Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8.
Buller, D. B., Reynolds, K. D., Yaroch, A., Cutter, G. R., Hines, J. M., Geno, C. R., Maloy, J. A., Brown, M., Woodall, G., & Grandpre, J., (2006). Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8. American Journal of Preventive Medicine, 30(1), 13-22.
Background: There are few effective sun-safety education programs for use in secondary schools. Project aims were to create a sun-safety curriculum for grades 6 to 8, and to test whether exposure to the curriculum would increase children’s sun-protection behavior.
Design: A pair-matched, group-randomized, pre-–post test, controlled trial was performed with middle schools as the unit of randomization. Teachers implemented the six-unit sun-safety curriculum in 2001–2003, and analyses were performed in 2003–2004.
Setting/Participants: A total of 2038 children from 30 middle schools in Colorado, New Mexico, and Arizona.
Main Outcome Measures: Self-reported sun-protection behavior using frequency ratings and diary.
Results: Compared to control schools, children receiving the curriculum reported more frequent sun protection (p 0.0035), and a greater proportion wore long-sleeved shirts during recess (p0.0001) and applied sunscreen (p0.0001). Exposure to the curriculum improved knowledge (p0.0001), decreased perceived barriers to using sunscreen (p 0.0046), enhanced self-efficacy expectations (p 0.0577) about sun safety, and reduced favorable attitudes toward sun tanning (p 0.0026 to 0.0001). In intent-to-treat analyses, the treatment effect was eliminated only under the most conservative assumptions about dropouts.
Conclusions: Educational approaches to sun safety in middle school may be effective for improving children’s sun safety. Potential trial limitations include measuring short-term outcomes, focusing on young adolescents, using active parental consent, and testing in the American Southwest.
