Skin cancer prevention for children, parents, and caregivers: A field test of Hawaii's SunSmart program

Background: Children are at particular risk for sun exposure, a major cause of skin cancer. Parents and caregivers Can help protect children by educating them about practicing safe sun habits, serving as role models, and providing supportive environments. Objective: We evaluated SunSmart, a cancer prevention program for 6- to 8-year-old children, their parents, and outdoor recreation staff. Methods: The intervention included staff training, on-site activities for children, interactive take-home booklets, behavior-monitoring scoreboards, incentives, providing sunscreen, and encouraging sun safe environments and policies. The program was evaluated by baseline and follow-up surveys of parents and recreation staff; monitoring forms, and on-site observations. Results: There were positive changes in all major outcomes, including knowledge; sun protection habits of parents, children, and staff; readiness to change; sun protection policies; and sun protection norms. The changes ranged from improvements of 3% to more than 20%, and several changes were statistically significant. Conclusion: The results demonstrated the feasibility and short-term impact of Hawaii's SunSmart program and suggested areas for refinement and expansion.