Prevalence of Sun Protection at Outdoor Recreation and Leisure Venues at Resorts in North America

Abstract

Background Exposure to solar ultra violet radiation (UVR) is a primary risk factor for skin cancer. Vacationers often fail to protect themselves from harmful UVR. Purpose The study assessed the sun protection practices of resort guests in various outdoor leisure and recreation venues during warm-weather seasons. Method 41 North American resorts were enrolled in a quasi-experimental randomized controlled trial. Adult guests were observed (n=4091) and surveyed (n=3694) in a cross sectional sample. Data collection was conducted in recreation and leisure venues with outdoors commons/reception areas acting as the comparison condition. Results The mean percent of vacationers at pools and beaches were more likely (p < 0.001) to wear sunscreen than in commons areas but less likely (p < 0.001) to wear cover-up clothing or use shade. In both samples, the combined sun protection scores were higher in commons areas compared to all venues except for outdoor dining (p < 0.001). Discussion Sun safety was suboptimal in all venues and was potentially mitigated by venue type. Translation to Health Education Practice Approaches are needed to encourage vacationers to practice comprehensive sun protection and to work with resorts to construct built environments that facilitate rather than act as barriers to sun safety.

Prevalence and Correlates of Observed Sun Protection Behaviors Across Different Public Outdoor Settings in Melbourne, Australia

“…The lower sun protection observed among males and adolescents in the present study is consistent with findings from self-report and direct observation surveys conducted both in Australia (Dixon et al, 2008; Dobbinson, Wakefield, Hill, et al, 2008; Makin et al, 2013; Volkov et al, 2013) and internationally (Buller et al, 2011; Kasparian et al, 2009; Pinault & Fioletov, 2017; Walkosz et al, 2017). It is unlikely that males and adolescents’ inferior use of physical sun protection would be offset by extensive use of sunscreen.…”

“…This study demonstrates differences in the prevalence and observed forms of sun protection used in public outdoor settings and variation by demographic and activity characteristics and weather conditions. Clothing covering at least 3/4 of the arms and/or legs was less commonly worn at pools/beaches relative to streets/cafes and parks/gardens, while shade was more commonly used at streets/cafes, in line with previous observations in outdoor dining areas, pools and beaches at North American holiday resorts (Walkosz et al, 2017). In the present study, there were some commonalities across settings, including that females and older adults were better protected than males and adolescents respectively, but sun protection (especially covering hat use and arm cover) was largely inadequate.…”

Walking and Sun Protective Behaviors: Cross-Sectional Associations of Beneficial Health Factors

“…Yet, if the type of physical activity is organized sports, the prevalence of sunscreen use is lower [7,8,23]. Sun avoidance behaviors, such as seeking shade or not going outdoors, is negatively related with leisure-time activity, such as in resorts or at beaches [24,25]. Similarly, we found that longer duration leisure walking was negatively associated with sun avoidance.…”

“…A different approach may be multicomponent community-wide interventions, which combine individual-level intervention with community or policy supports [43] or modifications of environments to facilitate sun protection. A review of environmental and policy interventions to promote sun protective behaviors in recreation and tourism settings have mixed results [44] and the provision of shade at vacation destinations may not be utilized by vacationers [25]. Some modifications of the built environment, such as bus stop shelters, store front canopies, or street trees, may provide some sun protection for transportation walking [45].…”

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

“…Particularly, since the amount of time people spent at recreational settings is increasing among Western populations [75,76]. The amount of UVR exposure at these venues is often high [21] while sun protection is regularly lacking during outdoor activities [77][78][79] and no prevention policies are at place. Moreover, children specifically are at high risk of receiving large amounts of UVR at playgrounds due to unavailability of shaded areas, as revealed by a recent study conducted in Germany [80].…”