Predictors of sunscreen use among schoolchildren participating in the U.S. Environmental Protection Agency's SunWise Program

Melanoma, the most commonly fatal form of skin cancer, continues to increase at rates higher than those for any other preventable cancers. In response, in 1998, the U.S. Environmental Protection Agency launched the SunWise Program. To date, more than 23,000 schools have registered for the program and an estimated 2,500,000 schoolchildren have participated. In advance of a major randomized trial testing the benefits of SunWise education, we conducted a pretest survey of 3,597 children ages 8-13 nationwide. With the goal of identifying prominent factors to inform future interventions, we examined the predictors of sunscreen use, the most routinely used form of sun protection by children and adults. Age and gender were found to be key predictors of sunscreen use. While routine sunscreen use (defined as “often” or “always”) exceeded 50% for children ages 8-11, fewer than 35% of children ages 12-13 reported using sunscreen. Strikingly, oldest boys (ages 12-13) were seven times less likely to report using sunscreen compared with youngest girls (ages 8-9). Other hypothesized explanatory factors such as number of hours in the sun per week and desire to obtain a tan were negligibly associated with sunscreen use. Most common barriers to sunscreen use included: forgot to put it on (55%) and sunscreen feels greasy on my skin (29%). In this, the largest survey to-date of young U.S. schoolchildren's use of sunscreen, we have identified a critical age for drop-off of sunscreen use and strengthened earlier observations indicating that pre-teen boys should be targeted in future educational programs.