Effects of the Sunny Days, Healthy Ways Curriculum on Students in Grades 6 to 8

University of Alabama at Birmingham, Birmingham, Alabama, United States
American Journal of Preventive Medicine (Impact Factor: 4.53). 02/2006; 30(1):13-22. DOI: 10.1016/j.amepre.2005.08.046
Source: PubMed

ABSTRACT There are few effective sun-safety education programs for use in secondary schools. Project aims were to create a sun-safety curriculum for grades 6 to 8, and to test whether exposure to the curriculum would increase children's sun-protection behavior.
A pair-matched, group-randomized, pre--post test, controlled trial was performed with middle schools as the unit of randomization. Teachers implemented the six-unit sun-safety curriculum in 2001-2003, and analyses were performed in 2003-2004.
A total of 2038 children from 30 middle schools in Colorado, New Mexico, and Arizona.
Self-reported sun-protection behavior using frequency ratings and diary.
Compared to control schools, children receiving the curriculum reported more frequent sun protection (p=0.0035), and a greater proportion wore long-sleeved shirts during recess (p<0.0001) and applied sunscreen (p<0.0001). Exposure to the curriculum improved knowledge (p<0.0001), decreased perceived barriers to using sunscreen (p=0.0046), enhanced self-efficacy expectations (p=0.0577) about sun safety, and reduced favorable attitudes toward sun tanning (p=0.0026 to <0.0001). In intent-to-treat analyses, the treatment effect was eliminated only under the most conservative assumptions about dropouts.
Educational approaches to sun safety in middle school may be effective for improving children's sun safety. Potential trial limitations include measuring short-term outcomes, focusing on young adolescents, using active parental consent, and testing in the American Southwest.

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Available from: David B Buller, Jan 07, 2014
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    • "Several studies suggest that a majority of school age children are poorly informed about cancer as well as preventive behavior [22-24]. The National Cancer Institute identified schools as having a central role in cancer prevention education [25]; school programs, however, often focus on only one behavioral risk factor [26-29]. We, therefore, designed the ‘Be smart against cancer’ (BSAC) program to target multiple risk factors for adult-onset cancer simultaneously by encouraging healthy lifestyles in a format especially designed for schools. "
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    ABSTRACT: Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the 'Be smart against cancer' (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: "What is cancer?," "Sun protection," "Non smoking," and "Physical activity, Healthy nutrition, and Limited alcohol consumption." Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p < .001), as well as in increasing intentions to engage in health-promoting behavior (p < .001), independent of a student's risk profile. Knowledge did not serve as a mediator for intention building. The BSAC is an effective school-based program for raising awareness of cancer, associated risk factors and intentions to engage in cancer-preventive behavior. The results indicate that the effectiveness of BSAC is independent of a student's risk profile. Therefore, it holds considerable promise as a broadly applicable program to raise cancer awareness and promote healthy behavior intentions.
    BMC Public Health 04/2014; 14(1):392. DOI:10.1186/1471-2458-14-392 · 2.26 Impact Factor
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    • "Facial freckling was collapsed to “none” vs “any.” Base skin pigmentation was measured using a colorimeter (Minolta Chroma Meter CR-400; Konica Minolta Sensing, Inc., Ramsey, New Jersey), which quantifies color using the 3-dimensional L-a-b system (16,17). The L-scale, which measures color from white to black, was used (smaller values indicate darker color) (18,19). "
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    ABSTRACT: Sun exposure is a major risk factor for skin cancer, but without physical activity, children are at risk of childhood obesity. The objective of this study was to explore relationships between parental perceptions of skin cancer threat, sun protection behaviors, physical activity, and body mass index (BMI) in children. This is a cross-sectional analysis nested within the Colorado Kids Sun Care Program sun safety intervention trial. In summer 2007, parent telephone interviews provided data on demographics, perceptions of skin cancer threat, sun protection behaviors, and physical activity. Physical examinations provided data on phenotype, freckling, and BMI. Data from 999 Colorado children born in 1998 were included in analysis. We used analysis of variance, Spearman's rho (ρ) correlation, and multivariable linear regression analysis to evaluate relationships with total amount of outdoor physical activity. After controlling for sex, race/ethnicity, skin color, and sun protection, regression analysis showed that each unit increase in perceived severity of nonmelanoma skin cancer was associated with a 30% increase in hours of outdoor physical activity (P = .005). Hours of outdoor physical activity were not related to perceived severity of melanoma or perceived susceptibility to skin cancer. BMI-for-age was not significantly correlated with perceptions of skin cancer threat, use of sun protection, or level of physical activity. The promotion of sun safety is not likely to inhibit physical activity. Skin cancer prevention programs should continue to promote midday sun avoidance and sun protection during outdoor activities.
    Preventing chronic disease 08/2012; 9(8):E143. DOI:10.5888/pcd9.110345 · 2.12 Impact Factor
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    • "This made it more difficult to demonstrate significant effects for the summer program on knowledge. Confidence in these scales is also bolstered by their use in the earlier SDHW middle school study where changes resulting from the intervention program were detected (Buller et al., 2006; Reynolds, Buller, Yaroch, Maloy, & Cutter, 2006). Skin cancer risk was measured by hair and skin color, skin sun sensitivity (propensity to sunburn and tan), and state lived for most of life (Weinstock, 1992). "
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    ABSTRACT: Few family-based interventions to increase sun safe behavior among adolescents have been evaluated. The present study tested an intervention that included tailored and nontailored print communications delivered by mail to adolescents (age 11 to 15) and their parents who were also participating in an evaluation of an in-school intervention. The use of sunscreen, protective clothing, and avoidance of the sun were promoted, and family communication and environmental change strategies were fostered. Adolescents and their parents were pretested in May of 2002 and posttested from August to October. Adolescents (N = 599) were stratified on experimental condition in the in-school study (in-school intervention vs control) and randomly were assigned from within strata to receive (N = 288) or not receive (N = 311) the summer intervention materials. No statistically significant effects were found for adolescents between the randomized experimental conditions. Parents' had increased knowledge (F = 5.52, p < .05) and propensity to have their child wear sunglasses (F = 4.07, p < .05). Greater program exposure/engagement led to enhanced sun protection behavior (e.g., fewer sunburns) and psychosocial factors among adolescents and parents. Greater exposure/engagement led to improvements in family interaction and home environment (e.g., shade audit completed). Future research is needed on exposure/engagement with family-based health messaging and on family-based sun safety programs for adolescents.
    Journal of Health Communication 10/2008; 13(7):619-36. DOI:10.1080/10810730802412149 · 1.61 Impact Factor
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