Skin Cancer Prevention for Children: A Critical Review

1999 ◽  
Vol 26 (3) ◽  
pp. 317-343 ◽  
Author(s):  
David B. Buller ◽  
Ron Borland
Keyword(s):  
Skin Cancer ◽  
Target Population ◽  
Sun Protection ◽  
Self Report ◽  
Skin Cancer Prevention ◽  
Future Research ◽  
Sun Safety ◽  
Innovative Strategies ◽  
Health Authorities ◽  
Positive Correlations

Increasing sun protection for children may reduce their risk for skin cancer, so many health authorities recommend comprehensive sun safety for children. Sun protection of children in North America and Europe is generally lower than desired and lower than in Australia. This article provides a critical reviewof evaluations on the effects of 24 sun protection programs for children under age 14. Programs are classified based on the target population, setting, and features. Most programs improved sun safety knowledge, but changes in sun protection attitude and behaviors were smaller. Multiunit presentations were more effective than short-duration presentations. Peer education was effective but needs further evaluation. Some programs for parents have been shown to increase sun protection for children. Strategies to improve sun safety policies need further study. A few community-wide programs have effectively improved sun protection. Future research should address innovative strategies and issues of design and measurement. There is no gold standard for measuring sun protection behavior, but self-report, prospective diaries, and observational techniques show small positive correlations.

A qualitative exploration of parental perceptions regarding children’s sun exposure, sun protection, and sunburn

2020 ◽  
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rowan Drittij ◽  
Hein de Vries ◽  
Francine Schneider
Keyword(s):  
Skin Cancer ◽  
Sun Exposure ◽  
Structured Interview ◽  
Sun Protection ◽  
Parental Perceptions ◽  
Skin Cancer Prevention ◽  
Protection Measure ◽  
Sun Safety ◽  
Protection Measures ◽  
Lack Of Knowledge

Sun protection among children is of utmost importance since sunburn in early life is a major risk factor for skin cancer development. Because parents play a vital role in enhancing sun safety among children, this study explored parental perceptions concerning sun exposure, sun protection behaviors, and sunburn in children. Additionally, the context in which children experience sunburn in order to assist the development, optimization, and targeting of sun safety interventions for parents is revealed.A qualitative study design, using a semi-structured interview guide addressing several themes (e.g. sun exposure, sun protection, and sunburn experiences), was used. Data were collected in the Netherlands in the fall of 2019. Parents were recruited via purposive sampling at schools, youth services centers, and social media. In total, 26 interviews were performed. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d =.84). Comprehensive findings concerning various themes were retrieved. It was found that sunburn was frequently prevalent among children, even though all parents reported using at least one sun protection measure. Parents were often unaware of their child’s sunburn and its severity. Regarding sun protection measures, parents demonstrated an overreliance on sunscreen, often failing to adequately protect their children’s skin. Water-related activities, a lack of shade, and lack of knowledge regarding UV-index were often related to sunburn. Moreover, unexpected sun exposure or longer exposure duration than initially planned were reported as challenging situations. The majority of parents had positive perceptions regarding tanned skin for both themselves as for children.This study provides directions for future skin cancer prevention efforts targeted at both parents and their children. Since a lack of knowledge regarding sufficient sun protection measures and sunburn occurrence in various situations was reported, educational efforts are warranted. Additionally, focusing on clothing, shade-seeking, and adequate sunscreen use is recommended to increase children’s sun safety. By intervening in the physical environment as well (e.g. providing shady areas), sun protection barriers can be reduced. Lastly, the general positive attitude toward tanned skin evident in this study is certainly worthy of attention in future interventions.

Identification of socio-cognitive determinants of parental sun protection behaviors to optimize intervention development

2020 ◽  
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rik Crutzen ◽  
Hein de Vries ◽  
Francine Schneider
Keyword(s):  
Skin Cancer ◽  
Self Efficacy ◽  
Sun Exposure ◽  
Action Planning ◽  
Later Life ◽  
Sun Protection ◽  
Survey Study ◽  
Skin Cancer Prevention ◽  
Sun Safety ◽  
Cognitive Determinants

