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Objectives: Increases in socially desirable responses in self-reports might occur in the context of ongoing public education. We examine concordance of trends in two long-term studies monitoring population impact for SunSmart., Methods: One study employed telephone interviews of Melbourne residents; the other entailed observations at public recreation venues across Melbourne. The studies assessed people's sun protection on identical weekend dates (Nw = 33 dates). Data from five summers between 1992 and 2001 (n ~ 23,000 individuals) were analysed. A body cover index score was calculated for participants on each date. Outcomes were aggregated separately for Saturdays and Sundays by date and year. Regression analyses tested whether these trends differed by survey method., Results: The pattern of change in body cover over time was similar for both surveys. Self-reported body cover was consistently higher than observed body cover, suggesting that social desirability bias may be present. Regression analyses showed no divergence between self-reported and observed trends in mean body cover, suggesting no evidence of significant increased social desirability bias in self-reporting over time., Conclusion: Findings suggest that self-report offers a valid means of assessing change in a population's sun protection compliance over time, at least when self-reports are precisely focussed for time and activity context.

Background: Reducing childhood exposure to ultraviolet radiation is important to minimize lifetime skin cancer risk., Objectives: We sought to describe the prevalence of children's sun-related behaviors and associated parental and other factors., Methods: In weekly cross-sectional telephone interviews during summer, 1140 parents/guardians of children aged 0 to 11 years were recruited. Parents provided proxy reports for one of their children. Key questions related to weekend sun protection and sunburn, parent's sun-related attitudes, and demographic characteristics. Potential predictors of children's sun protection and sunburn were analyzed adjusting for covariates including weather conditions on the previous weekend., Results: On summer weekends, 73% of children spent longer than 15 minutes outdoors in peak ultraviolet radiation periods. Of these, 64% were protected by a hat and 58% by sun-protection factor 15 or higher sunscreen, 32% stayed under shade, and 18% wore three-quarter or long-sleeved tops. Overall, 8% of children had sunburn. Parental attitudes were typically supportive of children's sun protection. Parental use of hats (odds ratio [OR] 3.1; 95% confidence interval [CI] 1.6-6.2), shade (OR 9.6; 95% CI 4.4-20.8), sunscreen (OR 12.6; 95% CI 5.2-30.4), longer leg cover (OR 10.3; 95% CI 4.4-24.0), and two or more protective behaviors (OR 5.7; 95% CI 2.8-11.9) increased the odds of their children practicing these behaviors, as did some parental attitudes., Limitations: We relied on cross-sectional parent reports., Conclusion: Although children's sun protection was favorable, there was room for improvement. Health promotion to improve sun-protection practices in adults may benefit children's sun-safe behaviors., (Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

Background: Reducing people's exposure to ultraviolet radiation is the primary strategy for skin cancer prevention., Objective: We sought to provide comprehensive national data on preventive behaviors and risk assessment for Australia., Methods: A national survey was conducted in summer 2003-2004. In 8 weekly cross-sectional surveys, adults and adolescents were interviewed about their sun protection and sunburn on the previous summer weekend. Adjustments were made for specific weather and ultraviolet radiation conditions relevant to time and location., Results: Adolescents were relatively homogeneous in their low compliance with sun protection (significantly less use of hats, covering clothing, shade, and sunglasses than adults) on weekends, and consequently were more likely to be sunburned than adults (25% compared with 18%; odds ratio=1.80, P<.001). Temperature was a significant predictor of sun-protective behaviors and a strong determinant of sunburn, as was ultraviolet radiation for adults' sunburn. Using shade, spending less time outdoors, and, for adults, wearing clothing covering were associated with reduced odds of sunburn., Limitations: The study relied on self-reported behaviors and sunburn., Conclusions: Further improvement in Australians' sun-protective behaviors is needed.

Background: The Australian state of Victoria has run a population-based skin cancer prevention program called SunSmart since 1988, incorporating substantial public education efforts and environmental change strategies. Trends over 15 years in behavioral risk factors for skin cancer were examined in a population exposed to the SunSmart program. Whether outcomes were associated with extent of SunSmart television advertising was then assessed., Methods: In nine cross-sectional surveys from 1987 to 2002, 11,589 adults were interviewed by telephone about their sun exposure and sun protection during outdoor activities on summer weekends. Analyses completed in 2007 adjusted for ambient temperature and ultraviolet radiation., Results: Sun protection and sunburn show substantial general improvement over time, but have stalled in recent years. Use of hats and sunscreens significantly increased over time and peaked during the mid to late 1990s, compared with the pre-SunSmart baseline. The mean proportion of unprotected skin was reduced and was lowest in the summer of 1997-1998. Summer sunburn incidence declined over time and was 9.1% in 2002, almost half baseline (OR=0.53; 95% CI=0.39-0.73). Higher exposure to SunSmart advertising in the 4 weeks before the interview increased: (1) preference for no tan, (2) hat and sunscreen use, and (3) proportion of body surface protected from the sun., Conclusions: The general improvement in sun-protective behaviors over time highlight that a population's sun-protective behaviors are amenable to change. Population-based prevention programs incorporating substantial television advertising campaigns into the mix of strategies may be highly effective in improving a population's sun-protective behaviors.