A randomized trial of the Hawaii SunSmart program's impact on outdoor recreation staff

Background: Skin cancer is the most common form of cancer in the United Sta tes and one of the most preventable. Prevention programs for children at ou tdoor recreation sites may influence not only the youth, but the staff, or caregivers, as well. By teaching children about sun protection, staff may a lso change their sun protection behaviors. Objective: We report on the impact of a childhood skin cancer prevention pr ogram (SunSmart) on staff at outdoor recreation sites where a child-focused intervention was conducted. Methods: The intervention included staff training, on-site activities deliv ered by staff, distribution of sunscreen, and the promotion of sun-safe env ironments. It was hypothesized that by teaching children about sun protecti on, staff would change their sun protection behaviors. A randomized trial a t 14 recreation sites (n = 176 staff) in Hawaii tested the efficacy of educ ation only. and education plus environmental changes, compared with a contr ol condition. Results: Results showed significant positive changes in knowledge, sun prot ection habits, norms, and sun protection policies. The education plus envir onment group was not superior to education alone. Conclusion: Changes in staff behavior and attitudes are important for their own health, as positive role models, and for the dissemination of skin can cer control programs.