Advertisement

European Journal of Dermatology

, Volume 28, Issue 3, pp 338–342 | Cite as

Sun protection in children: a behavioural study

  • Ana Filipa Duarte
  • António Picoto
  • Altamiro da Costa Pereira
  • Osvaldo Correia
Clinical Report

Abstract

Background

Incidence of skin cancer is increasing worldwide and UV exposure at a young age is an important risk factor.

Objectives

To compare sun exposure-related knowledge and behaviour among children during school and holiday periods.

Material & Methods

A cross-sectional study was undertaken at 12 Oporto public primary schools. Educational sessions for educators were head by dermatologists every spring from 2004 to 2012. An educational activity book, Play and Learn with Jo Spots, was distributed to all primary school children and was explained by the educators every year. A questionnaire about sun exposure and behaviour was given to students in 2004 and 2012.

Results

In total, 2,114 students answered the questionnaire (1,233 in 2004 and 881 in 2012). Children practiced more outdoor sports in 2012 than in 2004 (86% vs 56%; p<0.001), but spent less time outside when the sun’s rays were most dangerous. The use of hats (64% vs 59%; p = 0.028) and sunscreen (35% vs 15%; p<0.001) at school and the application of sunscreen before going to the beach improved over time (51% vs 26% in 2004; p<0.001). However, there was an increase in sunburn rate (43% vs 37%; p = 0.005).

Conclusion

Sun exposure-related behaviour among primary school students in Oporto is improving but is still far from optimal. School would appear to be an adequate setting for effective and long-lasting sun protection interventions, and the introduction of educational books at schools, such as Play and Learn with Jo Spots, might be effective in bringing about positive behavioural changes.

Key words

sun protection behaviour knowledge children educational activity book 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Supplementary material

40699_2018_3290_MOESM1_ESM.pdf (114 kb)
Sun protection in children: a behavioural study
40699_2018_3290_MOESM2_ESM.pdf (106 kb)
Sun protection in children: a behavioural study
40699_2018_3290_MOESM3_ESM.pdf (3.2 mb)
Sun protection in children: a behavioural study

