Motivating public school districts to adopt sun protection policies: a randomized controlled trial

• Published in: American journal of preventive medicine 2011-09, Vol.41 (3), p.309-316
• Main Authors: Buller, David B, Reynolds, Kim D, Ashley, Jeff L, Buller, Mary K, Kane, Ilima L, Stabell, Cheri L, Massie, Kim L, Liu, Xia, Cutter, Gary R
• Format: Article
• Language: English
• Subjects: California; Colorado; Female; Follow-Up Studies; Humans; Male; Organizational Policy; Parents; Public health education; Public schools; Randomized controlled trials; Safety; School boards; School districts; Schools - organization & administration; Skin cancer; Skin Neoplasms - prevention & control; Students; Sunburn - prevention & control; Sunlight - adverse effects; Technical assistance; United States; Web sites
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2011.04.019

In 2002, CDC recommended that the nation's schools establish policies that reduce sun exposure to decrease students' risk of skin cancer. A program to convince public school districts to adopt such a policy was evaluated. RCT. Public school districts in Colorado (n=56) and Southern California (n=56). Policy information, tools, and technical assistance were provided through printed materials, a website, meetings with administrators, and presentations to school boards. An RCT enrolled public school districts from 2005 to 2010. Policy adoption was promoted over 2 years at districts randomized to the intervention. School board-approved policies were obtained from 106 districts and coded at baseline and 2-year follow-up. Analyses were conducted in 2010. There was no difference in the percentage of districts adopting a policy (24% in intervention; 12% in control; p=0.142); however, intervention districts (adjusted M=3.10 of 21 total score) adopted stronger sun safety policies than control districts (adjusted M=1.79; p=0.035). Policy categories improved on sun safety education for students (intervention adjusted M=0.76; control adjusted M=0.43, p=0.048); provision of outdoor shade (intervention adjusted M=0.79; control adjusted M=0.28, p=0.029); and outreach to parents (intervention adjusted M=0.59; control adjusted M=0.20, p=0.027). Multifaceted promotion can increase adoption of stronger policies for reducing sun exposure of students by public school districts. Future research should explore how policies are implemented by schools.