Kaiser Kids Sun Care Program
|Purpose||Designed to increase awareness and promote sun protection behavior and practices. (2006)|
|Program Focus||Awareness building and Behavior Modification|
|Population Focus||Sun-exposed individuals|
|Age||Adolescents (11-18 years), Adults (40-65 years), Children (0-10 years), Young Adults (19-39 years)|
|Race/Ethnicity||Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin|
|Funded by||NCI (Grant number(s): CA74592)|
The Implementation Guide is a resource for implementing this program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the research-tested program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Products page.
Community Preventive Services Task Force Finding
Required resources include:
- Clinician orientation/training PowerPoint presentation
- Anticipatory guidance recommendations sheet
- Protection Tip Sheets
- Activity sheet for parents and children
About the Study
The Kaiser Kids Sun Care Program was evaluated using a randomized clinical trial to assess changes in provider delivery of sun protection advice and parents' practice of sun protection for their children. The intervention was delivered during well-child visits by healthcare providers from 14 primary care practices of Kaiser Permanente of Colorado. The 14 offices were matched into pairs according to patient volume, number and type of providers, and socio-demographic profiles of the populations served, and then randomly assigned to intervention and control groups. Offices in the control condition provided usual care: the use of prompt sheets for anticipatory guidance that included a prompt under the safety section to discuss the use of sunscreen for children age 6 months and older. Parents of children aged 1 to 6 months were identified using hospital birth records and contacted by telephone for recruitment.
The sample was composed of 728 parent-child pairs. Children were between the ages of 1 and 6 months at the start of the study, with 49.7% female and 50.3% male. Child's race/ethnicity was reported as White (61.7%), Black (0.8%), Hispanic (8.4%), other (4.4%), and missing (24.7%). The majority (78.6%) of the parents were between the ages of 25 and 39 years.
Parents' sun protection behaviors and parent-reported provider delivery of sun protection advice were gathered via telephone interviews with parents. Consenting parents completed a baseline interview at recruitment and at follow-up telephone interviews at 1-, 2-, and 3-year follow-ups. Parents were asked whether they "always, frequently, seldom, or never" use each of the following seven sun protection strategies for their child between 11 a.m. and 3 p.m.: stay inside, stay in the shade, use clothing that covers most of the arms and legs, use sunscreen with SPF>15, use a hat, limit time in the sun, and use sunglasses. Responses were combined into an additive scale that measured overall number and frequency of practices. Scale scores ranged from 7 (no strategies used ever) to 28 (all strategies used always). The researchers also examined the proportions of parents who reported frequently or always using each individual sun protection strategy. Parents were also asked whether they received any sun protection materials from their healthcare provider, whether their provider had discussed sun protection with them, and if so, what advice was given.
Health care providers completed written surveys prior to the implementation of the intervention and at 1-, 2-, and 3-year follow-ups. The questionnaire asked how often providers included eight anticipatory guidance topics in well-child care and how often they included seven specific sun protection topics when they discussed sun protection with parents.
Effects of the Kaiser Kids Sun Care Program on Parents' Sun Protection Behaviors
- At both the 2- and 3-year follow-up interviews, parents in the intervention group reported using significantly more sun protection strategies at higher frequencies (Year 2 M=18.52; Year 3 M=18.18) compared with parents in the control group (Year 2 M=18.05; Year 3 M=17.71; p<.05).
- At the 2-year follow-up, 79.2% of parents in the intervention group reported always or frequently using shade, compared to 71.9% of parents in the control group (p<.05). At the 3-year follow-up, parents in the intervention group reported always or frequently using hats (57.3%) and sunglasses (39.4%) significantly more often than parents in the control group (hats: 47.4%, p<.05; sunglasses: 29.9%, p<.05).
Effects of the Kaiser Kids Sun Care Program on Provider Delivery of Sun Protection Advice
- At the 3-year follow-up, parents in the intervention group reported discussing sun protection with their child's healthcare provider (75%) and receiving written or other materials about sun protection (72.5%) at significantly higher rates across all three follow-up interviews (p<.001) compared to parents in the control group (advice: 52.6%; materials: 40.2%), Furthermore, the advice delivered in the intervention group was considerably more in-depth, covering more topics about sun protection (e.g., limiting time in the sun; using sunscreen; avoiding midday sun; using shade, clothing, hats).
- Provider responses to the written questionnaires indicated that, at baseline, sun protection advice was the least common anticipatory guidance topic and was reported to be delivered more often by control group providers than intervention group providers (40% vs. 18% always or almost always discuss it, p=.03). At 1-, 2-, and 3-year follow-ups, higher proportions of providers in the intervention group compared to the control group reported routinely providing sun protection advice, although this difference was significant only at Year 1 follow-up (Year 1: 71% vs. 53%, p=.05; Year 2: 70% vs. 57%, p=.20; Year 3: 73% vs. 58%, p=.13).
Crane,L.A.; Deas,A.; Mokrohisky,S.T.; Ehrsam,G.; Jones,R.H.; Dellavalle,R.; Byers,T.E.; Morelli,J. (2006). A randomized intervention study of sun protection promotion in well-child care. Preventive Medicine, 42(3), 162-170.