A new quality metric for dermatology: The “SPA” (sunscreen, protective gear, and avoidance) questionnaire to assess sun protection practices

Background: Given the importance of counseling patients on UV radiation exposure, a Sunscreen, Protective Gear, and Avoidance (SPA) Questionnaire was developed to assess patients’ sun exposure and help physicians provide tailored counseling to their patients regarding safe sun protection practices. Materials and methods: Six Denver Veterans Affairs (VA) dermatology providers who were trained in using the questionnaire randomly selected patients in the Denver VA Dermatology clinic to pilot-test the questionnaire. Demographic information and responses were collected using the SPA Questionnaire. Results: 43/61 (70.5%) of patients answered “no” to at least one sun protection strategy. Of these 43 patients, 40 (93%) were provided with tailored counseling. Five out of six providers indicated that the questionnaire encouraged conversations about sun protection for skin cancer prevention. Conclusion: The SPA questionnaire is a simple measure of UV exposure risk, which can help clinicians determine the sun-protective behavior of patients and initiate dialogue to increase patient knowledge of sun protection practices.

Results of a Primary Skin-Cancer-Prevention Campaign in Early Childhood on Sun-Related Knowledge and Attitudes in Southern Hungary

Avoidance of ultraviolet (UV) exposure in early childhood is important for reducing the lifetime risk of developing skin cancer. The goal of the present prospective, multicenter pilot study was to assess the sun-protection practices in kindergartens and daycare centers and to evaluate sun protection knowledge and behavior among caregivers employed in the surveyed facilities. The study consisted of two parts. A baseline questionnaire was completed by the caregivers in relation to knowledge regarding basic sun protection and sun protection practices of the participating facilities. Afterward, a thirty-minute presentation was hosted in reference to this topic. Six months following the presentation, a follow-up questionnaire was distributed among the caregivers, evaluating the attitude-related and behavioral changes towards children. A total of 153 caregivers from five daycare centers (children between 6 months and 3 years of age) and sixteen kindergartens (children between 3 and 7 years of age) willfully participated in our study. According to our results, the main source of information regarding sun protection originated from different types of media. We found that staying in shaded areas and the use of protective clothing were not frequent in the facilities. Following our presentation regarding skin types and sunscreen use, protective measures improved, but not significantly (p = 0.222). The majority (92.31%) of caregivers distributed the information throughout their environment and also to parents. Sun protection knowledge is necessary; however, motivation among caregivers and parents and involvement of children is also relevant. Hence, a continuous, repetitive educational program regarding sun-smart behavior is deemed essential.

Sun Exposure Prevention Practices Within U.S. Naval Aviation

ABSTRACT Introduction Occupational exposure to ultraviolet radiation is a critical concern for those serving in the U.S. Military. Work and mission requirements predispose members to significant sun exposure, while sun-protective behavior often comes second to mission accomplishment. Prior research implicated institutional practices and constraints as preventing the routine use of sun protection modalities, but no large-scale studies have assessed service members’ perceptions regarding sun protection modalities available to them in their work environment or their daily sun protection practices. Methods The study employed a cross-sectional survey distributed to active duty (AD) U.S. Navy service members assigned to 1 of 19 aircraft squadrons based in Southern California and deployed on missions across the Pacific theater of operations. The intent was to evaluate rates of sunburn, sun-protective practices, and perceptions regarding sun exposure and prevention practices in their workplace. The study and survey tool received approval from the Naval Medical Center San Diego Institutional Review Board. Statistical analysis of survey answers was performed to assess for trends in response rates overall and response rates within sociodemographic groups. Pearson’s chi-squared tests were utilized to assess for significance where appropriate. P-values <.05 were used to determine statistically significant trends in response rates. Results One thousand surveys were distributed, of which 896 surveys were completed. The response rate was 89.6%. Eight hundred and eighty-eight surveys were included in the analysis. The surveyed population was consistent with the demographics of the U.S. Navy as a whole. 55.1% of survey respondents reported sunburn within the past year, higher than the rate reported in a previously surveyed civilian population. Reports of sunburn within the past year were not significantly different in regard to gender (P = .88), age (P = .53), and years of AD (P = .48). Increasing rank did show a significant correlation with reports of sunburn (P = .0) (Table S1). 62.2% of those surveyed reported frequent/routine use of some form of sun protection. This was lower than the rate reported in a previously surveyed civilian population. A large majority of service members surveyed (75.9%) reported using sunscreen with a sun protection factor >15. 29.1% of survey respondents reported working in direct sunlight always/almost always. This was lower than the rates reported in a previously surveyed U.S. Air Force population of aviation maintainers. Low rates of respondents reported frequent reminders to use sun protection (18.9%), and fewer reported the routine or frequent use of sunscreen while at work (12.3%). A higher percentage reported regular use of sunscreen during outdoor leisure activities (36.5%), suggesting a barrier to use in the workplace. Conclusions U.S. Military personnel report higher rates of sunburn and lower rates of routine use of sun protection practices compared to a previously surveyed civilian population. The overall rates of sun protection use while in the work setting are low both overall and compared to reports of routine use during outdoor leisure activities. Reported rates of reminders to use sunscreen are low, suggesting that increased education regarding the risk of excessive sun exposure and tools for effective sun protection are still needed.

What Sun Protection Practices Should Be Adopted by Trainee Teachers to Reduce the Risk of Skin Cancer and Other Adverse Outcomes?

Excessive sun exposure and insufficient protection are the main risk factors for the onset of melanoma and non-melanoma skin cancer (the most common types of cancer suffered by fair-skinned populations) and other adverse effects on the skin and eyes. Epidemiological data highlight the scant awareness of this risk among young people and the high rates of sunburn often recorded among this population. The main aim of the present study is to examine sun exposure and protection behavior by university students. A cross-sectional questionnaire-based study was undertaken to investigate sun exposure and protection practices among students of education sciences at a university in southern Spain. The data obtained were used to perform a descriptive, comparative analysis, by groups and by gender, of photoprotection and skin self-examination practices. The reliability and validity of the questionnaire were both tested. Of the 315 students who completed the questionnaire, 74.6% had suffered at least one sunburn during the previous year. Few made frequent use of sunscreen or protective clothing and 89.5% did not self-examine their skin. The metric properties of the questionnaire revealed its excellent reliability and validity. Among the Spanish university students considered, there was little awareness of the risk of excessive sun exposure, self-protection was insufficient, the potential exposure to dangerous levels of ultraviolet radiation was high, and most had suffered one or more sunburns in the last year. Intervention strategies should be implemented to highlight the risks involved and the need for more appropriate sun protection practices. Information campaigns should be conducted in this respect so that, when these students become teachers, they will have adequate knowledge of the risks involved and of the benefits of addressing this problem effectively, and will ultimately transfer these health education competences to their own students.