Evaluation of a sun safety education programme for primary school students in Switzerland

The incidence of skin cancer has increased worldwide, with rates being especially high in Switzerland compared with other European countries. Extensive sun exposure during childhood is considered a key factor for skin carcinogenesis. The aim of the study was to evaluate the impact of a school-based sun safety education programme developed by the Swiss Cancer Leagues on primary school students' sun-related knowledge, protective behaviours and sunburn rates. In summer 2011, 1-h sun safety education sessions were held at 33 primary schools throughout the Canton of Zurich (North-Eastern Switzerland). Children in the participating school classes (first, second and third graders) answered a questionnaire on their sun-related knowledge, behaviours and sunburn experience shortly before and 1 year after the intervention. Overall, 3110 completed pretest and 1738 post-test questionnaires were eligible for analysis. The evaluation of pretest data showed considerable room for improvement in terms of sun-related knowledge, considering that merely a good half of the children were conscious that the sun may present a hazard to health. Overall, more than 95% of students benefited from the protection of sunscreen (application by parents: 73%; application by child: 66%), but only 36% stated that they generally sought shade on sunny days. After the intervention, knowledge increased considerably and significantly (P<0.0001), but there was no change in sun-protective behaviours (use of sunscreen, seeking shade). However, we observed a nonsignificant trend towards decreased sunburn rates. The brief one-time sun safety education sessions were effective in sustainably improving children's sun-related knowledge and possibly to some extent in decreasing their sunburn rates.