Use of Sun-Protective Clothing at Outdoor Leisure Settings from 1992 to 2002: Serial Cross-sectional Observation Survey

Abstract

Background: Previous population-based surveys to monitor sun protection behavior over time have relied on self-report, which can be subject to recall and misclassification bias and social desirability bias. The present study aimed to describe the prevalence and determinants of teenagers' and adults' observed sun protection behavior while engaged in outdoor leisure activities on summer weekends, over a decade of the SunSmart skin cancer prevention program, which involved public education and advocacy. Method: Serial cross-sectional observational field surveys of teenagers and adults at leisure were undertaken during summer weekends between 11 a.m. and 3 p.m., from 1992 to 2002 (N = 46,810). The four types of setting for observation were parks and gardens, golf courses, tennis courts, and pools and beaches, located within a 25-km radius of Melbourne city center, Australia. The main outcome measure was a binary clothes cover

An Observational Study of Sun-Protective Behaviour at an Outdoor Spectator Sporting Event in a Region of High Sun Exposure

“…Certain fabrics such as synthetic fabrics have Ultraviolet Protection Factor values over 500, making them vastly superior to sunscreen [28]. Though sleeve length was only used for sun-protection by a relatively small percentage of those observed in this study, an observational study of 46,810 teenagers and adults at outdoor leisure activities near Melbourne, Australia, found significant improvements in the extent of body clothes cover over the decade 1992 to 2002 [29]. Sunglasses are necessary to protect the eyes from UVR, and are also underutilised in Australia.…”

Prevalence and determinants of Australian adolescents' and adults' weekend sun protection and sunburn, summer 2003-2004

“…Temperature and cloud models are presented in full for the nonbehavioral predictor models, as these generally had an improved model fit as determined by between 1992 and 2002 among people outdoors on summer weekends in parks, gardens, tennis courts, pools, and beaches, whereas clothing cover at golf courses declined. 12 Therefore, if there were comparable studies for other countries where fewer skin cancer control initiatives have been implemented, then we might anticipate that the prevalence levels of sun protection and sunburn for Australia would appear relatively favorable. Unfortunately, comparable data are lacking, and are partly limited by the complexity of measuring skin cancer prevention behaviors and sunburn 33,[38][39][40][41] and the need to consider different social and physical environments and contexts.…”

“…3,[5][6][7] Extensive monitoring of the public response to these programs has occurred in one state, including ongoing surveys of the population's sun-related behaviors using self-reports by telephone interviews since 1987 [8][9][10] and observational studies in outdoor settings since 1992. [11][12][13] National data on Australians' sun-protective behaviors and sunburn have been limited to data from surveys since 1993 of secondary students' usual sun-protective behaviors and sunburn during the past summer. 14 Thus, there were gaps in national data on adults' and children's sun-related behaviors and for smaller states and territories.…”

Time to Get Serious About Skin Cancer Prevention

“…Notably, self-reported sunburns declined nearly 50% by 2001 to 2002, and now, melanoma incidence has stabilized and mortality rates have declined, particularly among younger individuals (72,73). Despite the implementation and maintenance of a comprehensive approach for skin cancer prevention, Australia still finds room for improvement, including the need for continued promotion of individual behavior change and policy adoption (74)(75)(76). The sustainability of these gains also clearly requires continued infusion of resources, as evidenced by declines in negative attitudes toward desiring a tan when funding for sun protection programs in Victoria waned (77).…”