Journal of Cancer Education

, Volume 30, Issue 4, pp 736–742 | Cite as

Evaluation of Project Students are Sun Safe (SASS): A University Student-Delivered Skin Cancer Prevention Program for Schools

  • Raeann DavisEmail author
  • Lois J. Loescher
  • Jillian Rogers
  • Denise Spartonos
  • Aimee Snyder
  • Stephanie Koch
  • Robin B. Harris


Skin cancer is the most common cancer in the USA and is increasing in children and young adults. Adolescents are an important target population for sun-safety interventions with ultraviolet radiation as the strongest risk factor for developing skin cancer. Schools are an ideal setting to intervene with adolescents. A novel Arizona skin cancer prevention in-class education-activity program, Project ‘Students are Sun Safe’ (SASS), was designed to be delivered by university students for middle school and high school students. Participant students completed the pre- and post-program tests and a satisfaction questionnaire; teachers completed reviews. The evaluation examined the program’s influence on participants’ sun-safety knowledge, perceptions, and behaviors; satisfaction with the program; and intent to change. After exposure to Project SASS, participants were more likely to perceive a high risk of skin cancer, report negative attitudes toward tanned skin, and answer knowledge-based questions correctly. There were minimal differences in self-reported sun-safety behaviors, though participants did report intent to change. Both participants and teachers were satisfied with the program. Project SASS appears to be an effective sun-safety program for middle school and high school students for knowledge and perceptions, and the results confirm that appropriately tailoring program components to the target population has strong potential to impact adolescent perceived susceptibility, knowledge, and behavioral intent. The strengths and weaknesses of Project SASS have many implications for public health practice, and Project SASS may hold promise to be a model for skin cancer prevention in adolescents.


Sun safety Sun protection Adolescents Peer education School-based prevention programs High school Middle school Melanoma Skin neoplasms Prevention Ultraviolet radiation Tanning Skin cancer prevention 



The authors would like to thank the University of Arizona Foundation, Bert W. Martin Foundation, and the Tucson community, whose generous contributions made the start of Project SASS possible and continue to sustain the program today.


