Effectiveness of a Multicomponent Sun Protection Program for Young Children

Tom Magutu, Mercer University College of Pharmacy

Sunburns are a major risk factor for most melanomas.  Sunburns occurring in childhood are cited as posing the greatest risk to developing melanoma in the future. [1]

The American Cancer Society estimates that 76,380 new melanomas will be diagnosed in 2016, with 10,130 deaths due to melanoma. [2]


Title: Effectiveness of a Multicomponent Sun Protection Program for Young Children [3]
Design Randomized Trial; N= 300
Objective To determine whether a multicomponent sun protection program delivered in pediatric clinics during the summer could increase summertime sun protection among young children
Study Groups Parent child pairs were randomly assigned to either the Intervention group (n= 153) or control group (n= 147)
Methods The intervention group received a read-along book, a sun-protective swim shirt, and received four sun protection reminders weekly via text messages.  Each child’s skin melanin content was assessed by spectrophotometry at baseline and at follow-up four weeks later.
Duration May 15, 2015 to August 14, 2015
Primary Outcome Measure Sun protection use on both sunny days and cloudy days
Baseline Characteristics   Intervention, n (%) Control, n (%)
Male 69 (45.1) 75 (51.0)
Female 84 (54.9) 72 (49.0)
Age in years    
2-3 54 (35.3) 50 (34.0)
> 3-4 26 (17.0) 23 (15.6)
> 4-5 27 (17.6) 28 (19.0)
> 5-6 46 (30.1) 46 (31.3)
White (including Hispanics) 99 (64.7) 113 (76.9)
Black 20 (13.1) 18 (12.2)
Asian 19 (12.4) 10 (6.8)
Mixed race 5 (3.3) 2 (1.4)
Results Variable at follow up Control, mean (SD) Intervention, mean (SD) p value
Sunny day      
Sunscreen 3.66 (1.16) 3.93 (1.05) 0.03
Shirt 3.57 (1.15) 3.84 (1.07) 0.04
Hat 2.57 (1.25) 2.56 (1.23) 0.55
Shade 2.67 (0.88) 2.79 (0.97) 0.06
Cloudy days      
sunscreen 2.73 (1.19) 3.27 (1.20) 0.001
Shirt 3.67 (1.18) 3.76 (1.04) 0.15
Hat 2.42 (1.12) 2.35 (1.19) 0.20
Shade 2.52 (0.93) 2.56 (1.03) 0.27
Adverse Events Common Adverse Events: N/A
Serious Adverse Events: N/A
Percentage that Discontinued due to Adverse Events: N/A
Study Author Conclusions The multicomponent intervention was associated with increased sun protection behaviors among young children.  This implementable program can help augment anticipatory sun protection guidance in pediatric clinics and decrease children’s future skin cancer risk.


In this study, a multicomponent skin protection program increased the number of children who practiced sun protection behaviors over the summer.  The findings indicate that skin protection recommendations would be more effective if supported by an effective, easily accessible, multicomponent program that can be reinforced at home.  A possible limitation to the study is that although the participant population was ethnically heterogeneous, the relatively small number of children in each minority group prevented an ethnically stratified analysis of the data.



  1. Dennis LK, Vanbeek MJ, Beane freeman LE, Smith BJ, Dawson DV, Coughlin JA. Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis. Ann Epidemiol. 2008;18(8):614-27.
  2. What are the key statistics about melanoma skin cancer? What are the key statistics about melanoma skin cancer? Available at: http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-key-statistics. Accessed April 19, 2016.
  3. Ho BK, Reidy K, Huerta I, et al. Effectiveness of a Multicomponent Sun Protection Program for Young Children: A Randomized Clinical Trial. JAMA Pediatr. 2016;




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