Does being a "SunSmart School" influence hat-wearing compliance? An ecological study of hat-wearing rates at Australian primary schools in a region of high sun exposure

Preventive Medicine

Volumn 60, Issue , 2014, Pages 107-114

  Turner, Denise ^a   Harrison, Simone L ^a   Buettner, Petra ^b   Nowak, Madeleine ^a  

^a JAMES COOK UNIVERSITY   (Australia)

^b Tropical Health Solutions Pty Ltd   (Australia)

Author keywords

Hat wearing; Skin cancer; Sun protection; SunSmart; Ultraviolet radiation

Indexed keywords

HAT-WEARING; SKIN CANCER; SUN-PROTECTION; SUNSMART; ULTRAVIOLET RADIATION;

ADOLESCENT; ADULT; BENCHMARKING; CHILD; FEMALE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH PROMOTION; HUMANS; IMITATIVE BEHAVIOR; LEADERSHIP; MALE; PROTECTIVE CLOTHING; QUEENSLAND; SCHOOL HEALTH SERVICES; SEASONS; SKIN NEOPLASMS; STUDENTS; SUNLIGHT; TIME FACTORS; ULTRAVIOLET RAYS;

EID: 84893979624     PISSN: 00917435     EISSN: 10960260     Source Type: Journal    
DOI: 10.1016/j.ypmed.2013.12.020     Document Type: Article

References (69)

