PREDICTORS OF SUNSCREEN USE IN CHILDHOOD

Objective: To identify risk factors predictive of sunscreen use in chi ldren. Design: Cross-sectional review of convenience sample. Setting: Emergency department of a regional referral pediatric hospital. Subjec ts: Nine hundred twenty-five parents of children presenting to the eme rgency department in August 1993. Main Outcome Measures: Parental risk factors assessed were use of sunscreen, tanning behaviors, previous b listering sunburn, knowledge of cancer risk related to sunburn and sun protection factor definition, education level, and other health-promo ting behaviors. The parents were asked about perceived risk for their child's being sunburned in the next month or development of skin cance r in their lifetime, as well as an estimation of safe sun exposure tim e far their child. Child risk factors included a history of previous p ainful sunburn and parental assessment of their child's skin type base d on susceptibility to sunburn. Results: Eighty-four percent of parent s reported that their children had used sunscreen at least once in the previous 2 months. The use of sunscreen in children younger than 1 ye ar was 54%, from 1 to 12 years of age was 91%, and older than 12 years was 68%. Factors associated with increased likelihood of sunscreen us e were age of 1 to 12 years, parental use of sunscreen, estimation of safe sun exposure of less than 30 minutes, description of child skin t ype as burns ''sometimes,'' ''easily,'' or ''always,'' and correct def inition of sun protection factor. Application of a multivariate model yielded a sensitivity of 96%, specificity of 36%, and positive predict ive value of sunscreen use of 89%.Conclusions: Sunscreen use in parent s is predictive of use in their children and relates more to experienc e with sunburn than with concerns about future skin cancer risk.