School policies that improve sun safety for children are essential to comprehensive school-based skin cancer prevention; however, a policy is only successful if school administration and teachers are aware of it and implement it. California was one of the first states that enacted legislation governing sun protection for students in public schools. In a recent publication in Preventing Chronic Disease, KB’s Dr. David Buller, Julia Berteletti and Mary Buller along with collaborators at Claremont Graduate University (CGU), Kaiser Permanente Center for Health Research (KPCHR) and the non-profit organization, Sun Safety for Kids (SSK), discuss how they explored the extent and accuracy of knowledge among principals and teachers in California public school districts about the content written in their district’s written sun safety policy.
Elementary schools in California school districts were recruited to a parent study via their principal and were eligible if 1) they subscribed to the California School Boards Association, 2) had adopted the recommended sun safety Sample Board Policy (designated BP 5141.7), and 3) posted their version of Board Policy 5141.7 online. A total of 118 principals provided consent for their school to participate and nominated one teacher or staff member who would be involved in implementing sun safety practices at the school and 109 of the 118 teachers completed the baseline survey.
The baseline survey for both principal and teacher asked whether or not the school district had a policy on sun protection for students. Those who answered yes were presented with a list of policy components and asked to indicate which components were included in the policy. Respondents were also asked about job characteristics, skin type, personal or family history of skin cancer, and demographic characteristics. Policy knowledge among principals and teachers was compared with the content of the written school district sun safety policy and principals’ and teachers’ knowledge of each component was classified as accurate or inaccurate. …
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In the March 20, 2018 issue of the Journal of the American Medical Association, the U.S. Preventive Services Task Force (USPSTF) published a recommendation statement on behavioral counseling to prevent skin cancer.
The publication updated the 2012 USPSTF recommendation on behavioral counseling for the prevention of skin cancer.
The USPSTF determined that behavioral counseling interventions are of moderate benefit in increasing sun protection behaviors in children, adolescents, and young adults with fair skin types (aged 6 months to 24 years old). They found adequate evidence that behavioral counseling interventions result in a small increase in sun protection behaviors in adults older than 24 years with fair skin types.
The USPSTF, however, found inadequate evidence on the benefits and harms of counseling adults about skin self-examination to prevent skin cancer. This conclusion was based on the lack of evidence that skin self-examination is beneficial.
Two editorials – one led by Dr. June Robinson from the Department of Dermatology at the Northwestern University Feinberg School of Medicine in Chicago and the other led by Dr. David Buller, Director of Research at Klein Buendel – were also published along with the Task Force recommendations.
The editorial by Robinson and Jablonski points out that while physicians are trusted sources of health information, people at risk for skin cancer or with a family history of skin cancer may also find family members to be useful networks for information on prevention and self-examination.
The editorial by Buller, Heckman, and Manne expresses disappointment in the Task Force not recommending skin self-examination and points out that some ongoing studies to determine effectiveness of skin self-examination may find that it is effective.
Both editorials describe the Task Force’s definition of risk as “fair skin types” as narrow. They believe that many other people are at risk for skin cancer and could benefit from sun protection education and counseling. Some groups mentioned in the editorials include people who sunburn but are not considered fair-skinned, people who use indoor tanning equipment, children and adolescents, Hispanics, and people who are physically active outdoors. According to the authors, it is important not to disenfranchise these groups within the diverse U.S. population.
Skin cancer is the most common type of cancer1 but the primary risk factor for skin cancer, UV exposure, is the most avoidable.2 Purpose-built shade not only reduces UV exposure,3 it can also come with other benefits like provide protection without requiring planning4 and may even provide protection for individuals with negative attitudes towards sun safety who seek shade to keep cool.5
In a recent publication in American Journal of Public Health, KB’s Dr. David Buller, Mary Buller and collaborators in Australia, at the University of Melbourne (Dr. Dallas English) and Cancer Council Victoria, (Dr. Suzanne Dobbinson) conducted a stratified randomized study in Melbourne, Australia and Denver, Colorado where shade sails were built in 1 of 2 passive recreation areas (PRAs) in full sun in 144 parks (71 in Melbourne and 73 in Denver). The use of the PRAs with shade sails built as part of the study were compared with the nearby non-shaded PRAs for use by park visitors. The authors tested two hypotheses – the first being that the introduction of shade sails over PRAs would increase the use of these PRAs by visitors compared to unshaded PRAs – and the second being that the increase in use of shaded PRAs would be larger in Melbourne, Australia than Denver, Colorado due to stronger norms for sun safety in Australia than the United States.
Public parks enrolled in the study had to contain at least two unshaded PRAs that were in full sun at pretest, and one of the two PRAs had to contain a space where a shade sail could be constructed. Trained observers made observations at the PRAs for 30-minute periods on four weekend days during a 20-week period in the summer months for each city at pretest and posttest to determine the number of visitors during peak UV hours (11 am to 3 pm). Shade sails were designed to be attractive while also providing shade during peak UV times and the shade cloth selected reduced UV by at least 94%. …
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Areli Chacón Silva, Ph.D., is the Interim Director of the Leadership Studies Program at the University of Texas at El Paso. She has a BA in International Business from Tecnológico de Monterrey (ITESM) (1996), an MBA from Angelo State University (1999), and a PhD in Economics from the University of La Havana (2011). Her research explores the Latino market in the United States, as well as business expansion opportunities for Mexican businesses. She has experience researching the cultural values of Latinos in America.
