Motivating Public School Districts to Adopt Sun Protection Policies: A Randomized Controlled Trial

BackgroundIn 2002, CDC recommended that the nation's schools establish policies that reduce sun exposure to decrease students' risk of skin cancer.PurposeA program to convince public school districts to adopt such a policy was evaluated.DesignRCT.Setting/participantsPublic school districts in Colorado (n=56) and Southern California (n=56).InterventionPolicy information, tools, and technical assistance were provided through printed materials, a website, meetings with administrators, and presentations to school boards. An RCT enrolled public school districts from 2005 to 2010. Policy adoption was promoted over 2 years at districts randomized to the intervention.Main outcome measuresSchool board–approved policies were obtained from 106 districts and coded at baseline and 2-year follow-up. Analyses were conducted in 2010.ResultsThere was no difference in the percentage of districts adopting a policy (24% in intervention; 12% in control; p=0.142); however, intervention districts (adjusted M=3.10 of 21 total score) adopted stronger sun safety policies than control districts (adjusted M=1.79; p=0.035). Policy categories improved on sun safety education for students (intervention adjusted M=0.76; control adjusted M=0.43, p=0.048); provision of outdoor shade (intervention adjusted M=0.79; control adjusted M=0.28, p=0.029); and outreach to parents (intervention adjusted M=0.59; control adjusted M=0.20, p=0.027).ConclusionsMultifaceted promotion can increase adoption of stronger policies for reducing sun exposure of students by public school districts. Future research should explore how policies are implemented by schools.