Survey of Sun Protection Policies in Juvenile Detention Centers in Pennsylvania: Are we also Protecting Vulnerable Communities?

The incidence rate of skin cancer is increasing in the United States and blistering sunburns during childhood or adolescence is a major risk factor. The Center for Disease Control and Prevention (CDC) developed a set of guidelines to provide schools with a comprehensive approach to preventing skin cancer among adolescents and young people. The objective of this study was to determine the prevalence of sun protection policies, environmental features, and attitudes in institutions responsible for school-aged populations, such as children in juvenile detention centers. Surveys were sent to all (n = 19) public juvenile detention centers in Pennsylvania .Overall, 63.2% (n=12) of the juvenile detention centers in Pennsylvania responded to the survey. Of the 12 centers, 50% (n=6) allow residents to wear hats, 25% (n=3) allow residents to wear sunglasses, 66.7% (n=8) allow residents to wear sunscreen without a provider’s note, and 25% (n=3) provide sun protection education. All the facilities (100%) reported shade-producing structures, but 83.3% (n=10) cover less than 25% of the outdoor activity areas. The CDC’s guidelines include recommendations for schools to encourage skin cancer prevention on school property and elsewhere. Among public juvenile detention centers in PA, we found an absence of policies to reduce sun exposure and a lack of knowledge about the CDC guidelines to prevent skin cancer. Despite these results, administrators are largely in favor of stronger policies and believe sun exposure is an important health issue.

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

10.31234/osf.io/f8brk ◽

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.

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

10.31234/osf.io/yuqzd ◽

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.

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Identification of Relevant Sociocognitive Determinants Explaining Multiple Parental Sun Protection Behaviors

Health Education & Behavior ◽

10.1177/10901981211010434 ◽

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.

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Fighting Skin Cancer With a Musical Sound

Social Marketing Quarterly ◽

10.1177/1524500413506583 ◽

2013 ◽

Vol 19 (4) ◽

pp. 279-289 ◽

Cited By ~ 3

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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A Randomized Clinical Trial of Precision Prevention Materials Incorporating MC1R Genetic Risk to Improve Skin Cancer Prevention Activities Among Hispanics

Cancer Research Communications ◽

10.1158/2767-9764.crc-21-0114 ◽

2022 ◽

Vol 2 (1) ◽

pp. 28-38

Author(s):

John Charles A. Lacson ◽

Scarlet H. Doyle ◽

Jocelyn Del Rio ◽

Stephanie M. Forgas ◽

Rodrigo Carvajal ◽

...

Keyword(s):

Skin Cancer ◽

Cancer Prevention ◽

Cancer Susceptibility ◽

Sun Exposure ◽

Sun Protection ◽

Skin Cancer Prevention ◽

Public Health Approach ◽

Average Risk ◽

Cancer Worry ◽

Prevention Activities

Purpose: Skin cancer incidence is increasing among Hispanics, who experience worse outcomes than non-Hispanic Whites. Precision prevention incorporating genetic testing for (melanocortin-1 receptor) MC1R, a skin cancer susceptibility marker, may improve prevention behavior. Experimental Design: Hispanic participants (n = 920) from Tampa, FL and Ponce, PR, were block-randomized within MC1R higher- and average-risk groups to precision prevention or generic prevention arms. We collected baseline information on demographics, family history of cancer, phenotypic characteristics, health literacy, health numeracy, and psychosocial measures. Participants reported weekday and weekend sun exposure (in hours), number of sunburns, frequency of five sun protection behaviors, intentional outdoor and indoor tanning, and skin examinations at baseline, 3 months, and 9 months. Participants also reported these outcomes for their eldest child ≤10 years old. Results: Among MC1R higher-risk participants, precision prevention increased sunscreen use (OR = 1.74, P = 0.03) and receipt of a clinical skin exam (OR = 6.51, P = 0.0006); and it decreased weekday sun exposure hours (β = −0.94, P = 0.005) and improved sun protection behaviors (β = 0.93, P = 0.02) in their children. There were no significant intervention effects among MC1R average-risk participants. The intervention did not elevate participant cancer worry. We also identified moderators of the intervention effect among both average- and higher-risk participants. Conclusions: Receipt of MC1R precision prevention materials improved some skin cancer prevention behaviors among higher-risk participants and their children and did not result in reduced prevention activities among average-risk participants. Despite these encouraging findings, levels of sun protection behaviors remained suboptimal among participants, warranting more awareness and prevention campaigns targeted to Hispanics Significance: Our results support a precision public health approach to reducing skin cancers among Hispanics, an underserved population in precision medicine, and may additionally improve preventive behaviors among their children.

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

Frontiers in Public Health ◽

10.3389/fpubh.2021.596253 ◽

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.

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“It is more than just Sunscreen”: Analyzing skin cancer narratives on Instagram (Preprint)

10.2196/preprints.34940 ◽

2021 ◽

Author(s):

Basma Gomaa ◽

Rebecca Fagen Houghton ◽

Nicole Crocker ◽

Eric Walsh-Buhi

Keyword(s):

