Prevalence and Correlates of Observed Sun Protection Behaviors Across Different Public Outdoor Settings in Melbourne, Australia

Abstract

Skin cancer prevention efforts in Australia have increasingly incorporated a focus on protection during incidental sun exposure. This complements the long-present messages promoting protection in high-risk settings and avoidance of acute intense bouts of sun exposure. Data from two waves of a cross-sectional direct observational survey was used to assess the prevalence and correlates of N = 12,083 adolescents’ and adults’ sun protection behavior (arm and leg cover, hat, sunglasses, and shade cover). Individuals were observed in public outdoor settings in Melbourne, Australia during peak ultraviolet (UV) times (11 a.m.–3 p.m.) on summer weekends. Settings included pools and beaches, parks and gardens, and for the first time in 2018, outdoor streets and cafés which may capture more incidental forms of sun exposure and represent another public setting where Australians commonly spend time outdoors. Females and older adults were consistently better protected than males and adolescents. Physical activity was strongly associated with low shade cover across settings. Weather was more strongly associated with sun protection at outdoor streets/cafes and parks/gardens than at pools/beaches but use of observed sun protection (particularly arm cover and covering hat) was low across settings. Continued public education about UV risk and its relation to weather and the seasons is needed to promote the routine use of multiple forms of sun protection during outdoor activities in peak UV times, especially among males and adolescents. Findings also highlight the importance of considering activity demands of public spaces in shade planning to optimize sun protection during outdoor activities in public spaces.

Serial Cross‐Sectional Observations of Sun‐Protective Behaviors at an Annual Outdoor Motorsport Event in Tropical Queensland, Australia

“…Interestingly females had poorer hatwearing and sleeve-wearing practices than males in this setting. While this finding mirrors that reported for incidental exposure around solar noon on weekdays in summer (12) it contrasts that reported for nonsporting events and outdoor leisure settings where females tend to be better protected than males (11,22,23), possibly reflecting the nature of this outdoor motorsport event.…”

“…This suggests that participants overreport their use of sun protection most likely to provide what they perceive to be a desirable response. Despite the objectivity, improved accuracy, and other benefits of observational studies of sun-protective behaviors, relatively few observational studies appear in the literature (10)(11)(12)(22)(23)(24)(25)(26)(27)(28).…”

High temperatures on mental health: Recognizing the association and the need for proactive strategies—A perspective

“… 87 Augmenting this, investigations advocate for the use of hats and sunglasses for supplementary outdoor protection. 88 On the environmental front, research substantiates the advantages of maintaining cool indoor spaces through mechanisms such as window shading. 22 Libraries and community centers, often equipped with air conditioning, have been established as invaluable resources for seeking respite from the heat when access is limited at home.…”

“…They specifically recommended the use of breathable materials like cotton or linen 87 . Augmenting this, investigations advocate for the use of hats and sunglasses for supplementary outdoor protection 88 . On the environmental front, research substantiates the advantages of maintaining cool indoor spaces through mechanisms such as window shading 22 .…”

Forty years of Slip! Slop! Slap! A call to action on skin cancer prevention for Australia

“…The demise of the NSPS means a combination of complementary methods is required to fill the gap in data on sun-protection knowledge, attitudes and behaviour which is essential to underpin skin cancer prevention initiatives. Cancer Council plans to continue the collection of observational data on sun-protection behaviours 24 , and data on attitudes and knowledge through representative online surveys, however the only way to now collect high-quality behavioural data on sun protection is via government population surveys that can achieve high response rates. Given skin cancer's significance as Australia's national cancer, and the considerable health and economic burdens it presents, data on sun-protection behavioural measures should be prioritised for collection in government surveys over the long term to provide vital population-level data for monitoring of behavioural risk factors for skin cancer.…”