The use of observational methods for monitoring sun-protection activities in schools

Evaluation of health promotion interventions aimed at behavioural or enviro nmental change involves assessing change that occurs as a result of the pro gram, Direct observational methods can be used for this purpose and this pa per describes three such methods that we pilot tested for use in a 5-year i ntervention study aimed at reducing sun exposure in primary school children . (1) Monitoring 'No hat, no play' policies. This method involved video tap ing children in selected school play areas during lunch time and analysing the content of the videos to assess the proportion of children wearing vari ous types of hats. (2) Assessing shade provision in the playground. This me thod involved taking aerial photographs of each school and using them to es timate the proportion of shade in play areas available to children at lunch time, (3) Shade use. This involved children wearing polysulphone film badge s to measure the amount of UV-B exposure they received during one lunch per iod, relative to the total possible dose registered on index badges. Each m ethod was implemented successfully, and we demonstrated that the video and aerial photography methods produced highly reproducible results and that al l three methods were feasible. These three methods will be used in our inte rvention study to assess longitudinal change in schools' sun-protection pol icy and practice.