181112 If you build it, will adolescents seek shade? Results of a cluster randomised trial in secondary schools

Monday, October 27, 2008: 9:00 AM

Suzanne Dobbinson, PhD , Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Carlton Victoria 3053, Australia
Vanessa White, BBSc , Lincoln Centre for Research on Ageing, Austalian Institute for Primary Care, La Trobe University, Bundoora Victoria 3086, Australia
Melanie Wakefield, PhD , Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Carlton Victoria 3053, Australia
Kris Jamsen, MBiostat , Centre for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton Victoria 3053, Australia
Victoria White, PhD , Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Carlton Victoria 3053, Australia
Patricia Livingston, PhD , Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Burwood Victoria 3125, Australia
Dallas English, PhD , Centre for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton Victoria 3053, Australia
Julie Simpson, PhD , Centre for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton Victoria 3053, Australia
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.

Learning Objectives:
1.Recognize a need to develop successful interventions to improve adolescentsí sun-protective behaviors for skin cancer prevention. 2.List elements to consider when planning a shade development in schools. 3.Discuss the potential role of local environmental approaches as compared to educational and psycho-social interventions for reducing adolescents' sun exposure.

Keywords: Behavior Modification, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am principal investigator and author of this study funded by a 3-year National Health and Medical Research Council research project grant.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.