Determinants of inadequate parental sun protection behaviour in their children--results of a cross-sectional study in Germany.

Unprotected sun exposure especially during childhood is a risk factor for skin cancer. A combined use of sun protection measures is recommended to protect children. However, the prevalence and determinants for combined use have been scarcely studied in children. The objective of this study was to identify determinants of parental sun protection behaviour. A cross-sectional survey was performed in five regions in Bavaria (Germany) during school entrance health examination (2010/2011). Parents of 4579 children (47% female, aged 5-6 years) completed a self-administered questionnaire (response 61%). Most children were regularly protected with single measures (shade (69%), clothes (80%), hat (83%), sunscreen (89%), sunglasses (20%)). However, regarding regular and combined use, >50% of children were inadequately protected. Larger family size, lower household equivalent income, darker skin and sunburn history were associated with inadequate use of different sun protection measures. The less frequent use of one sun protection measure was associated with less frequent use of the others. Child's sex, migration background, parental education and sun exposure showed inconsistent results regarding the different sun protection outcomes. Based on our results a regular, combined and correct use of multiple sun protection for children should be promoted independent of sociodemographic characteristics. Priority of shade, clothes and hat before sunscreen should be clarified.

Klostermann S ，Bolte G ，GME Study Group 《-》

A comparison of patterns of sun protection during beach holidays and everyday outdoor activities in a population sample of young German children.

Reducing exposure to ultraviolet (UV) radiation is the main effective measure for preventing skin cancer. Educational campaigns targeting sun protection have been focused either on behaviour on the beach during the summer holiday alone, or during everyday outdoor activities of the children. Little is known about the comparison between these different settings. To analyse whether parents apply similar protective measures to reduce UV exposure for their young children in different outdoor environments. Families (n = 2619) with children aged 3-6 years (response: 64·7%) were enrolled in a population-based survey in the German city of Erlangen and its surrounding rural county. Using a self-administered standardized questionnaire parents gave information about demographic and photosensitivity data of their children, their knowledge about risk factors for skin cancer and their typical instructions given to their children when these played outside on a summer day in different outdoor environments. Significant discrepancies regarding the four UV protective measures (clothes, shade, sunhat, sunscreen) for children between an everyday outdoor setting and a holiday setting on the beach were observed. A high level of parental risk factor knowledge was significantly associated with a better protection for children in all four measures only on the beach. Photosensitivity and demographic characteristics had some impact on protective behaviour, too. Measures of sun protection were reduced with children's increasing age. Skin cancer prevention campaigns should target the encouragement of sun protection for children also in outdoor activities of daily living, not only during a summer holiday on the beach.

Li J ，Uter W ，Pfahlberg A ，Gefeller O ... -  《-》

Certification of sun protection practices in a German child day-care centre improves children's sun protection--the 'SunPass' pilot study.

Aulbert W ，Parpart C ，Schulz-Hornbostel R ，Hinrichs B ，Krüger-Corcoran D ，Stockfleth E ... -  《-》

Summer sun exposure: knowledge, attitudes, and behaviors of Midwest adolescents.

Robinson JK ，Rademaker AW ，Sylvester JA ，Cook B ... -  《PREVENTIVE MEDICINE》

Influence of age, gender, educational level and self-estimation of skin type on sun exposure habits and readiness to increase sun protection.

Sun exposure habits and the propensity to undertake sun protection differ between individuals. Not least in primary prevention of skin cancer, aiming at reducing ultraviolet (UV) exposure, knowledge about these factors may be of importance. The aim of the present study was to investigate, in a primary health care (PHC) population, the relationship between sun exposure habits/sun protection behaviour/readiness to increase sun protection and gender, age, educational level and skin UV-sensitivity. The baseline data from a previously performed RCT on skin cancer prevention was used. 415 patients, aged > 18 years, visiting a PHC centre in southern Sweden, filled-out a questionnaire mapping sun exposure, readiness to increase sun protection according to the Transtheoretical Model of Behaviour Change (TTM), and the above mentioned factors. Female gender was associated with more frequent suntanning (p < 0.001) and sunbed use (p < 0.05), but also with more extensive sunscreen use (p < 0.001). High age was in general associated with low level of sun exposure and high level of protection. Subjects with low educational level reported less frequent sunscreen use than those with higher educational level, and also chose lower SPF (p < 0.001). For almost all parameters, high skin UV-sensitivity was associated with markedly lower sun exposure (p < 0.001) and more pronounced readiness to increase sun protection. Females and subjects with high educational level reported higher readiness to increase sunscreen use than males and subjects with lower educational level (p < 0.001). Gender, age, educational level and skin type appear to be important factors affecting sun exposure habits and sun protection behaviour, which supports the idea of appropriate mapping of these factors in patients in order to individualise sun protection advice according to the individual patient situation and capabilities.

Falk M ，Anderson CD 《-》