Sun protection counseling for children - Primary care practice patterns and effect of an intervention on clinicians

Objectives: To describe current primary care sun protection advice for chil dren and assess the effect on clinicians of an intervention to enhance thei r sun protection advocacy. Setting: Primary care practices caring for children in New Hampshire with s pecial attention to clinicians serving 10 towns that were involved in a ran domized controlled trial of the multicomponent SunSafe intervention involvi ng schools, recreation areas, and primary care practices. Design/Intervention: A statewide survey of all primary care clinicians serv ing children addressed their self-reported sun protection advocacy practice s. Clinicians in 10 systematically selected rural towns were involved in th e subsequent intervention study. The primary care intervention provided ass istance to practices in establishing an office system that promoted sun pro tection advice to children and their parents during office visits. Main Outcome Measures: Sun protection promotion activities of primary care clinicians as determined by their self report, research assistant observati on, and parent interviews. Results: Of 261 eligible clinicians responding to the statewide survey, abo ut half provide sun protection counseling "most of the time" or "almost alw ays" during summer well care visits. Pediatricians do so more often than fa mily physicians. Clinicians involved in the intervention increased their us e of handouts, waiting room educational materials, and sunscreen samples. C ompared with control town parents, parents in intervention towns reported a n increase in clinician sun protection advice. Conclusions: The SunSafe primary care intervention increased sun protection counseling activities of participating clinicians. A single-focus preventi ve service office system is feasible to include in community interventions to promote sun protection.