Improving Sun-Safe Knowledge, Attitude and Behaviour in Parents of Primary School Children: a Pilot Study

Abstract

Excessive sun exposure, mainly in childhood, represents one of the major skin cancer risk factors. Sun protection habits should start early in life to be effective. The purpose of this study was to investigate knowledge, attitude and sun protection behaviour in parents (P) and in their children (C). The educational intervention addressed the parents of 131 primary school pupils in Valencia, Spain, during the school year 2007-2008. A self-administered pre- and post-intervention questionnaire was handed in during school hours to be filled in by parents. Parents' compliance was very high (88 %). At baseline, regular high-sun-protective-factor (>15) sunscreen use was common (P, 64 %; C, 95 %); wearing clothing (T-shirt: P, 34 %, C, 62 %; hat: P, 29 %, C, 64 %) and sun avoidance at midday (P, 23 %; C, 29 %) were less frequent. Almost 70 % of parents reported difficulties, mainly due to the children's refusal. A high knowledge score (median, 6/7) and a medium/high attitude score (median, 24/30) in parents were observed; however, lifetime sunburn history was generally reported (P, 88 %; C, 24 %). Factors associated with parents' knowledge were a personal history of sunburns and regularly repeating sunscreen application to children (median score: 6 vs 5; p ≤ 0.01) Predictors of a more favourable attitude were female caretakers and having daughters (median score: 30 vs 25 and 25 vs 24, respectively; p ≤ 0.01). A trend towards limited post-intervention positive changes emerged; however, sun avoidance habit decreased (35 vs 20 %, p = 0.01). Despite a high level of parents' knowledge, sun protection in children is not adequate, and sunburns are not uncommon. Unfavourable beliefs and attitudes need to be overcome and quality of messages improved to achieve sun-safe exposure in children.

Sun protection in children: a behavioural study

“…An ideal time to promote good sun-protective behaviour would appear to be during childhood [8,10]. Our findings confirm that schools are an adequate setting for educational interventions targeting sun-protective attitudes and behaviours, supporting previous reports [3]. Overall, we observed an improvement in behaviour between 2004 and 2012, confirming that it is worth continuing efforts targeting young children.…”

“…T he incidence of skin cancer has increased steadily in recent decades, and a direct correlation with sun exposure, especially at a young age, has long been recognized [1,2]. UV protection measures should start in early childhood [3], since avoidance of intense sun exposure and adoption of behaviours that limit sun exposure are likely to decrease the risk of skin cancer (including melanoma) in adulthood [4]. Children spend a large part of their time at school, and schools can thus play an important role in helping to protect them from UV exposure [5].…”

Pigmented naevi and sun protection behaviour among primary and secondary school students in an Eastern Hungarian city

“…In Hungary, there are not yet any sun protection and awareness programmes such as those that have been implemented in the USA (43)(44)(45) and Australia (46). Observations in these studies support the need for consistent counselling with children and their parents regarding the appropriate use of sun protection, which is also confirmed by other studies (47,48). Moreover, environmental interventions, such as the use of shade structures, are also required to support educational lessons (49), besides combined behavioural and political interventions (50).…”

Skin cancer prevention campaign in childhood: survey based on 3676 children in Brazil

“…Several campaigns for sun protection and skin cancer prevention for children have been developed in different countries of the world, showing very favourable results in education and awareness towards the sun …”

“…Several campaigns for sun protection and skin cancer prevention for children have been developed in different countries of the world, showing very favourable results in education and awareness towards the sun. [8][9][10][11][12][13][14][15] Recently, Guy Jr et al 16 reviewed the important role of schools in the prevention of skin cancer in the USA. The authors emphasized the importance of education in photoprotection in the schools given the amount of time that the children spent in these places.…”