Despite widespread information about sunscreen, surveys indicated that nearly half of U.S. children under the age 12 experienced at least one sunburn. This two-year study evaluated Sun Protection is Fun! (S.P.F.), an intervention delivered through preschools.  The intervention includes a set of materials for parents and training for preschool staff.  S.P.F. is based on Social Cognitive Theory to influence adults’ behaviors to apply sunscreen and limit young children’s sun exposure.

Twenty preschools participated in the study.  Ten used S.P.F. and ten served as controls with a brochure on sun safety.  Staff were given training to use an educational curriculum with students, newsletters for themselves, and sunscreen products for use on students (with parent permission).  Parents received a video which modeled sun-protection practices, four newsletters, a handbook about reducing children’s exposure to sunlight, and a guide on skin cancer. A cross-sectional survey was administered to parents of children enrolled in participating preschools at the end of each summer for three years, with the first survey used as baseline information.  A separate survey assessed the staff use of sunscreen on the children at school and on field trips.

More than half of participating parents reported viewing the video (57% in year one, and 64% in year two); 74% read the handbook both years, and most read the newsletters (67% in year one, and 75% in year two).  At the end of 12 months, there were no significant differences in parents’ use of sunscreen. However, parents in the intervention group were more likely to re-apply sunscreen as recommended and practice some sun-avoidance (particularly use of hats) than the control group.  At the end of two years, preventive sunscreen use was significantly higher for intervention parents.

The intervention had a positive influence on parents’ beliefs that sunscreen use was important.  Intervention parents were more likely to recall that teachers used sunscreen on students.  Staff in intervention schools appeared more likely to increase sunscreen use.

(Gritz E.R., et al. Prev Med 2005;41:357-366)

Comment: The limited effects confirmed that take-home materials are not usually sufficient to achieve significant behavior changes. Preschools are a good setting to model desired health-protection practices, but staff contact time with parents is limited, and parent meetings are not usually well attended.  --J.O.