References

  1. 1.
    Gritz ER, Tripp MK, de Moor CA, Eicher SA, Mueller NH, Spedale JH. Skin cancer prevention counseling and clinical practices of pediatricians. Pediatr Dermatol 2003; 20: 16–24.CrossRefPubMedGoogle Scholar
  2. 2.
    McKinlay A, Breitbart EW, Ringborg U, Greinert R. ’Children under the Sun’–UV radiation and children’s skin.WHOWorkshop–Children’s sun protection education. Eur J Cancer Prev 2002; 11: 397–405.CrossRefPubMedGoogle Scholar
  3. 3.
    Cercato MC, Nagore E, Ramazzotti V, Sperduti I, Guillen C. Improving sun–safe knowledge, attitude and behaviour in parents of primary school children:a pilot study. J Cancer Educ 2013; 28: 151–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Berneburg M, Surber C. Children and sun protection. Br J Dermatol 2009; 3: 33–9.CrossRefGoogle Scholar
  5. 5.
    Guy GP Jr., Holman DM, Watson M. The important role of schools in the prevention of skin cancer. JAMA Dermatol 2016; 152: 1083–4.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Geller AC, Colditz G, Oliveria S, et al. Use of sunscreen, sunburning rates, and tanning bed use among more than 10 000 US children and adolescents. Pediatrics 2002; 109: 1009–14.CrossRefPubMedGoogle Scholar
  7. 7.
    Saraiya M, Glanz K, Briss P, Nichols P, White C, Das D. Preventing skin cancer:findings of the Task Force on Community Preventive Services On reducing Exposure to Ultraviolet Light. MMWR Recomm Rep 2003; 52: 1–12.PubMedGoogle Scholar
  8. 8.
    Lin JS, Eder M, Weinmann S. Behavioral counseling to prevent skin cancer:a systematic review for the U.S. Preventive Services Task Force. Ann Int Med 2011; 154: 190–201.PubMedGoogle Scholar
  9. 9.
    Saraiya M, Glanz K, Briss PA, et al. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation:a systematic review. Am J Prev Med 2004; 27: 422–66.PubMedGoogle Scholar
  10. 10.
    Hewitt M, Denman S, Hayes L, Pearson J, Wallbanks C. Evaluation of’ Sun–safe’:a health education resource for primary schools. Health Educ Res 2001; 16: 623–33.CrossRefPubMedGoogle Scholar
  11. 11.
    Dixon H, Borland R, Hill D. Sun protection and sunburn in primary school children:the influence of age, gender, and coloring. Prev Med 1999; 28: 119–30.CrossRefPubMedGoogle Scholar
  12. 12.
    Correia O, Barros AM, Rocha N, et al. Skin cancer primary prevention programme for school children. Analysis of behavioral practices. Skin Cancer 2006; 21: 67–76.Google Scholar
  13. 13.
    Reinau D, Meier C, Gerber N, Hofbauer GF, Surber C. Sun protective behaviour of primary and secondary school students in North–Western Switzerland. Swiss Med Wkly 2012; 24: 13520.Google Scholar
  14. 14.
    Balato N, Gaudiello F, Balato A, Monfrecola G. Sun habits in the children of Southern Italy. J Am Acad Dermatol 2007; 57: 883–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Autier P, Boniol M, Dore JF. Sunscreen use and increased duration of intentional sun exposure:still a burning issue. Int J Cancer 2007; 121: 1–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Thieden E, Philipsen PA, Sandby–Moller J, Wulf HC. Sunscreen use related to UV exposure, age, sex, and occupation based on personal dosimeter readings and sun–exposure behavior diaries. Arch Dermatol 2005; 141: 967–73.PubMedGoogle Scholar
  17. 17.
    Jansen R, Osterwalder U, Wang SQ, Burnett M, Lim HW. Photoprotection:part II. Sunscreen:development, efficacy, and controversies. J Am Acad Dermatol 2013; 69: 881–2.Google Scholar
  18. 18.
    Gefeller O, Pfahlberg A. Sunscreen use and melanoma:a case of evidence–based prevention? Photodermatol Photoimmunol Photomed 2002; 18: 153–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Garbe C. Patterns of sun protection for young children:do we deliver the right sun–protection messages? Br J Dermatol 2012; 166: 1365–2133.CrossRefGoogle Scholar
  20. 20.
    Skotarczak K, Osmola–Man Kowska A, Lodyga M, Polanska A, Mazur M, Adamski Z. Photoprotection:facts and controversies. Eur Rev Med Pharmacol Sci 2015; 19: 98–112.PubMedGoogle Scholar
  21. 21.
    Dudley DA, Cotton WG, Winslade MJ, et al. An objective and cross–sectional examination of sun–safe behaviours in New SouthWales primary schools. BMC Public Health 2017; 17: 21.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Li J, Uter W, Pfahlberg A, Gefeller O. A comparison of patterns of sun protection during beach holidays and everyday outdoor activities in a population sample of young German children. Br J Dermatol 2012; 166: 803–10.CrossRefPubMedGoogle Scholar
  23. 23.
    Gilaberte Y, Alonso JP, Teruel MP, Granizo C, Gallego J. Evaluation of a health promotion intervention for skin cancer prevention in Spain:the SolSano program. Health Promot Int 2008; 23: 209–19.CrossRefPubMedGoogle Scholar
  24. 24.
    Vuadens A, Ackermann S, Levi F, Bulliard JL. Sun–related knowledge and attitudes of primary and secondary schoolchildren in western Switzerland. Eur J Cancer Prev 2016; 5: 5.Google Scholar
  25. 25.
    Dadlani C, Orlow SJ. Planning for a brighter future:a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online J 2008; 14: 1.PubMedGoogle Scholar
  26. 26.
    Everett Jones S, Guy GP Jr.. Sun safety practices among schools in the United States. JAMA Dermatol 2017; 153: 391–7.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Ackermann S, Vuadens A, Levi F, Bulliard JL. Sun protective behaviour and sunburn prevalence in primary and secondary schoolchildren in western Switzerland. Swiss Med Wkly 2016;12.Google Scholar
  28. 28.
    Naldi L, Chatenoud L, Bertuccio P, et al. Improving sun–protection behavior among children:results of a cluster–randomized trial in Italian elementary schools. The “SoleSi SoleNo–GISED” Project. J Invest Dermatol 2007; 127: 1871–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Crane LA, Asdigian NL, Baron AE, et al. Mailed intervention to promote sun protection of children:a randomized controlled trial. Am J Prev Med 2012; 43: 399–410.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Ho BK, Reidy K, Huerta I, et al. Effectiveness of a multicomponent sun protection program for young children:a randomized clinical trial. JAMA Pediatr 2016; 170: 334–42.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Fernandez–Morano T, De Troya–Martin M, Rivas–Ruiz F, et al. Behaviour, attitudes and awareness concerning sun exposure in adolescents on the Costa del Sol. Eur J Dermatol 2014; 24: 85–93.PubMedGoogle Scholar
  32. 32.
    Aulbert W, Parpart C, Schulz–Hornbostel R, Hinrichs B, Kruger–Corcoran D, Stockfleth E. Certification of sun protection practices in a German child day–care centre improves children’s sun protection–the’ SunPass’ pilot study. Br J Dermatol 2009; 3: 5–12.CrossRefGoogle Scholar
  33. 33.
    Munoz Negro JE, Buendia–Eisman A, Cabrera Leon A, Serrano Ortega S. Variables associated with sun protection behaviour of preschoolers. Eur J Dermatol 2011; 21: 985–90.PubMedGoogle Scholar

Copyright information

© John Libbey Eurotext 2018

Authors and Affiliations

  • Ana Filipa Duarte
    • 1
    • 2
  • António Picoto
    • 2
  • Altamiro da Costa Pereira
    • 3
    • 4
  • Osvaldo Correia
    • 1
    • 2
    • 3
    • 4
  1. 1.Centro Dermatologia EpidermisInstituto CUFPortoPortugal
  2. 2.Portuguese Skin Cancer AssociationPortoPortugal
  3. 3.Center for Health Technology and Services Research (CINTESIS) and Department of Health Information and Decision Sciences, Faculty of MedicineUniversity of PortoPortoPortugal
  4. 4.Faculty of MedicineUniversity of PortoPortoPortugal

Personalised recommendations