Background: Adequate sun safety during childhood is crucial for decreasing skin cancer risk in later life. Although parents are an essential target group in applying sun protection measures for their children, interventions are often not directed at parents. This study identifies the most relevant determinants in predicting parental sun protection intentions and behaviors to provide guidance for future intervention development.Methods: A longitudinal survey study with two measurements was conducted among Dutch parents (N=670) of children (4-12 years old). Twenty-seven socio-cognitive determinants were examined in terms of relevance regarding four parental sun protection behaviors in different sun exposure situations. The CIBER approach was used to visualize room for improvement (sample means) on all determinants and their association strengths (correlations) with sun protection intentions and behaviors.Results: Behavior-specific rather than generic determinants were most relevant in explaining all sun protection behaviors. Of these determinants, attitude, self-efficacy and action planning, and especially parental feelings of difficulty in performing sun protection behaviors, were most relevant. Altogether, the explained variance of all socio-cognitive determinants was highest for shade-seeking behavior (R2= .41 and .43) and lowest for supportive behavior (R2=.19 and .29) in both planned and incidental sun exposure situations respectively.Discussion: This study provides detailed insight into relevant socio-cognitive determinants of parental sun protection behaviors in various sun exposure situations. This insight provides guidance for composing parental skin cancer prevention interventions. Future composition of sun safety interventions should emphasize on enhancing parental feelings of self-efficacy, especially for shade-seeking and clothing behaviors.

scholarly journals Identification of Relevant Sociocognitive Determinants Explaining Multiple Parental Sun Protection Behaviors

2021 ◽  
pp. 109019812110104
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rik Crutzen ◽  
Hein de Vries ◽  
Francine Schneider
Keyword(s):  
Skin Cancer ◽  
Self Efficacy ◽  
Sun Exposure ◽  
Later Life ◽  
Sun Protection ◽  
Survey Study ◽  
Skin Cancer Prevention ◽  
Sun Safety ◽  
And Behaviors ◽  
Insight Into

Background Adequate sun safety during childhood is crucial for decreasing skin cancer risk in later life. Although parents are an essential target group in applying sun protection measures for their children, insight into the determinants associated with their sun protection behaviors is limited. Aims This study aims to identify the most relevant determinants in predicting multiple parental sun protection intentions and behaviors in different sun exposure situations. Method A longitudinal survey study with two measurements was conducted among Dutch parents ( N = 670) of children (4–12 years old). Twenty-seven sociocognitive determinants were examined in terms of relevance regarding four parental sun protection behaviors in different sun exposure situations. The Confidence Interval-Based Estimation of Relevance approach was used to visualize room for improvement (sample means) on all determinants and their association strengths (correlations) with sun protection intentions and behaviors. Results Behavior-specific rather than generic determinants were most relevant in explaining all sun protection behaviors. Of these determinants, attitude, self-efficacy and action planning, and especially parental feelings of difficulty in performing sun protection behaviors, were most relevant. Altogether, the explained variance of all sociocognitive determinants was highest for shade-seeking behavior ( R2 = .41 and .43) and lowest for supportive behavior ( R2 = .19 and .29) in both planned and incidental sun exposure situations, respectively. Discussion This study provides detailed insight into relevant sociocognitive determinants of parental sun protection behaviors in various sun exposure situations and directions for composing parental skin cancer prevention interventions. Conclusions Future composition of sun safety interventions should emphasize on enhancing parental feelings of self-efficacy, especially for shade-seeking and clothing behaviors.

scholarly journals A Qualitative Exploration of Parental Perceptions Regarding Children's Sun Exposure, Sun Protection, and Sunburn

2021 ◽  
Vol 9 ◽  
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rowan Drittij ◽  
Hein de Vries ◽  
Francine Schneider
Keyword(s):  
Skin Cancer ◽  
Sun Exposure ◽  
Structured Interview ◽  
Sun Protection ◽  
Parental Perceptions ◽  
Skin Cancer Prevention ◽  
Protection Measure ◽  
Sun Safety ◽  
Protection Measures ◽  
Uv Index

