Motivating Public School Districts to Adopt Sun Protection Policies

Abstract

Background In 2002, CDC recommended that the nation’s schools establish policies that reduce sun exposure to decrease students’ risk of skin cancer. Purpose A program to convince public school districts to adopt such a policy was evaluated. Design RCT. Setting/Participants Public school districts in Colorado (n=56) and Southern California (n=56). Intervention Policy information, tools and technical assistance were provided through printed materials, a website, meetings with administrators, and presentations to school boards. An RCT enrolled public school districts from 2005 to 2010. Policy adoption was promoted over 2 years at districts randomized to the intervention. Main Outcome Measures School board–approved policies were obtained from 106 districts and coded at baseline and 2-year follow-up. Analyses were conducted in 2010. Results There was no difference in the percentage of districts adopting a policy (24% in intervention; 12% in control; p=0.142); however, intervention districts (adjusted M=3.10 of 21 total score) adopted stronger sun safety policies than control districts (adjusted M=1.79; p=0.035). Policy categories improved on sun safety education for students (intervention adjusted M=0.76; control adjusted M=0.43, p=0.048), provision of outdoor shade (intervention adjusted M=0.79; control adjusted M=0.28, p=0.029), and outreach to parents (intervention adjusted M=0.59; control adjusted M=0.20, p=0.027). Conclusions Multifaceted promotion can increase adoption of stronger policies for reducing sun exposure of students by public school districts. Future research should explore how policies are implemented by schools.

What strategies are used to build practitioners’ capacity to implement community-based interventions and are they effective?: a systematic review

“…Of the 12 studies that assessed adoption , four found a significant within group difference [ 22 , 24 , 26 , 40 ] and two found significant between group differences in adoption rates with the intervention group having higher rates than the comparison [ 39 , 47 ]; four additional studies found an increase in adoption following the capacity-building intervention without testing for significance [ 21 , 25 , 46 , 48 ]. Findings were mixed, however, as four studies found non-significant group differences in adoption rates [ 24 , 26 , 44 , 49 ]. Of the 11 studies that assessed effects on the extent or fidelity of implementation , all but one reported that capacity building had a positive effect.…”

Skin cancer interventions across the cancer control continuum: Review of technology, environment, and theory

“…These types of interventions often take place in school settings and can involve constructing shade structures. 18, 51 Because schools often do not have policies that facilitate sun safety, built environment and policy interventions in school settings could have a major impact on skin cancer outcomes. 52 Policies at workplaces—particularly those involving outdoor work such as ski slopes or zoos—were targeted in relatively few interventions.…”

“…12, 17 Examining multiple types of environmental manipulations promotes understanding of these initiatives within the context of skin cancer behavioral change interventions. 18–20…”

A Randomized Trial of an Advanced Sun Safety Intervention for Vacationers at 41 North American Resorts

“…Given the limited effectiveness of directly intervening with individuals, an alternative approach may be to address policy and environmental features of resorts. Studies of school and occupational sun safety have found that senior managers can be convinced to adopt sun protection policies (Buller, Walkosz, Buller, & Wallis, 2015, December; Buller, Reynolds, et al, 2011), which could overcome detrimental effects of management turnover or varied commitment of managers to sun safety. Encouraging resorts to provide shade structure also may attract vacationers to use shaded areas (Dobbinson et al, 2014; Dobbinson et al, 2009).…”