Currently, Dr. Chacón Silva is working with KB as a collaborating scientist with Dr. Gill Woodall and Dr. David Buller on WayToServe Español: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers (R44MD010405; Dr. Gill Woodall, Principal Investigator). This research project is funded by the National Institute on Minority Health and Health Disparities at the National Institutes of Health. On this project, she will assist with the creation of culturally-appropriate content and the translation of the English WayToServe® online responsible alcohol server training program to Spanish. She will ensure that the translation is compatible with the values and needs of workers in Spanish language-dominant bars and restaurants. The randomized control trial will take place at Spanish-dominant businesses in the Southwestern region of the United States.
In addition to her research collaboration with KB, Dr. Chacón Silva serves as Chair of the Curriculum Development Committee of the (L.E.A.D. Program) for Wise Latina International, a non-profit organization whose mission is to educate and empower Latinas and women of all walks of life to overcome barriers, to be self-reliant, to become leaders, and to act as agents of change in our communities.
Dr. Chacón Silva served on the Editorial Board Member Committee at the International Case Center of Tecnológico de Monterrey (ITESM) from 2008 to 2012. Her research has appeared in the International Journal of Case Method Research and Application and other scholarly outlets. She has worked as a consultant in international business, leadership, and business logistics since 2001.
Dr. Chacón Silva is also the co-author of the book ¡Reconquest! Advice for Business Owners in Chihuahua to do Business with Latinos in the US (2010). The book presents the results of research funded by CONACYT (National Science and Technology Fund of Mexico: CHIH-2006-CO2-59483) to developing capacity building strategies for Chihuahuan business people to increase commerce with Latinos in the United States, through the concept of the nostalgia marketing.
School policies that improve sun safety for children are essential to comprehensive school-based skin cancer prevention. California was one of the first states that enacted legislation governing sun protection for students in public schools. In a research letter recently published in JAMA Dermatology, KB’s Julia Berteletti, Dr. David Buller and Lucia Liu along with collaborators at Claremont Graduate University and the non-profit organization, Sun Safety for Kids, looked at how elementary schools in California adopted a policy for sun safety as recommended by the California School Boards Association (CSBA), a nonprofit membership-based education association representing elected officials who govern public school districts.
The Sample Policy, created through a collaboration with CSBA during a previous study, was based on sun safety recommendations put forth by California law and the Centers for Disease Control and Prevention recommendations and was disseminated to member school districts. The authors examined the content of sun safety policies for any deviation from the Sample Policy for 190 member districts that included elementary schools, subscribed to CSBA policy services, and posted their Board Policy online. The sun safety content of the Sample Policy and each districts’ sun safety policy was coded in 11 categories, such as sunscreen use, UV protective clothing, student education, and shade provision. Each policy was scored on content per category, strength of action specified, and intent for sun protection.
The majority of policies addressed sunscreen, protective clothing and hats. Most included shade, scheduling of outdoor activities to avoid peak UV hours, staff modeling and parent outreach. 75% of policies included student education. Educating teachers, resource allocation, and accountability were addressed in almost no policies. Also, 40% of districts altered their own policy to remove some content from the CSBA Sample Policy. The most frequently removed items were student education, outdoor shade or parent outreach. Authors also found that districts that removed content had significantly more students and administrators than those that adopted the Sample Policy verbatim.
Authors concluded that the CSBA played an influential role in the school districts’ adoption of sun safety policy and suggest that establishing a partnership with a similar association could be an important part of achieving school-based skin cancer prevention.
This research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD074416; Dr. Kim Reynolds, Claremont Graduate University and Dr. David Buller, KB, Principal Investigators).
Klein Buendel is a proud North American organizer and host of the 4th International Conference on UV and Skin Cancer Prevention being held May 1-4, 2018 in Toronto, Canada. The 2018 conference is being organized by a joint planning committee of skin cancer prevention experts in Canada and the United States from Ryerson University in Toronto, the Canadian Dermatology Association, and Klein Buendel.
The UV and Skin Cancer Prevention conferences provide an innovative scientific program that showcases the work of the international skin cancer prevention community. The previous conferences have been held in Copenhagen, Denmark (2011), Berlin, Germany (2013), and Melbourne, Australia (2015) and have attracted international experts in skin cancer prevention, UV radiation science, dermatology, allied behavioral and clinical disciplines and members of the environmental planning and design communities who are working in the field of UV and skin cancer prevention. The conferences have been organized by local planning committees dedicated to advancing skin cancer prevention.
The Toronto conference will feature multiple concurrent sessions and poster sessions addressing primary and secondary prevention, school settings, worksites, shade design, sun safety campaigns, indoor tanning trends, sunscreen, and more.
Special plenary sessions will address:
- New Research Methods for Skin Cancer Prevention
- Issues in Dissemination of Skin Cancer Prevention Interventions
- Second Generation Audiences for Skin Cancer Prevention
- Environmental Issues in Skin Cancer Prevention
- Screening for Skin Cancer Prevention
Four additional workshops will be held on May 1st:
- Sun Safety and Skin Health in Youth
- Young Adulthood Physical Activity
- Skin Smart Campus
- Online, Mobile, and Social Media Interventions
To see the program-at-a-glance, speakers, and registration information, visit…