Sun protection among children is of utmost importance since sunburn in early life is a major risk factor for skin cancer development. Because parents play a vital role in enhancing sun safety among children, this study explored parental perceptions concerning sun exposure, sun protection behaviors, and sunburn in children. Additionally, the context in which children experience sunburn in order to assist the development, optimization, and targeting of sun safety interventions for parents is revealed. A qualitative study design, using a semi-structured interview guide addressing several themes (e.g., sun exposure, sun protection, and sunburn experiences), was used. Data were collected in the Netherlands in the fall of 2019. Parents were recruited via purposive sampling at schools, youth services centers, and social media. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d = 0.84). In total, 26 interviews were performed (n = 17 mothers, n = 17 daughters, aged between 4 and 11 years). Parental perceptions and recall of their child's lifetime sunburn were frequent, even though all parents reported using at least one sun protection measure during sun exposure situations and parents seemed often unaware of their child's sunburn. Moreover, parents reported an overreliance on sunscreen, often failing to adequately protect their children's skin. Water-related activities, a lack of shade, and misconceptions regarding UV-index were often related to sunburn. In addition, unexpected sun exposure or longer exposure duration than initially planned were reported as challenging situations. The majority of parents had positive perceptions regarding tanned skin for both themselves as for children. This study provides directions for skin cancer prevention efforts targeted at both parents and their children. Since a lack of knowledge regarding sufficient sun protection measures and sunburn occurrence in various situations was reported, educational efforts are warranted. Additionally, focusing on clothing, shade-seeking, and adequate sunscreen use is recommended to increase children's sun safety. By intervening in the physical environment as well (e.g., providing shady areas), sun protection barriers can be reduced. Lastly, the general positive attitude toward tanned skin evident in this study is certainly worthy of attention in future interventions.

scholarly journals Are Environmental Interventions Targeting Skin Cancer Prevention among Children and Adolescents Effective? A Systematic Review

2020 ◽  
Vol 17 (2) ◽  
pp. 529 ◽  
Author(s):  
K. Thoonen ◽  
L. van Osch ◽  
H. de Vries ◽  
S. Jongen ◽  
F. Schneider
Keyword(s):  
Skin Cancer ◽  
Cancer Prevention ◽  
Children And Adolescents ◽  
Sun Protection ◽  
Skin Cancer Prevention ◽  
Sun Safety ◽  
Environmental Interventions ◽  
Prevention Interventions ◽  
Safety Interventions ◽  
Cognitive Determinants

Skin cancer, which is increasing exceedingly worldwide, is substantially preventable by reducing unprotected exposure to ultraviolet radiation (UVR). Several comprehensive interventions targeting sun protection behaviors among children and adolescents in various outdoor settings have been developed; however, there is a lack of insight on stand-alone effectiveness of environmental elements. To compose future skin cancer prevention interventions optimally, identification of effective environmental components is necessary. Hence, an extensive systematic literature search was conducted, using four scientific databases and one academic search engine. Seven relevant studies were evaluated based on stand-alone effects of various types of environmental sun safety interventions on socio-cognitive determinants, sun protection behaviors, UVR exposure, and incidence of sunburns and nevi. Free provision of sunscreen was most often the environmental component of interest, however showing inconsistent results in terms of effectiveness. Evidence regarding shade provision on shade-seeking behavior was most apparent. Even though more research is necessary to consolidate the findings, this review accentuates the promising role of environmental components in skin cancer prevention interventions and provides directions for future multi-component sun safety interventions targeted at children and adolescents in various outdoor settings.

Testing General Versus Specific Behavioral Focus in Messaging for the Promotion of Sun Protection Behaviors

2019 ◽  
Author(s):  
Amy Bleakley ◽  
Amy B Jordan ◽  
Andrew A Strasser ◽  
Deann Lazovich ◽  
Karen Glanz
Keyword(s):  
Skin Cancer ◽  
Cancer Prevention ◽  
Sun Protection ◽  
Skin Cancer Prevention ◽  
Sun Safety ◽  
The Public ◽  
Gender And Age ◽  
Prevention Behavior ◽  
The Usa ◽  
Shade Condition

Abstract Background Recommendations for skin cancer prevention include behaviors such as using sunscreen, seeking shade, and wearing a shirt with sleeves, but the best way to persuasively communicate this information to the public is not clear. Purpose To test whether a messaging strategy using videos that focus on one specific behavior at a time versus a more general or multibehavior sun protection message is effective at changing attitudinal beliefs and intention with regard to sun protection behaviors. Methods Online experiment among non-Hispanic white 18–49 year old adults in the USA. Participants were randomly assigned to one of four conditions, each one with health messages on a different sun protection prevention behavior: “using sunscreen” (Condition 1, n = 259), “seeking shade” (Condition 2, n = 245), or “covering up” (Condition 3, n = 289). Condition 4 (the control, n = 251) is a multibehavior message that equally promotes sunscreen, seeking shade, and covering up and features a general message on sun safety. Results ANOVA and path analysis results suggest that messages which emphasize a single sun protection behavior compared with general sun safety messaging could potentially be a promising approach. The effectiveness of the videos in influencing attitudinal beliefs varied by behavior, with some gender and age moderation. There was an indirect effect on intention to use sunscreen. Conclusions This study advances our understanding of strategies for skin cancer prevention campaigns. Specifically, it suggests that focusing on a single sun protection behavior with targeted beliefs may be valuable as a first step in encouraging sun safety.