Risk Factors ◽

Social Media ◽

Skin Cancer ◽

Public Awareness ◽

Sun Exposure ◽

The United States ◽

Skin Cancer Prevention ◽

Cancer Risks ◽

Cancer Society ◽

Social Media Platforms

BACKGROUND Skin cancer is among the deadliest forms of cancer in the United States. The American Cancer Society reported that 3 million skin cancer cases could be avoided every year if individuals are more aware of the risk factors related to sun exposure and other forms of prevention. Social media platforms may serve as potential intervention modalities that can be employed to raise public awareness of several diseases and health conditions, including skin cancer. Social media platforms are efficient, cost-effective tools for health-related content to reach a broad number of individuals who are already using the spaces in their day-to-day personal lives. In 2010, Instagram was launched, and it is now utilized by 1 billion users, of which 90% are under the age of 35 years. Despite previous research highlighting the potentiality of image-based platforms in skin cancer prevention and the popularity of Instagram to raise awareness, yet there is still a lack of studies describing skin cancer-related content on Instagram. OBJECTIVE The current study aims to describe skin cancer-related content on Instagram, including the origin (i.e., source characteristics) and attributes of these social media posts (i.e., content characteristics). The study also seeks to reveal content themes in terms of skin cancer risks, treatment, and prevention. METHODS Through Crowdtangle, a tool owned and operated by Facebook, which tracks engagement of the publicly available content on Facebook pages, subreddits, and Instagram accounts, we retrieved content from publicly available accounts on Instagram for the 30 days preceding May 14, 2021. Out of 1,000 posts reviewed, N=592 (59.2%) met the inclusion criteria and were human coded and analyzed. Two raters coded the posts independently. RESULTS Profiles representing organizations were slightly more common than individual accounts: n=321 vs 256 (54% vs 43%). The type of media included in the posts varied, with posts containing photos occurring more frequently (n=315, 53%), compared to posts containing infographics (n=233, 39%), or videos (n=85, 14%). Melanoma was the most mentioned type of skin cancer (n=252, 43%). Prevention methods were discussed in Instagram posts more often than risk factors (n=404, 68%) vs (n=271, 46%). Only 80 out of 592 posts (14%) provided a citation from a medical source. CONCLUSIONS This study’s findings highlight the potential role of Instagram as a platform for improving awareness of skin cancer risks and the benefits of prevention practices. We believe social media is the most promising venue for researchers and dermatologists to dedicate their efforts and presence in widely reaching the public to educate about skin cancer and empower prevention.

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Sun Protection Behaviors Associated with Self-Efficacy, Susceptibility, and Awareness among Uninsured Primary Care Patients Utilizing a Free Clinic

Dermatology Research and Practice ◽

10.1155/2015/753681 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Akiko Kamimura ◽

Maziar M. Nourian ◽

Jeanie Ashby ◽

Ha Ngoc Trinh ◽

Jennifer Tabler ◽

...

Keyword(s):

Primary Care ◽

Skin Cancer ◽

Self Efficacy ◽

The United States ◽

Sun Protection ◽

Skin Cancer Prevention ◽

Free Clinic ◽

Cancer Awareness ◽

Male And Female ◽

Primary Care Patients

Background. Skin cancer is the most commonly diagnosed form of cancer in the United States (US). However, knowledge, behaviors, and attitudes regarding sun protection vary among the general population. The purpose of this study is to examine sun protection behaviors of low-income primary care patients and assess the association between these health behaviors and the self-efficacy, susceptibility, and skin cancer awareness.Methods. Uninsured primary care patients utilizing a free clinic (N=551) completed a self-administered survey in May and June 2015.Results. Using sunscreen was the least common tactic among the participants of this study. Skin cancer awareness and self-efficacy are important to improve sun protection behaviors. Spanish speakers may have lower levels of skin care awareness compared to US born and non-US born English speakers. Male and female participants use different sun protection methods.Conclusion. It is important to increase skin cancer awareness with self-efficacy interventions as well as education on low-cost sun protection methods. Spanish speaking patients would be a target population for promoting awareness. Male and female patients would need separate gender-specific sun protection education. Future studies should implement educational programs and assess the effectiveness of the programs to further promote skin cancer prevention among underserved populations.

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Assessment of knowledge of skin cancer prevention and its relation with sun exposure and photo protection amongst gym academy members on the south of Santa Catarina, Brazil

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962012000100004 ◽

2012 ◽

Vol 87 (1) ◽

pp. 36-43 ◽

Cited By ~ 8

Author(s):

Mariana Rocha Fabris ◽

Edson Souza Machado Durães ◽

Beatriz Castellar de Faria Martignago ◽

Luiz Felipe de Oliveira Blanco ◽

Thiago Rocha Fabris

Keyword(s):

Skin Cancer ◽

Cancer Prevention ◽

Sun Exposure ◽

Sun Protection ◽

Protective Measure ◽

Skin Cancer Prevention ◽

Cross Sectional ◽

Protection Measures ◽

Study Results ◽

The World

BACKGROUND: Skin cancer is the most frequent neoplasia in several parts of the world and also in Brazil. There is evidence of an increase in morbidity and mortality from skin cancer. Although the incidence of skin cancer is increasing, it is estimated that 45% of all preventable cancers worldwide are skin neoplasias. Several studies have emphasized the need for campaigns to encourage sun protection. OBJECTIVE: To assess the knowledge about skin cancer prevention and its association with sun exposure and photo protection in gym members. METHODS: We conducted a cross-sectional, descriptive and quantitative study during January to July 2009, including gym members of both sexes in the city of Criciuma. A self-administered questionnaire was used. The statistical analysis was conducted in a descriptive way in regards to the absolute and relative frequencies of the variables under study. RESULTS: Of the 317 questionnaires studied, 62% were from women and 38% from men. Skin types II and III predominated, and the average age was 27.6 years. 94.3% of the participants reported that they had heard about the risks of sun exposure, mostly in terms of skin cancer risk (80.8%). Most participants, especially women, reported some form of sun protective measure. CONCLUSION: The population studied, similar to that in other regions of Brazil and the world, is aware of the risks of excessive sun exposure and skin cancer prevention, but has not yet incorporated appropriate sun protection measures into their daily habits.

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