  1. 1.
    Strouse JJ, Fears TR, Tucker MA, Wayne AS (2005) Pediatric melanoma: risk factor and survival analysis of the surveillance, epidemiology and end results database. J Clin Oncol 23(21):4735–41CrossRefPubMedGoogle Scholar
  2. 2.
    Efron PA, Chen MK, Glavin FL, Kays DW, Beierle EA (2008) Pediatric basal cell carcinoma: case reports and literature review. J Pediatr Surg 43(12):2277–80CrossRefPubMedGoogle Scholar
  3. 3.
    Hingle M, Snyder A, McKenzie N, Thomson C, Logan R, Ellison E et al (2014) Effects of an SMS-based skin cancer prevention campaign in adolescents. Health, American Journal of PublicGoogle Scholar
  4. 4.
    Purdue MP, Freeman LE, Anderson WF, Tucker MA (2008) Recent trends in incidence of cutaneous melanoma among US Caucasian young adults. J Invest Dermatol 2905–8Google Scholar
  5. 5.
    Dadlani C, Orlow SJ (2008) Planning for a brighter future: a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online 14(9):1Google Scholar
  6. 6.
    Cheng CE, Irwin B, Mauriello D, Hemminger L, Pappert A, Kimball AB (2010) Health disparities among different ethnic and racial middle and high school students in sun exposure beliefs and knowledge. J Adolesc Health 47(1):106–109CrossRefPubMedGoogle Scholar
  7. 7.
    Montague M, Borland R, Sinclair C (2001) Slip! slop! slap! and SunSmart, 1980–2000: Skin cancer control and 20 years of population-based campaigning. Health Educ Behav 28(3):290–305CrossRefPubMedGoogle Scholar
  8. 8.
    Reynolds KD, Buller DB, Yaroch AL, Maloy J, Geno CR, Cutter GR (2008) Effects of program exposure and engagement with tailored prevention communication on sun protection by young adolescents. J Health Commun 13(7):619–636PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Pichon LC, Mayer JA, Hoerster KD, Woodruff SI, Slymen DJ, Belch GE et al (2009) Youth access to artificial UV radiation exposure: practices of 3647 US indoor tanning facilities. Arch Dermatol 145(9):997–1002PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Kristjansson S, Helgason AR, Mansson-Brahme E, Widlund-Ivarson B, Ullen H (2003) 'You and your skin': a short-duration presentation of skin cancer prevention for teenagers. Health Educ Res 18(1):88–97CrossRefPubMedGoogle Scholar
  11. 11.
    Hughes BR, Altman DG, Newton JA (1993) Melanoma and skin cancer: evaluation of a health education programme for secondary schools. Br J Dermatol 128(4):412–7CrossRefPubMedGoogle Scholar
  12. 12.
    Geller A, Rutsch L, Kenausis K, Selzer P, Zhang Z (2003) Can an hour or two of sun protection education keep the sunburn away? Evaluation of the Environmental Protection Agency’s SunWise School Program. Environ Health: A Global Access Sci Source 2(13)Google Scholar
  13. 13.
    Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D et al (2004) Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med 27(5):422–466PubMedGoogle Scholar
  14. 14.
    de Vries H, Lezwijn J, Hol M, Honing C (2005) Skin cancer prevention: behaviour and motives of Dutch adolescents. Eur J Cancer Prev 14(1):39–50CrossRefPubMedGoogle Scholar
  15. 15.
    Thomas K, Hevey D, Pertl M, Ni Chuinneagain S, Craig A, Maher L (2011) Appearance matters: the frame and focus of health messages influences beliefs about skin cancer. Br J Health Psychol 16:418–429CrossRefPubMedGoogle Scholar
  16. 16.
    Bandi P, Cokkinides VE, Weinstock MA, Ward E (2010) Sunburns, sun protection and indoor tanning behaviors, and attitudes regarding sun protection benefits and tan appeal among parents of us adolescents-1998 compared to 2004. Pediatr Dermatol 27(1):9–18CrossRefPubMedGoogle Scholar
  17. 17.
    Williams M, Jones SC, Caputi P, Iverson D (2012) Australian adolescents’ compliance with sun protection behaviours during summer: the importance of the school context. Health Promot Int 27(1):15–22CrossRefPubMedGoogle Scholar
  18. 18.
    Harris RB, Griffith K, Moon TE (2001) Trends in the incidence of nonmelanoma skin cancers in southeastern Arizona, 1985-1996. J Am Acad Dermatol 45(4):528–36CrossRefPubMedGoogle Scholar
  19. 19.
    Diffey BL, Norridge Z (2009) Reported sun exposure, attitudes to sun protection and perceptions of skin cancer risk: a survey of visitors to Cancer Research UK's SunSmart campaign website. Br J Dermatol 160(6):1292–8CrossRefPubMedGoogle Scholar
  20. 20.
    Kamell JM, Rietkerk W, Lam K, Phillips JM, Wu JJ, McCullough JL et al (2011) Medical students educate teens about skin cancer: what have we learned? J Cancer Educ 26(1):153–5PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Branstrom R, Kasparian NA, Chang YM, Affleck P, Tibben A, Aspinwall LG et al (2010) Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomarkers Prev 19(9):2199–210PubMedCentralCrossRefPubMedGoogle Scholar
  22. 22.
    Bristow BN, Casil J, Sorvillo F, Basurto-Davila R, Kuo T (2013) Melanoma-related mortality and productivity losses in the USA, 1990-2008. Melanoma Res 23(4):331–5PubMedGoogle Scholar
  23. 23.
    Aquilina S, Gauci AA, Ellul M, Scerri L (2004) Sun awareness in Maltese secondary school students. J Eur Acad Dermatol Venereol 18(6):670–5CrossRefPubMedGoogle Scholar
  24. 24.
    Reding DJ, Fischer V, Gunderson P, Lappe K, Anderson H, Calvert G (1996) Teens teach skin cancer prevention. J Rural Health 12(4 Suppl):265–72CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Raeann Davis
    • 1
    • 2
    Email author
  • Lois J. Loescher
    • 3
    • 1
  • Jillian Rogers
    • 4
  • Denise Spartonos
    • 5
  • Aimee Snyder
    • 1
  • Stephanie Koch
    • 1
    • 5
  • Robin B. Harris
    • 1
  1. 1.Zuckerman College of Public HealthThe University of ArizonaArizonaUSA
  2. 2.University of California DavisDavisUSA
  3. 3.College of NursingThe University of ArizonaArizonaUSA
  4. 4.Scottsdale HealthcareArizona State UniversityArizonaUSA
  5. 5.Skin Cancer InstituteThe University of Arizona Cancer CenterArizonaUSA

Personalised recommendations