Evaluation of 'Sun-safe': a health education resource for primary schools

The aim of the study was to assess the effectiveness of 'Sun-safe', a compu ter-based resource designed to promote skin cancer awareness and educate ch ildren, aged 10-11 years, about the effects of excessive exposure to the su n and associated skin cancer preventive behaviours. Effectiveness was measu red by changes in knowledge, attitudes and behavioural. intentions using a self-completed questionnaire. A cluster, controlled evaluation design was u sed. Twelve schools were randomly allocated to the intervention arms of the study (workbook or computer), with a further four schools acting as contro ls (no intervention). One school allocated to the computer group had seriou s technical problems with their computers on the day of the intervention an d had to be excluded from the study, leaving six schools in the workbook gr oup and five in the computer group. One class in each of the 15 schools par ticipated. The questionnaire was administered before the intervention, the day after and 6 weeks thereafter. The primary outcome measures were changes in mean scores at 6 weeks. In all, 376 children, 83% of the roll, complete d both pre- and 6-week tests. Mixed-model analysis, allowing for pre-interv ention score and the cluster effect, showed significant increases in knowle dge scores in all three groups [workbook 2.36, 95% confidence interval (Cl) : 1.66 to 3.05; computer 1.73, 95% CI: 1.00 to 2.46; control 0.93, 95% CI: 0.11 to 1.74], but only the workbook group was significantly better than th e control group (1.43, 95% CI: 0.36 to 2.50) and there was no significant d ifference between the intervention groups (0.63, 95% CI: -0.38 to 1.63). Wi th regard to attitudes, both interventions showed significantly greater inc reases in scores than the control group, but there was no significant diffe rence between them (workbook 2.37, 95% CI: 1.27 to 3.47; computer 1.92, 95% CI: 0.76 to 3.09; control -0.01, 95% CI: -1.28 to 1.27). Although the mean increases for behavioural intentions scores were small (workbook 0.66, 95 % CI: 0.26 to 1.05; computer 1.11, 95% CI: 0.70 to 1.51; control 0.08, 95% CI: -0.37 to 0.52), those for the intervention groups were significantly be tter than the control group, but were not significantly different from each other. The evaluation showed significant improvements in knowledge, attitu des and behavioural intentions, which were still present 6 weeks after the intervention This suggests that interventions employing the Sun-safe workbo ok and computer-based resources could be most usefully put into effect in t he week before the start of the summer holidays.