1. American Academy of Pediatrics Ultraviolet light: a hazard to children. Pediatrics 1999, 104:328-333.
2. Aulbert W., Parpart C., Schulz-Hornbostel R., Hinrichs B., Kruger-Corcoran D., Stockfleth E. Certification of sun protection practices in a German child day-care centre improves children's sun protection - the 'SunPass' pilot study. Br. J. Dermatol. 2009, 161:5-12.
3. Australian Curriculum Assessment and Reporting Authority My School 2012, Guide to understanding ICSEA, ACARA Sydney, Australia.
4. Australian Curriculum Assessment and Reporting Authority(ACARA) My School 2010, ACARA, Sydney, Australia, (Accessed from http://www.myschool.edu.au (11/01/2013)).
5. Australian Radiation Protection and Nuclear Safety Agency. Accessed May 2009 to June 2011. Townsville realtime UV index data [Online]. Available: [Accessed May 2009 to June 2011. http://www.arpansa.gov.au/uvindex/realtime/tow_rt.htm.
6. Australian Institute of Health and Welfare (AIHW) Cancer in Australia: An Overview, 2008, Cancer Series No. 46 2008, AIHW, Canberra.
7. Australian Institute of Health and Welfare, Australasian Association of Cancer Registries Cancer in Australia: An Overview, Cat. No. CAN56 2010, AIHW, Canberra.
8. Autier P., Dore J., Cattaruzza M.S., et al. Sunscreen use, wearing clothes, and number of nevi in 6- to 7-year-old European children. J. Natl. Cancer Inst. 1998, 90:1873-1880.
9. Bauer J., Garbe C. Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data. Pigment Cell Res. 2003, 16:297-306.
10. Bauer J., Buttner P.G., Wiecker T.S., Luther H., Garbe C. Effect of sunscreen and clothing on the number of melanocytic nevi in 1,812 German children attending day care. Am. J. Epidemiol. 2005, 161:620-627.
11. Berhard G., Mayer B., Seckmeyer G., Moise A. Measurements of spectral solar UV irradiance in tropical Australia. J. Geophys. Res. Atmos. 1997, 102:8719-8730.
12. Buettner P.G., Raasch B.A. Incidence rates of skin cancer in Townsville, Australia. Int. J. Cancer 1998, 78:587-593.
13. Bureau of Meteorology, Building your 'weather' skills, Forecasting the weather. Commonwealth of Australia, Bureau of Meteorology. Accessed from (27/11/2012). http://www.bom.gov.au/info/ftweather/page_30.shtml.
14. Bureau of Meterology Townsville Area Climate and History 2009, (Accessed from http://www.bom.gov.au/weather/qld/townsville/climate_and_history.shtml (21/07/2009)).
15. Bureau of Meterology Townsville, Queensland. Weather Observations 2011, (Accessed from http://reg.bom.gov.au/climate/dwo/IDCJDW4128.latest.shtml (May 2009 to June 2011)).
16. Cancer Council Australia's Skin Cancer Committee's National Schools Working Group Being SunSmart - A Guide for Primary Schools 2005, The Cancer Council, Australia.
17. Cancer Council Queensland SunSmart Policy Guidelines 2009, (Accessed from http://www.cancerqld.org.au/pdf/SunSmartPolicyGuildelines-Schools.pdf (07/07/2009)).
18. Cancer Council Queensland SunSmart School Application Form 2013, (Accessed from http://www.cancerqld.org.au/page/prevention/skin_cancer/national_sunsmart_schools_and_early_childhood_centres/sunsmart_school_application_form/ (13/06/2013)).
19. Cancer Council Victoria SunSmart Program 2003-2006 2002, Cancer Council Victoria, Victoria.
20. Cancer Research U.K. Sun Protection in Schools 2009, SunSmart, Cancer Research UK, London.
21. Dadlani C., Orlow S.J. Planning for a brighter future: a review of sun protection and barriers to behavioral change in children and adolescents. Dermatol Online J. 2008, 14:1.
22. Department of Education and Employment and Training State School Full-time Enrolment Counts, Census 2005-2009. Queensland Government 2009, (Accessed http://education.qld.gov.au/school/statistics (12/04/2010)).
23. Diffey B., Cheeseman J. Sun protection with hats. Br. J. Dermatol. 1992, 127:10-12.
24. Dixon H., Borland R., Hill D. Sun protection and sunburn in primary school children: the influence of age, gender, and colouring. Prev. Med. 1999, 28:119-130.
25. Downs N.J., Parisi A.V. Comparing Variations in the UV Facial Exposure Received by School Children in South-East Queensland, Australian Institute of Physics 17th National Congress 2006 2006, Brisbane, Australia.
26. English D.R., Milne E., Simpson J.A. Sun protection and the development of melanocytic nevi in children. Cancer Epidemiol. Biomarkers Prev. 2005, 14:2873-2876.
27. Enta T. Melanocytic nevi in sun-protected Canadian Hutterite children. Arch. Dermatol. 1998, 134:379-381.
28. Fritschi L., McHenry P., Green A.C., MacKie R.M., Green L., Siskind V. Naevi in schoolchildren in Scotland and Australia. Br. J. Dermatol. 1994, 130:599-603.
29. Ghissassi F.E., Baan R., Straif K., et al. A review of human carcinogens - part D: radiation. Lancet Oncol. 2009, 10:751-752.
30. Gies P., Javorniczky J., Roy C., Henderson S. Measurements of the UVR protection provided by hats used at school. Photochem. Photobiol. 2006, 82:750-754.
31. Giles-Corti B., English D.R., Costa C., Milne E., Cross D., Johnston R. Creating SunSmart schools. Health Educ. Res. 2004, 19:98-109.
32. Glanz K., Chang L., Song V., Rommel S., Muneoka L. Skin cancer prevention for children, parents, and caregivers: a field test of Hawaii's SunSmart program. J. Am. Acad. Dermatol. 1998, 38:413-417.
33. Green A.C., MacLennan R., Siskind V. Common acquired naevi and the risk of malignant melanoma. Int. J. Cancer 1985, 35:297-300.
34. Green A., MacLennan R., Youl P., Martin N. Site distribution of cutaneous melanoma in Queensland. Int. J. Cancer 1993, 53:232-236.
35. Green A., Battistutta D., Hart V., Leslie D., Weedon D. Skin cancer in a subtropical Australian population: incidence and lack of association with occupation. The Nambour Study Group. Am. J. Epidemiol. 1996, 144:1034-1040.
