Hats on Head Start: A A Survey of Sun Protection Behaviors in Head Start and Other Early Childhood Education Programs

The study aims are:

1. To assess current exposure to sun and UV in programs of children participating in an
early childhood educational program.

2. To assess current policies regarding sun protection and sunscreen use in programs for
early childhood education.

3. To assess the current attitudes towards sun safety among caregivers and teachers in
programs for early childhood education.

4. To explore association of sun protective behaviors with risk factors such as
socioeconomic status, per student classroom budget, program setting (i.e. urban,
suburban, or rural), race/ethnicity, size of school program, school budget for
supplies, and ages of children enrolled in program.

The sample of stakeholders, who will be surveyed, is consistent with samples used in our
prior research. A sample size of 250 phone interviews will be adequate to show trends in sun
safety policies among early education programs. Power analysis is based on the use of sun
protection, our primary outcome. Our preliminary data show that 15% of schools almost always
or always schedule outdoor activities to avoid times when the sun was at peak intensity. The
sample size required to sensitively detect a 20% difference in using sun protection between
those that comply with recommendations and those that do not is 250 respondents assuming an
alpha < 0.05 and power >= 0.8 in a two-tailed test on a two-group sample. This sample size
will adequately power the study for detecting 30% difference in sun protection use between
the two groups.

Inclusion Criteria:

- Someone 18 years of age and older, who is a teacher, administrator, aide, or other
staff member of a Head Start program, day care program, camp, or elementary school.

- Participants agree to a structured phone interview regarding their program's policies
for sun safety, their opinions on certain health behaviors, and the demographics of
their student population.

- Participants will be interviewed on the phone and guided through a questionnaire
which should take approximately 10 minutes to complete.

Exclusion Criteria:

- Participants who do not know their program's procedures for sun protection will not
be able to participate, but may transfer the phone call to another colleague who can
answer the questions accurately. Participants without the ability to speak in English
will be excluded from the study.