The purpose of the proposed study is to develop, implement, and evaluate a skin cancer prevention program designed to reduce ultraviolet radiation (UVR) exposure among children enrolled in preschools. Theory-based interventions will be developed and delivered to preschool employees, parents, and children. Preschool sites will be randomized to receive either a comprehensive intervention or a minimal intervention. Changes in employee/parent UVR knowledge and attitudes as well as changes in UVR protective actions directed toward child and self (sunscreen use and sun avoidance) will be measured. Sun exposure among children will be measured using a scale that combines exposure and protection data. Interventions will be directed at four levels: 1) the institutional commitment, 2) policies and practices, 3) the preschool employees, and 4) the parent/child level. Social Learning Theory will provide the conceptual foundation for the interventions. Measurement and evaluation procedures will determine: 1) a reduction in exposure to UVR among preschoolers, 2) change from baseline in employee/parent cognitive knowledge and behavioral practices, 3) change from baseline in organizational policies and practices, and 4) the extent of program implementation. This study will result in a model program and process to reduce UVR exposure among young children. The findings of this study will contribute to applied social science, both to the theoretical foundations of behavioral change and also to an understanding of organizations and environments that promote and enable positive health behavior change.
