Translation of District Sun Safe Policies to Schools

描述(申请人提供)：这项研究的目的是测试一种新的干预措施，旨在促进个别小学执行学区议会阳光安全政策。预计这将改变学校层面的阳光安全做法，并改善特殊干预(SI)条件下在校儿童的阳光安全行为。对SI的评估将在一项随机的实践试验中进行，在该试验中，N=142所学校被随机分为两组：(A)实施促进阳光安全政策实施的战略的SI条件，以及(B)接受国家学校阳光安全指南副本的注意控制条件。学校将被分成三组，以方便项目后勤。主要结果将是在基线和基线后24个月由校长和每所学校的一名教师填写的问卷中，自我报告学校一级的阳光安全做法(例如，安排避开紫外线高峰时间，允许使用帽子)。一名PTA代表将报告PTA在基线后参与学校一级实践的情况。校本实践将根据疾病控制与预防中心建议的政策程序进行评估，并建立在我们最近的太阳安全学校研究中成功评估学区区议会政策的类似衡量策略的基础上。问卷将通过互联网、电话或邮寄的方式完成。为比较学区区议会政策与学校层面的做法，各参与地区的校董会政策将按政策元素进行编码。从每所学校随机抽样的家长将完成一份问卷，报告目标儿童的太阳安全行为，并指明学校进行的太阳安全沟通的次数。家长问卷将通过在线、邮寄或电话方式填写。家长对孩子行为的报告将使用自我报告措施收集，并根据每天/每周的日记进行验证。参与的学校(N=142)将从加利福尼亚州克莱蒙特方圆100英里范围内的30个学区招募，克莱蒙特位于洛杉矶县东部，距离洛杉矶市中心约35英里。这一半径将提供296所符合条件的小学。干预措施将包括三个部分：(1)面对面访问和后续沟通；(2)印刷和在线资源；以及(3)支持学校阳光安全做法的初步改变的小额补助金。干预部分将促进CDC建议的10个政策部分的实施，包括防晒霜的使用、紫外线防护服、帽子、学生教育、教师教育、提供遮阳物、安排避免紫外线暴露峰值的时间表、家长外展、为防晒安全分配资源，以及为防晒做法建立问责制度。在这项研究中，80%的功率可用于检测P&lt；0.05单尾检验的预测处理差异。将进行经济分析，以提供对学校管理人员有用的成本效益信息，以便将来使用该计划。该项目具有重大意义和创新性，将扩展我们早期对学校防晒政策采用的研究，确定政策通过是否单独产生实施或学校需要技术援助，并填补防晒政策研究的空白。

DESCRIPTION (provided by applicant): The objective of this study is to test a novel intervention designed to facilitate the implementation of school district board sun safety policy by individual elementary schools. It is expected to produce a change in sun safety practices at the school level and improve the sun safety behavior of children attending schools in the special intervention (SI) condition. Evaluation of the SI will occur in a randomized practical trial in whih N=142 schools are randomized to either: (a) an SI condition where strategies to facilitate sun safe policy implementation are delivered, and (b) an attention-control condition that receives copies of national guidelines for school sun safety. Schools will be divided into three cohorts to facilitate the project logistics. The primary outcome will be self-reported school-level practices for sun safety (e.g., scheduling to avoid peak UV hours, allowing use of hats) from questionnaires completed by the principal and one teacher at each school at baseline and 24-months post-baseline. A PTA representative will report on PTA involvement in school-level practices post-baseline. School-based practices will be assessed with a measure based on policy procedures recommended by CDC and built on a similar measurement strategy used successfully to evaluate school district board policy in our recent Sun Safe Schools study. Questionnaires will be completed using internet, telephone, or mail. To provide a comparison between the school district board policy and school-level practices, the board policy of each participating district will be coded for policy elements. A random sample of parents from each school will complete a questionnaire reporting the sun safety behavior of the target child and indicating the number of sun safety communications from the school. The parent questionnaire will be completed online, by mail or by telephone. Parent reports of child behaviors will be collected using self-report measures validated against daily/weekly diaries. Participating schools (N=142) will be recruited from 30 school districts within a radius of 100 miles of Claremont, California, a city in eastern Los Angeles County approximately 35 miles from downtown Los Angeles. This radius will provide access to 296 eligible elementary schools. The intervention will include three components: (1) in-person visits and follow-up communications, (2) printed and online resources, and (3) mini-grants to support initial changes in school sun safety practices. Intervention components will promote implementation of the 10 policy components recommended by CDC including sunscreen use, UV protective clothing, hats, student education, teacher education, provision of shade, scheduling to avoid peak UV exposure, parent outreach, resource allocation for sun safety, and an accountability system for sun safe practices. In this study 80% power is available to detect the predicted treatment differences at p<.05 one-tailed. Economic analyses will be conducted to provide cost-effectiveness information useful to school administrators for future use of the program. The project is significant and innovative and, will extend our earlier research on adoption of school sun protection policies, determine if policy adoption alone produces implementation or schools need technical assistance, and fills a gap in sun protection policy research.