The Effect of Nurse Health Education and Follow-up Programme on Sun Protection Behaviors of Children
Condition: Nurse's Role; Cancer
Study type: Interventional

Summary: 
      The aim of the study is to determine the effect of nurse health education and follow up
      program on sun protection behaviors of children. The study as a randomized controlled group
      was implemented in February- October 2014 in Turkey. After obtaining the parents' and the
      children's written consent, data were collected through face-to-face interviews using, the
      instruments (stages of change, the decisional balance scale, child and parental sun
      protection behavior form, self-efficacy form) on sun protection based on the transtheoretical
      model.
    

Detailed description: 
      Approximately 25% of lifelong sun exposure is formed prior to the age of 18. A significant
      correlation between exposure to ultraviolet radiation in childhood and skin cancer in
      adulthood draws attention to the importance of sun protection behaviors to be applied in this
      period. School-age children are easily reachable to promote preventive health behaviors. The
      aim of the study is to determine the effect of nurse health education and follow up program
      on sun protection behaviors of children. The study as a randomized controlled group trial was
      implemented in February- October 2014. Purposive nonprobability sampling was used to select
      25 schools in Izmir Karşıyaka district and research was conducted in two schools where
      attending the children coming from medium families. Risk assessment for skin cancer was
      performed by Fitzpatrick classification with 260 children before the study. Out of these
      children, 144 were found to be risky and were randomized to intervention (n = 40) and control
      (n = 40) groups according to their age, gender, and skin type. In the survey, the effect size
      was identified as 0.73 by a 5% error and 80% confidence. After obtaining the parents' and the
      children's written consent, data were collected through face-to-face interviews using, the
      instruments (stages of change, the decisional balance scale, child and parental sun
      protection behavior form, self-efficacy form) on sun protection based on the transtheoretical
      model. Turkish validity and reliability study of the scale was conducted by Aygün and Ergün
      (2013). The intervention group was trained about sun protection behaviors in six sessions.
      Each session lasted 45 minutes. Refresher training was organized on the 15th day, on 1st
      month 2nd month after the first session. At the beginning and at the end of the program,
      decisional balance and self-efficacy of children were evaluated. Data were analyzed by
      frequencies, regression, Wilcoxon signed-rank test, paired-samples t-test, independent
      samples t-test, Mann-Whitney U test, Friedman's test, and Chi-square test. Written consent
      was taken from children and their parents, schools, and the local ethics committee.
    

Intervention name(s): education
Intervention type(s): Behavioral
Intervention description(s): The intervention group was offered a six-hour training program based on the transtheoretical model in order to promote sun protection behavior and to reinforce self-efficacy. The program was prepared by the researchers in consideration of the SunSmart Program implemented in Australia, the SunWise School Program developed by the United States Environmental Protection Agency. The program included various educational tools such as a sun protection story, activity book, PowerPoint presentations, cartoons, and puzzles.
Refresher training was conducted 15 days, 1 month, and 2 months after the initial training. Sun protection behavior and self-efficacy of the children were evaluated at the beginning of the study and six months after the program. As gifts to support their sun protection behavior, the children were given an FDA-approved sunscreen with 50+ SPF, a white cotton short-sleeved T-shirt as protective clothing, sunglasses with 100% UV protection, and a wide-brimmed hat.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: nursing; Transtheoretical model; sun protection; self-efficacy; decisional balance; prevention