Semi-tailored newsletter sun protection intervention for parents of children age 6-9

Using the Precaution Adoption Process Model, we developed a semi-tailored sun protection newsletter intervention for parents of children age 6-9. 811 families were recruited from medical practices and community settings in 2003-04 and randomly assigned to intervention or control groups. In the spring of three sequential years, families assigned to the intervention received a series of 3-4 newsletters designed to enhance perceptions of risk and reduce barriers to sun protection. Mailings included resources such as swim shirts, sun hats, sunscreen, and tree seeds, and learning activities for children. Sun protection behavior was assessed through telephone interviews of parents each summer, with the baseline measure in 2004 and final follow-up measure in 2007 (response rates > 90%). Repeated measures analysis of a composite sun protection measure that combined use of mid-day sun avoidance, protective clothing, hat, shade and sunscreen showed a significant study group by time interaction (p<0.001). Frequency of sunburn was lower in the intervention compared to control group for each follow-up year, but only significant for the 1st follow-up (49% vs. 60%; p=0.01). The intervention group reported significantly higher use of clothing for the 1st and 2nd follow-ups; higher use of hats at the 2nd follow-up; higher use of shade at the 3rd follow-up; and higher use of sunscreen at the 2nd follow-up (p's<0.05). In general, group differences in use of sun protection strategies by year reflected the behaviors emphasized in the intervention for that year. The results suggest that behavioral effects of the intervention were short-lived.