Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8

Am J Prev Med. 2006 Jan;30(1):13-22. doi: 10.1016/j.amepre.2005.08.046.

Abstract

Background: 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.

Design: 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.

Setting/participants: A total of 2038 children from 30 middle schools in Colorado, New Mexico, and Arizona.

Main outcome measures: Self-reported sun-protection behavior using frequency ratings and diary.

Results: 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.

Conclusions: 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Arizona
  • Child
  • Colorado
  • Curriculum*
  • Female
  • Health Behavior*
  • Health Education / methods*
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion / methods*
  • Humans
  • Linear Models
  • Male
  • Matched-Pair Analysis
  • New Mexico
  • Program Evaluation
  • Protective Clothing / statistics & numerical data
  • Safety
  • School Health Services / organization & administration*
  • Students / psychology
  • Sunburn / prevention & control*
  • Sunlight / adverse effects*
  • Sunscreening Agents / therapeutic use

Substances

  • Sunscreening Agents