Randomized controlled trial evaluating an intervention supporting implementation of sun safety policies in California public elementary schools

Parent reports of sun safety communication and behaviour for students in a randomised trial on a school policy implementation intervention

“… Comparison was adjusted for 1 parent perceived importance skin cancer prevention; 2 parent perceived appearance with tan; 3 parent perceived personal risk for skin cancer; 4 complaint about wearing long‐sleeve shirts or long pants in the summer; 5 negative opinions about sunscreens; 6 parent confidence in getting children to practice sun safe behaviours; 7 parent phenotypic index; 8 family skin cancer history; 9 parent age; 10 parent ethnicity and race; 11 parent gender; 12 primary school only vs. primary and middle/high school; 13 distance in miles from School of community and Global Health; 14 total number of students enrolled; 15 total number of teachers; 16 total number of administrators; 17 student teacher ratio; 18 per cent of students in free or reduced price meals program; 19 per cent of Hispanic or Latino students; 20 per cent of Hispanic or Latino teachers; 21 per cent of Hispanic or Latino administrators; 22 per cent of White non‐Hispanic students; 23 per cent of White non‐Hispanic administrators; 24 per cent of female students. Sample size is slightly reduced when covariates are added in the models .…”

“…It is notable that the SSS intervention motivated many principals to select parent communication as a practice to implement when working with the SSS coaches, and more principals at intervention schools also reported communicating with parents about sun safety and requested parents provide sun safety resources (e.g. sunscreen and sun‐protective clothing) than principals at control schools 18 . Further, parents did not report any differences in the schools’ communication about other health and safety topics by treatment group, suggesting that the intervention increased school communication about sun safety specifically, not health and safety communication generally.…”

“…The trial has a number of strengths and weaknesses 18 . The prospective, randomised design, the high level of participation by schools (>90%) in the intervention, and the very high retention rates (>90%) ruled out several threats to validity.…”

“…The SSS intervention (see full description elsewhere 18 ) was based on Diffusion of Innovation Theory (DIT) 21 and involved trained sun safety coaches providing support to school staff for policy implementation. Coaches met with school principals, the content of the district's sun safety policy (from policy coding) was reviewed, a sun safety practice checklist was completed, information resources provided and plans formulated for implementing sun safety practices.…”

“…geographic region, 12 population density, 13 grade level, 12,13 enrolment size, 12,14 student socioeconomic status 12 and resources 15 ), very few studies have tested interventions intended to facilitate policy implementation 16,17 . Implementation of school sun safety practices in the trial are reported elsewhere 18 …”