Translation of District Sun Safe Policies to Schools

描述（由申请人提供）：本研究的目的是测试一种新的干预措施，旨在促进个别小学实施学区董事会的阳光安全政策。期望在学校层面产生太阳安全实践的变化，并改善特殊干预（SI）条件下在校儿童的太阳安全行为。SI的评估将在随机实践试验中进行，其中N=142所学校被随机分配到：(a) SI条件，其中提供促进阳光安全政策实施的策略，以及(b)注意力控制条件，接收国家学校阳光安全指南的副本。学校将分为三组，以方便项目的后勤工作。主要结果将是由每所学校的校长和一名教师在基线和基线后24个月完成的问卷中自我报告学校层面的阳光安全实践（例如，安排时间避免紫外线高峰时间，允许戴帽子）。一名家长会代表将报告家长会在基线后参与校级实践的情况。以学校为基础的实践将根据CDC推荐的政策程序进行评估，并建立在我们最近在太阳安全学校研究中成功评估学区董事会政策的类似测量策略的基础上。调查问卷将通过网络、电话或邮件完成。为了在学区董事会政策和学校层面的做法之间提供比较，每个参与地区的董事会政策将被编码为政策要素。从每所学校随机抽取家长完成一份调查问卷，报告目标孩子的阳光安全行为，并指出学校的阳光安全沟通次数。家长问卷将通过网络、邮件或电话填写。父母对儿童行为的报告将通过每日/每周日记的自我报告来收集。参与的学校（N=142）将从加利福尼亚克莱蒙特方圆100英里内的30个学区招募，克莱蒙特是洛杉矶县东部的一个城市，距离洛杉矶市中心约35英里。这个半径将提供296所符合条件的小学。干预将包括三个组成部分：(1)亲自访问和后续沟通，(2)印刷和在线资源，以及(3)小额赠款，以支持学校阳光安全实践的初步变化。干预部分将促进实施疾病预防控制中心建议的10项政策组成部分，包括防晒霜的使用、防紫外线服装、帽子、学生教育、教师教育、提供遮阳、安排避免紫外线峰值暴露、家长外展、日光安全资源分配以及日光安全实践问责制。在本研究中，在单尾p< 0.05的情况下，有80%的概率可以检测到预测的治疗差异。将进行经济分析，以提供对学校管理人员将来使用该计划有用的成本效益信息。该项目意义重大，具有创新性，将扩展我们前期关于学校防晒政策实施的研究，确定政策单独实施是否产生实施效果，还是学校需要技术援助，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.