The occupational environment is a new venue for skin cancer prevention. Go Sun Smart (GSS) is a workplace sun safety program developed for the North American ski industry with funding from the National Cancer Institute. It successfully reduced sunburning among employees in a randomized trial at 26 ski areas. There is a unique opportunity to conduct a Phase IV trial on the dissemination and impact of GSS on a sample of worksites representing the entire ski industry through collaboration with the National Ski Areas Association (NSAA). The project specific aims are to (a) disseminate GSS to North American ski areas and monitor decisions by managers to adopt it; (b) create programs to assist managers to implement GSS based on diffusion of innovations theory (DIT); (c) compare basic and enhanced dissemination strategies that vary in intensity of support in an effort to determine their differential effects on adoption and implementation of GSS; and (d) determine the association of GSS implementation with employees' and guests' sun safety. Disseminating such a program through complex organizations involves individual differences and decision-making among managers, structural differences between employers, and features of health promotion programs, important DIT mediators and moderators. The target population is NSAA-member ski areas in North America and their managers, employees and guests. A group-randomized pretest-posttest controlled design will be conducted. Go Sun Smart will be disseminated to 60 ski areas randomly selected from NSAA's membership through its communication channels (regional and national meetings; annual management training). They will be randomly assigned to receive either a basic dissemination strategy (presentations at NSAA regional and national meetings; printed program instructions) representing """"""""usual care"""""""" for this industry or an enhanced strategy (the basic program plus personal contacts through in-person visits and electronic communication to promote implementation and reduce barriers). Pretest and posttest on-site observations of the implementation of sun safety communication (including GSS at posttest) will be the primary outcome. Managers' decisions to adopt GSS and employees' and guests' sun protection will be assessed in telephone and on-site surveys at pretest and posttest This Phase IV trial will test program adoption (decisions by managers), program implementation (by managers), and program impact (on sun protection by employees and guests) in a sample of an entire outdoor recreation industry. ? ?
