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Exposure to the sun by infants has been demonstrated to increase the risk of the development of melanoma and other skin cancers later in life. A cohort of 508 women who delivered healthy Caucasian babies were followed up at 1 year to determine their knowledge, attitudes and practices regarding sun protection towards themselves and their child. In addition, the 1-year-old infants were assessed by a trained nurse for the number of nevi they had on their skin. Results indicate caregivers reported a high level of sun-protection practices towards their child, with 93% of the caregivers reporting usually or always placing the child in the shade when going outside. Further, 81% of the caregivers reported usually or always placing a hat on the child, while 64% reported usually or always applying sunscreen to the child's exposed skin. Interestingly, only 61% of the caregivers reported that they stayed in the shade to reduce sun exposure and only 42% wore a hat when out in the sun. Mother's own personal sun-protection methods predicted the method of sun protection that she would most likely use for the child. While children appear to be reasonably protected from the sun, they are influenced by their mother's own behaviors.

This paper reports data on the first national survey of sun-protection measures of Australian secondary school students. A cross-sectional survey of a representative sample of 23,915 Australian school children in Years 7-12 was conducted in 1993. Students were questioned about usual sun-protection practices, beliefs about skin cancer and suntans, and sunburn history. The results showed differences in sun-protection behaviours as a function of 'year level', 'gender', 'skin type' and 'concern about getting cancer' among others. Adolescents who believe there is a lot they can do to avoid skin cancer are more likely to engage in sun-protective behaviours. Males were more likely to wear a cap, yet females tended to use sunscreen. The use of clothing to protect themselves from the sun was higher in males, yet females were more likely to stay mainly in the shade. All behaviours decreased with age. Poorer protective practices were also associated with increased sunburn, except for sunscreen use where the converse was the case. Suntan was still a desire for adolescents. While there is considerable room for improvement in the sun-protection behaviour of adolescents (particularly those in higher grades), most students usually take some precautions. However, by Year 12 (17 and 18 year olds) less than half report usually wearing a hat and just two-thirds reported usual sunscreen usage.

The aim of the project was to develop a survey instrument to monitor relevant health status and health-related behaviors among secondary school students. The development of the instrument occurred in three main phases: collection of existing surveys, workshops with relevant health professionals and focus groups with adolescents. The topics for inclusion were refined using Health Goals and Targets for Australian Children and Youth and consultations with health professionals, and included alcohol/illicit drug use, smoking, nutrition, exercise, injury, mental health, violence and sexual health. Content validity was demonstrated through a comprehensive literature review, review and application of existing instrumentation, dialog and exchange with health professionals, and focus groups with adolescents. The process of peer review through correspondence with health professionals, and the coordination of workshops and focus groups established face validity. Responses from students also indicated that they interpreted the questions as intended. The instrument was piloted in five secondary schools during class periods. Process evaluation was also conducted to determine the appropriateness of the survey and the procedures used in administering the survey. Feedback from school staff was supportive and favorable with respect to the choice of issues. Reliability was assessed by a test-re-test procedure 2 weeks apart. In general, most of the questions showed moderate to high reliability (kappa > 0.5) indicating agreement of 50% or greater. This instrument was developed as a monitoring instrument and places emphasis on determining prevalence levels of a range of health issues and health behaviors to assist with identifying clustering patterns of negative health outcomes. Although the instrument is primarily for use with students in school hours, the nature of the instrument allows modification for use in older groups of adolescents and out-of-school youth. The final version of the questionnaires for senior and junior students can be accessed via the Internet (http://;+www.spmed.uq.edu.au/CHPCPR /qu estionnaire).