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Background: This study examined implementation of district sun safety policy in schools and tested correlates of implementation in California public school districts. Methods: Principals (N = 118) and teachers (N = 113) in California public elementary schools (N = 118) were recruited and completed a survey on sun protection policies and practices. The sample contained schools whose districts subscribed to the California School Boards Association and adopted Board Policy 5141.7 for sun safety. Principals and teachers reported on implementation of 10 school practices related to BP 5141.7 indicating which practices were implemented in the school. Results: Years in public education (Exponentiated Score (ES) = 0.51, p < 0.001), years worked in the current district (ES = 0.49, p < 0.001), perception that parents should take action to protect children from the sun (ES = 0.43, p < 0.01), and personal skin phenotype (Low Risk ES = 0.55; High Risk ES = 0.09, p < 0.05) were associated with number of practices implemented in the school using multiple Poisson regression. Conclusions: Policy implementation is more likely among schools with experienced faculty, when parents are seen as important partners in student skin cancer prevention, and when school principals and teachers have a lower personal risk phenotype.

Background: An economic evaluation of Sun Safe Schools intervention designed to aid California elementary schools with implementing sun safety practices consistent with local board–approved policy. Design: Program cost analysis: intervention delivery and practice implementation. Setting: California elementary schools (58 interventions and 60 controls). Principals at 52 intervention and 53 control schools provided complete implementation data. Participants: Principals completing pre-/postintervention surveys assessing practice implementation. Intervention: Phone-based 45-minute session with a project coach on practice implementation, follow-up e-mails/phone contacts, $500 mini-grant. Schools chose from a list of 10 practices for implementation: ultraviolet monitoring, clothing, hats, and/or sunscreen recommendations, outdoor shade, class education, staff training and/or modeling, parent outreach, and resource allocation. The duration of intervention was 20 months. Rolling recruitment/intervention: February 2014 to December 2017. Measures: Intervention delivery and practice implementation costs. Correlations of school demographics and administrator beliefs with costs. Analysis: Intervention delivery activities micro-costed. Implemented practices assessed using costing template. Results: Intervention schools: 234 implemented practices, control schools: 157. Twenty-month delivery costs: $29 310; $16 653 (per school: $320) for project staff, mostly mini-grants and coaching time. Administrator costs: $12 657 (per school: $243). Per-student delivery costs: $1.01. Costs of implemented practices: $641 843 for intervention schools (per-school mean: $12 343, median: $6 969); $496 365 for controls (per-school mean: $9365, median: $3123). Delivery costs correlated with implemented practices (0.37, P <.01) and total practice costs (0.37, P <.05). Implemented practices correlated with principal beliefs about the importance of skin cancer prevention to student health (0.46, P <.001) and parents (0.45, P <.001). Conclusion: Coaching of elementary school personnel can stimulate sun safety practice implementation at a reasonable cost. Findings can assist schools in implementing appropriate sun safety practices. [ABSTRACT FROM AUTHOR]

Background: In 2002, CDC recommended that the nation's schools establish policies that reduce sun exposure to decrease students' risk of skin cancer., Purpose: A program to convince public school districts to adopt such a policy was evaluated., Design: RCT., Setting/participants: Public school districts in Colorado (n=56) and Southern California (n=56)., Intervention: Policy 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 Measures: School board-approved policies were obtained from 106 districts and coded at baseline and 2-year follow-up. Analyses were conducted in 2010., Results: There 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)., Conclusions: Multifaceted 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., (Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)