• K Glanz, J E Maddock, R A Lew, and L Murakami-Akatsuka.
• Cancer Research Center of Hawaii, University of Hawaii at Manoa, USA.
• J. Am. Acad. Dermatol. 2001 Jun 1; 44 (6): 973-8.

BackgroundSkin cancer is the most common form of cancer in the United States and one of the most preventable. Prevention programs for children at outdoor recreation sites may influence not only the youth, but the staff, or caregivers, as well. By teaching children about sun protection, staff may also change their sun protection behaviors.ObjectiveWe report on the impact of a childhood skin cancer prevention program (SunSmart) on staff at outdoor recreation sites where a child-focused intervention was conducted.MethodsThe intervention included staff training, on-site activities delivered by staff, distribution of sunscreen, and the promotion of sun-safe environments. It was hypothesized that by teaching children about sun protection, staff would change their sun protection behaviors. A randomized trial at 14 recreation sites (n = 176 staff) in Hawaii tested the efficacy of education only, and education plus environmental changes, compared with a control condition.ResultsResults showed significant positive changes in knowledge, sun protection habits, norms, and sun protection policies. The education plus environment group was not superior to education alone.ConclusionChanges in staff behavior and attitudes are important for their own health, as positive role models, and for the dissemination of skin cancer control programs.

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