Mediterranean dietary pattern and skin cancer risk: A prospective cohort study in French women

2019 ◽  
Vol 110 (4) ◽  
pp. 993-1002 ◽  
Author(s):  
Yahya Mahamat-Saleh ◽  
Iris Cervenka ◽  
Marie Al Rahmoun ◽  
Isabelle Savoye ◽  
Francesca Romana Mancini ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Cancer Risk ◽  
Prospective Cohort ◽  
Proportional Hazards ◽  
Meat Products ◽  
Cox Proportional Hazards ◽  
Skin Cancer Prevention ◽  
Future Research ◽  
Cancer Risk Factors ◽  
Skin Cancer Risk

ABSTRACT Background The Mediterranean diet (MD) has been reported to be associated with lower cancer risk. However, while previous studies explored major single components of the MD, only 1 previous study has investigated adherence to the MD in relation to melanoma risk. Objective The aim of this study was to explore the relations between adherence to the MD and the risk of skin cancer, including melanomas, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). Design Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a prospective cohort of 98,995 French women aged 40–65 y in 1990. Dietary data were collected via a validated food questionnaire in 1993. Adherence to the MD was assessed using a 9-unit dietary score that incorporates intakes of fruit, vegetables, legumes, cereal products, olive oil, fish, dairy products, meat products, and alcohol. We used Cox proportional hazards regression models to compute HRs and 95% CIs adjusted for age and main known skin cancer risk factors. Results From 1993 to 2008, a total of 2003 skin cancer cases were ascertained among 67,332 women, including 404 melanomas, 1367 BCCs, and 232 SCCs. Score of adherence to the MD was associated with lower risk of skin cancer (HR: 0.83; 95% CI: 0.73, 0.93 for high compared with low score, Ptrend = 0.001). MD score was also inversely and linearly associated with risks of melanoma (HR: 0.72; 95% CI: 0.54, 0.96; Ptrend = 0.02) and BCC (HR: 0.77; 95% CI: 0.66, 0.90; Ptrend = 0.0006) but not SCC (HR: 1.08; 95% CI: 0.75, 1.55; Ptrend = 0.68), although with no heterogeneity across skin cancer types (Pheterogeneity = 0.23). Conclusion These findings suggest that adherence to the MD is associated with a lower skin cancer risk in women, particularly melanoma and BCC. If confirmed in future research, these findings may have important implications in skin cancer prevention.

Fighting Skin Cancer With a Musical Sound

2013 ◽  
Vol 19 (4) ◽  
pp. 279-289 ◽  
Author(s):  
Sofia Potente ◽  
Vanessa Rock ◽  
Jacqueline McIver ◽  
Melinda Williams ◽  
Christopher Magee ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Sun Exposure ◽  
Sun Protection ◽  
Skin Cancer Prevention ◽  
The Sun ◽  
Media Campaigns ◽  
Social Marketing Campaign ◽  
South Wales ◽  
The Media ◽  
Key Barrier

Australian youth have good knowledge about skin cancer prevention as a result of over three decades of traditional mass media campaigns. However, youth sun protection behavior remains poor. This case study describes the results of a unique social marketing campaign (the Sun Sound) aimed at translating youths’ knowledge into improved sun protection behavior. Formative research identified that a key barrier to sun protection was youth regularly forgot to protect their skin. As such, the campaign centered on a musical jingle that was broadcast at outdoor recreational settings as a “cue to action” reminder to use sun protection at the time and point of sun exposure. The Sun Sound was trialed at two coastal communities in New South Wales, Australia, during summer 2009–2010. The media launch generated 17.6 million Australian audience impressions (advertising value A$257,785). Intercept surveys conducted with 467 youth aged 12–18 years found there was high unprompted recall (41%) and understanding (79%) of the Sun Sound message. The Sun Sound was found to be an effective cue to action in prompting sun protection behaviors when heard, with over a third (38%) of respondents reporting use of additional sun protection upon hearing the jingle. Since the pilot, the Sun Sound has expanded to over 60 pools, beaches, and selected venues across Australia. The campaign demonstrates it is possible to influence behavior by targeting audiences at the actual point that behavior occurs, using research-informed insights and a relevant marketing mix.

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