More research is needed to determine the prevalence of pathologically unhealthy, obsessive, "self-defined healthy," eating behaviors, and to determine if ON is a unique eating disorder or just a subset of another disorder.

The Kidskin Study is a 5-year intervention study (1995-1999) involving 1,776 5- and 6-year-old children attending 33 primary schools in Perth, Western Australia. The aim of the study is to design, implement, and evaluate an intervention to reduce sun exposure in young children. There are three study groups: a control group, a "moderate intervention" group, and a "high intervention" group. The control schools receive the standard Western Australian health education curriculum, while the moderate and high intervention schools receive a specially designed curricular intervention. In addition, children in the high intervention group receive program materials over the summer holidays, when exposure is likely to be highest, and are offered sun-protective swimwear at low cost. The main outcome measure is the number of nevi on the back. Other outcomes include nevi on the chest (boys only), face, and arms, levels of suntanning, degree of freckling, and sun-related behaviors. At baseline, the three groups were similar with respect to nevi and freckling after adjustment for observer and month of observation. Sun exposure was slightly higher in the high intervention group. The groups were also similar with respect to most potential confounders, although they differed with respect to Southern European ethnicity and parental education.

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Objective: To evaluate a school-based intervention in terms of reducing children's sun exposure and improving their use of sun protection measures.Methods: 'Kidskin' is a five-year, school-

Evaluation of health promotion interventions aimed at behavioural or environmental change involves assessing change that occurs as a result of the program. Direct observational methods can be used for this purpose and this paper describes three such methods that we pilot tested for use in a 5-year intervention study aimed at reducing sun exposure in primary school children. (1) Monitoring 'No hat, no play' policies. This method involved video taping children in selected school play areas during lunch time and analysing the content of the videos to assess the proportion of children wearing various types of hats. (2) Assessing shade provision in the playground. This method involved taking aerial photographs of each school and using them to estimate the proportion of shade in play areas available to children at lunchtime. (3) Shade use. This involved children wearing polysulphone film badges to measure the amount of UV-B exposure they received during one lunch period, relative to the total possible dose registered on index badges. Each method was implemented successfully, and we demonstrated that the video and aerial photography methods produced highly reproducible results and that all three methods were feasible. These three methods will be used in our intervention study to assess longitudinal change in schools' sun-protection policy and practice.