Persistent increase in children's sun protection in a randomized controlled community trial

Background. Reducing sun exposure during childhood may prevent skin cancer later in life. Sun protection increased immediately following implementatio n of the SunSafe multicomponent, community-based intervention delivered in 1996 through schools, day care centers, primary care offices, and beach rec reation areas. Whether sun protection levels would remain higher than prein tervention levels the following summer was unknown. Methods. A randomized controlled trial based in 10 New Hampshire towns addr essed children's use of protective clothing, shade, and sunscreen at freshw ater beach areas. The intervention was provided initially between March and May 1996. A brief project followup contact was provided to schools, day ca re centers, beaches, and primary care offices between March and May 1997 to restock intervention materials and to answer questions. Observations of 14 90 children during June through August of 1997 were compared with observati ons made prior to any intervention between June and August of 1995. Results. In intervention towns, the proportion of children using at least s ome sun protection increased by 0.15 from 0.58 in 1995 to 0.73 in 1997 whil e the proportion in control towns increased by 0.03 (P = 0.033). This incre ase was due to more use of sunscreen, but not more use of protective clothi ng or shade. In 1997, caregivers of children in intervention towns reported receiving more sun protection information from school and health care sour ces than control town caregivers (62% versus 33%, P < 0.006). Conclusions. In intervention communities, a higher proportion of children u sed sun protection in 1997 than at baseline. Increases from 1995 to 1997 we re similar in magnitude to short-term increases between 1995 and 1996 that we have been previously reported. (C) 2000American Health Foundation and Ac ademic Press.