36. Harrison S.L., Nikles J. Preliminary observations of hat wearing in Brisbane schools. Ann. ACTM 2012, 13:38.
37. Harrison S.L., MacLennan R., Speare R., Wronski I. Sun exposure and melanocytic naevi in young Australian children. Lancet 1994, 344:1529-1532.
38. Harrison S.L., MacKie R.M., MacLennan R. Development of melanocytic nevi in the first three years of life. J. Natl. Cancer Inst. 2000, 92:1436-1438.
39. Harrison S.L., Buettner P.G., MacLennan R. The North Queensland "sun-safe clothing" study: design and baseline results of a randomized trial to determine the effectiveness of sun-protective clothing in preventing melanocytic nevi. Am. J. Epidemiol. 2005, 161:536-545.
40. Harrison S.L., Buettner P.G., MacLennan R., Woosnam J., Hutton J., Nowak M. Sun-safe clothing helps to prevent the development of pigmented moles - results of a randomised control trial in young Australian children. Ann. ACTM 2010, 11:49-50.
41. Heal C., Buettner P.G., Raasch B.A., Browning S. Minor skin excisions in general practice in North Queensland. Aust. Fam. Physician 2006, 35:825-828.
42. Hill D., Dixon H. Promoting sun protection in children: rationale and challenges. Health Educ. Behav. 1999, 26:409-417.
43. Hinde S. Welcome to the Sun Shame State, The Sunday Mail 2009, 4-5. Queensland Newspapers Pty. Ltd, Brisbane.
44. Holman C.D., Armstrong B.K. Cutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types. J. Natl. Cancer Inst. 1984, 73:75-82.
45. Hunter S., Love-Jackson K., Abdulla R., et al. Sun protection at elementary schools: a cluster randomized trial. J. Natl. Cancer Inst. 2010, 102:484-492.
46. I-Kuei L. A concordance correlation coefficient to evaluate reproducibility. Biometrics 1989, 45:255-268.
47. Kelly J.W., Rivers J.K., MacLennan R., Harrison S.L., Lewis A.E., Tate B.J. Sunlight: a major factor associated with the development of melanocytic naevi in Australian schoolchildren. J. Am. Acad. Dermatol. 1994, 30:40-48.
48. Kimlin M., Parisi A. Ultraviolet protective capabilities of hats under two different atmospheric conditions. 2nd Internet Photochemistry and Photobiology Conference 1999.
49. Kricker A., Armstrong B.K., English D.R. Sun exposure and non-melanocytic skin cancer. Cancer Causes Control 1994, 5:367-392.
50. Lagerlund M., Dixon H.G., Simpson J.A., Spittal M., Taylor H.R., Dobbinson S.J. Observed use of sunglasses in public outdoor settings around Melbourne, Australia: 1993 to 2002. Prev. Med. 2006, 42:291-296.
51. Milne E., Corti B., English D.R., Cross D., Costa C., Johnston R. The use of observational methods for monitoring sun-protection activities in schools. Health Educ. Res. 1999, 14:167-175.
52. Milne E., English D.R., Corti B., et al. Direct measurement of sun protection in primary schools. Prev. Med. 1999, 29:45-52.
53. Moise A.F., Buttner P.G., Harrison S.L. Sun exposure at school. Photochem. Photobiol. 1999, 70:269-274.
54. Montague M., Borland R., Sinclair C. Slip! Slop! Slap! and SunSmart, 1980-2000: skin cancer control and 20years of population-based campaigning. Health Educ. Behav. 2001, 28:290-305.
55. O'Riordan D.L., Geller A.C., Brooks D.R., Zhang Z., Miller D.R. Sunburn reduction through parental role modeling and sunscreen vigilance. J. Pediatr. 2003, 142:67-72.
56. Raasch B.A., Buettner P.G., Garbe C. Basal cell carcinoma: histological classification and body-site distribution. Br. J. Dermatol. 2006, 155:401-407.
57. Radvan D. Advances Towards a SunSmart State: Sun Protection in Schools, Advances Towards a SunSmart State - From Research to Practice 2006, Queensland Health and The Cancer Council Queensland, Brisbane, Australia.
58. Reeder A.I., Jopson J.A., Gray A. Primary school sun protection policies and practices 4years after baseline - a follow up study. Health Educ. Res. 2012, 27:844-856.
59. Reynolds K.D., Buller D.B., French S.A., Buller M.K., Ashley J.L. School sun-protection policies: measure development and assessments in 2 regions of the United States. J. Sch. Health 2012, 82:499-507.
60. Sagebiel R.W. Melanocytic nevi in histologic association with primary cutaneous melanoma of superficial spreading and nodular types: effect of tumor thickness. J. Invest. Dermatol. 1993, 100:322S-325S.
61. Sander-Wiecker T., Luther H., Buettner P.G., Bauer J., Garbe C. Moderate sun exposure and nevus counts in parents are associated with development of melanocytic nevi in childhood: a risk factor study in 1,812 kindergarten children. Cancer 2003, 97:628-638.
62. Skender-Kalnenas T.M., English D.R., Heenan P.J. Benign melanocytic lesions: risk markers or precursors of cutaneous melanoma?. J. Am. Acad. Dermatol. 1995, 33:1000-1007.
63. SunSmart Victoria SunSmart. Our History 2012, Cancer Council Victoria, Victoria: Australia, (Accessed from http://www.sunsmart.com.au/about_us/our_history (25/01/2013)).
64. The Cancer Association of South Africa Be SunSmart: A Guide for Schools 2010, Bedfordview, South Africa.
65. The National Society to Prevent Blindness The American Optometric Association, Ophthalmology. Statement on Ocular ultraviolet radiation hazards in sunlight. American Optometric Association 1993.
66. Turner D., Harrison S., Buettner P., Nowak M. School Sun-protection Policies - Does Being SunSmart Make a Difference? 2013, Unpublished research.
67. Turrisi R., Hillhouse J., Heavin S., Robinson J., Adams M., Berry J. Examination of the short-term efficacy of a parent-based intervention to prevent skin cancer. J. Behav. Med. 2004, 27:393-412.
68. Wong J.C.F., Cowling I., Parisi A. Reducing Human Exposure to Solar Ultraviolet Radiation 1997, First Internet Conference on Photochem Photobiol.
69. Youl P.H., Janda M., Aitken J.F., Del Mar C.B., C W.D., Baade P.D. Body site distribution of skin cancer, pre-malignant and common benign pigmented lesions excised in general practice. Br. J. Dermatol. 2011, 165:35-43.