaches the earth's surface comprises approximately 95% UVA and 5% UVB rays. 1 Sand, snow, concrete, and water can reflect up to 85% of sunlight, thus intensifying exposure. 2 UVR can penetrate to a depth of 60 cm in water and result in significant exposure. UVA rays are relatively constant throughout the day and the year. UVB rays have greater intensity in summer than in winter, at midday than in morning or late afternoon, in

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Section: Prevention Programsmentioning

confidence: 99%

Ultraviolet Radiation: A Hazard to Children and Adolescents

Balk¹,

Binns²,

Brumberg³

et al. 2011

Pediatrics

View full text Add to dashboard Cite

show abstract

“…The SunWise program has been shown to promote improvement in knowledge, intentions to play in the shade and to use sunscreen, and attitudes regarding healthiness of a tan. 217 A recent study of the SunWise program demonstrated that every federal dollar invested in it generates $2 to $4 in public health benefits. 218…”

Section: Prevention In Schoolsmentioning

confidence: 99%

Ultraviolet Radiation: A Hazard to Children and Adolescents

Balk¹

2011

Pediatrics

248

141

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Sunlight sustains life on earth. Sunlight is essential for vitamin D synthesis in the skin. The sun's ultraviolet rays can be hazardous, however, because excessive exposure causes skin cancer and other adverse health effects. Skin cancer is a major public health problem; more than 2 million new cases are diagnosed in the United States each year. Ultraviolet radiation (UVR) causes the 3 major forms of skin cancer: basal cell carcinoma; squamous cell carcinoma; and cutaneous malignant melanoma. Exposure to UVR from sunlight and artificial sources early in life elevates the risk of developing skin cancer. Approximately 25% of sun exposure occurs before 18 years of age. The risk of skin cancer is increased when people overexpose themselves to sun and intentionally expose themselves to artificial sources of UVR. Public awareness of the risk is not optimal, compliance with sun protection is inconsistent, and skin-cancer rates continue to rise in all age groups including the younger population. People continue to sunburn, and teenagers and adults are frequent visitors to tanning parlors. Sun exposure and vitamin D status are intertwined. Adequate vitamin D is needed for bone health in children and adults. In addition, there is accumulating information suggesting a beneficial influence of vitamin D on various health conditions. Cutaneous vitamin D production requires sunlight, and many factors complicate the efficiency of vitamin D production that results from sunlight exposure. Ensuring vitamin D adequacy while promoting sun-protection strategies, therefore, requires renewed attention to evaluating the adequacy of dietary and supplemental vitamin D. Daily intake of 400 IU of vitamin D will prevent vitamin D deficiency rickets in infants. The vitamin D supplementation amounts necessary to support optimal health in older children and adolescents are less clear. This report updates information on the relationship of sun exposure to skin cancer and other adverse health effects, the relationship of exposure to artificial sources of UVR and skin cancer, sun-protection methods, vitamin D, community skincancer-prevention efforts, and the pediatrician's role in preventing skin cancer. In addition to pediatricians' efforts, a sustained public health effort is needed to change attitudes and behaviors regarding UVR exposure. Pediatrics 2011;127:e791-e817 BACKGROUND Sunlight sustains life on earth. The sun provides warmth, is needed for photosynthesis, drives biorhythms, and promotes feelings of well-being, and sunlight is essential for vitamin D synthesis in skin.Sophie J. Balk, MD, and the COUNCIL ON ENVIRONMENTAL HEALTH and SECTION ON DERMATOLOGY

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“…They have been shown to improve patient knowledge, but not enough to change relevant behaviors. [11][12][13] It is well known, for example, Cédric Rat, MD 1,2 Gaelle Quereux, MD that awareness of the risks associated with tanning beds does not prevent the use of such equipment. 14 Various factors promoting behavior changes have been described from a theoretical perspective in the literature.…”

Section: Introductionmentioning

confidence: 99%

Targeted Melanoma Prevention Intervention: A Cluster Randomized Controlled Trial

Rat¹,

Quéreux²,

Rivière³

et al. 2014

The Annals of Family Medicine

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PURPOSE Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives. We aimed to assess the effect of such an intervention on patient prevention behavior. METHODSWe conducted a pilot clustered randomized controlled trial, comparing a targeted screening and education intervention with a conventional information-based campaign in 20 private surgeries in western France. In the intervention group, 10 general practitioners identified patients at elevated risk for melanoma with a validated assessment tool, the Self-Assessment Melanoma Risk Score (SAMScore), examined their skin, and counseled them using information leaflets. In the control group, 10 general practitioners displayed a poster and the leaflets in their waiting room and examined patients' skin at their own discretion. The main outcome measures were sunbathing and skin self-examinations among patients at elevated risk, assessed 5 months later with a questionnaire.RESULTS Analyses were based on 173 patients. Compared with control patients, intervention patients were more likely to remember the campaign (81.4% vs 50.0%, P = .0001) and to correctly identify their elevated risk of melanoma (71.1% vs 42.1%, P = .001). Furthermore, intervention patients had higher levels of prevention behaviors: they were less likely to sunbathe in the summer (24.7% vs 40.8%, P = .048) and more likely to have performed skin self-examinations in the past year (52.6% vs 36.8%, P = .029). The intervention was not associated with any clear adverse effects, although there were trends whereby intervention patients were more likely to worry about melanoma and to consult their general practitioner again about the disease. CONCLUSIONSThe combination of use of the SAMScore and general practitioner examination and counseling during consultations is an efficient way to promote patient behaviors that may reduce melanoma risk. Extending the duration of follow-up and demonstrating an impact on morbidity and mortality remain major issues for further research.

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Can an hour or two of sun protection education keep the sunburn away? Evaluation of the Environmental Protection Agency's Sunwise School Program

Cited by 52 publications

References 21 publications

Ultraviolet Radiation: A Hazard to Children and Adolescents

Ultraviolet Radiation: A Hazard to Children and Adolescents

Ultraviolet Radiation: A Hazard to Children and Adolescents

Targeted Melanoma Prevention Intervention: A Cluster Randomized Controlled Trial

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