Evaluation of the educational intervention "living with the sun" by preschool and first-year primary school students: a pilot study

Background: "Convive con el Sol" (Living with the sun) is an educational programme to promote education about sun exposure and healthy photoprotection habits among Spanish children. Objectives: This study evaluated the effects of the "Convive con el Sol" school-based sun protection programme on the sun safety habits, attitudes, knowledge, and practices in preschool and first-year primary school students. Materials & Methods: A quasi-experimental pilot study was established with a pre-test/post-test design and without a control group to evaluate the efficacy of the "Convive con el Sol" programme in children aged 3-8 years. Two questionnaires were used to evaluate the programme: the CHRESI questionnaire and the SolSano questionnaire. Results: Seven educational centres participated in the study. The number of completed baseline questionnaires was 351 for the CHRESI survey and 226 for the SolSano survey. After the intervention, the students improved their sun protection practices; fewer students went to the beach or swimming-pool at noon (9.8% vs 5.5%; p = 0.03), and more schoolchildren used cream with an SPF rating >15 (37.6% vs 76.2%; p <0.01) and repeatedly applied sunscreen if continuously exposed (67.4% vs 82.7%; p <0.01). Conclusion: Our findings show that the "Convive con el Sol" educational intervention improved photoprotection practices in children aged 3-8 years, but did not reduce the percentage of sunburned children. This pilot study serves as a starting point for designing educational interventions, targeting students, teachers, and families.

Prevalence and predictors of sunburn among beachgoers.

BACKGROUND: Painful sunburns at any age are one of the main risk factors for skin cancer. OBJECTIVES: To determine the prevalence and predictors of sunburn among beachgoers. METHODS: A cross-sectional health survey was conducted at the beach during the summer. Adults >18 years with an understanding of Spanish were interviewed using a questionnaire about behaviours, attitudes and knowledge related to sun exposure at the beach. A descriptive analysis was performed, and a log-binomial regression model was used to determine predictors of sunburn. RESULTS: The survey was completed by 1054 beachgoers, with a mean age of 43.8 (SD: 18.7) years, 61.2% women, skin phototypes i (13.6%), ii (22.3%), iii (34.0%) and iv (30.2%). 46.9% of responders reported at least one painful sunburn during the previous summer. Age, sex, education, skin phototype, midday sun exposure, sun protection habits, attitudes towards tanning and knowledge about skin cancer were identified as independent predictors of sunburn. CONCLUSIONS: It is necessary to develop photoprotection campaigns aimed at beachgoers, particularly in young people, men, those with skin phototypes I-III and secondary or university education. Educational strategies should be aimed at discouraging sun exposure at midday, changing attitudes towards tanning and improving knowledge about skin cancer.

Validation of the 'CHRESI' questionnaire on habits related to sun exposure during childhood.

Sun exposure in childhood is the main risk determinant for skin cancer in adulthood. Several questionnaires have been used to examine behaviour patterns in terms of sun exposure in childhood, but none have been subjected to a rigorous analysis of their measurement properties. To evaluate the psychometric properties of a questionnaire adapted to investigate children's sun exposure behaviour, a two-stage validation study was carried out. First, in a transverse study, the questionnaire was administered to a sample of 333 children recruited from schools, and the validity and internal consistency were analysed. Second, 32 children recruited in a hospital setting were interviewed for the test-retest analysis. All the items in the 'Photoprotection habits' category were significantly correlated. Principal components analysis showed that two components accounted for over 53% of the variance. The Cronbach's α-coefficient was 0.63 for the first component and 0.43 for the second. In the stability analysis, the percentage of absolute agreement exceeded 70% for all the questions. The Questionnaire on Habits RElated to Sun exposure during Infancy (CHRESI) questionnaire examines sun protection habits by children. Its proven reliability, validity and stability make it a useful tool both in epidemiologic research and in the development and evaluation of campaigns to reduce the risk of skin cancer.