If you build it, will adolescents seek shade? Results of a cluster randomised trial in secondary schools

Secondary schools have been slow to create supportive environments for students' sun protection in Australia and the United States. Despite good knowledge of skin cancer, the majority of Australian adolescents desire a suntan and resist sun protection. This study evaluated a shade development strategy to reduce their sun exposure. 51 secondary schools with limited shade participated in the cluster-randomized trial. 25 schools were randomly assigned to receive the intervention (a shade-sail built in winter 2005) and 26 schools to observation-only. At each school, boundaries for a full-sun site were defined and student usage observed weekly during lunch over the spring/summer pre/post-test. Outcomes were assessed by group difference in student numbers using the sites before and after creation of the newly shaded intervention areas. An un-paired t-test compared group observed use in an intention-to-treat analysis. Aggregate summary measures were used to adjust for clustering within schools. Results showed the average number of students using the sites at control schools decreased slightly (-0.03) and increased at intervention schools (2.63) (p=.011). On average, 2.67 more students used the newly shaded intervention sites compared with full-sun control sites. There was no evidence of shade avoidance. However, mean use of the sites was relatively low. In conclusion, secondary students will use, rather than avoid, purpose-built shade in schools, and investing in shade for schools has potential. This presentation will also examine factors that maximise shade usage by students.

ents.