| dc.description.abstract | A Quality Improvement Project: Implementing the SunWise Education Program in Middle School Adolescents Amanda Merino Specialty Area: Doctor of Nursing Practice, Family Practice Committee Chair: JoAnn Peterson, DNP, APRN, FNP-BC Committee Member: Diane Mahoney, DNP, FNP-BC, WHNP-BC Problem: The most common form of cancer in the United States (U.S.) is skin cancer (Center for Disease Control and Prevention [CDC], 2016). Two to three million non-melanoma cancers are diagnosed yearly, while 71,000 cases are diagnosed as melanoma and include a mortality rate of 9,394 deaths yearly (CDC, 2016; World Health Organization [WHO], 2016). In fact, the occurrence of melanoma is rising 2.9% every year in children and adolescents who are less than 20 years old (Davis et al., 2015). With that said, most skin cancers are preventable and are caused by exposure to ultra violet (UV) radiation, with the most prominent source from the sun’s natural rays (Skin Cancer Foundation, 2016). The risk for skin cancer doubles if a single, severe sunburn is experienced in childhood (CDC, 2016). The CDC (2016) reports that only a small percentage of high school students (13% of girls and 7% of boys) apply sunscreen when outside for an hour or more. A call to action to reduce risky sun practices amongst adolescents, Goal 2, strategy 2B, encourages schools, particularly kindergarten through eighth grade (K-8), to incorporate sun safety education in the curriculum (United States Department of Health and Human Services [USDHHS], 2014). Project Aim: The aim of this DNP project was to implement the SunWise program which is the first nationally recognized, multidimensional, interactive, sun protection education program that uses evidence-based recommendations to provide middle school adolescents with an increase of sun prevention knowledge needed to change attitude, perceptions and intent to change their current behavior of risky sun practices and overexposure to the sun. The SunWise program specifically targets children and adolescents in primary and secondary schools (K-8) and is funded through the US Environmental Protection Agency (EPA) (Geller et al., 2002). Project Method: The theoretical framework for this project is based on the Health Belief Model (HBM) to evaluate adolescents perceived notions, which include basic knowledge about sun prevention, benefits and risks of sun exposure, and the intent to change current practices to recommended behaviors. A sample of sixth graders attending an urban, local, middle school in Kansas City, Kansas, during Spring 2017 was utilized. A 90-minute session that includes a PowerPoint presentation, video clips, active learning discussion and a group activity focused on the damaging impact ultraviolet (UV) radiation has from both a health-based and appearance-based perspective. A Derma-Scan (skin-viewing device) was also used to evaluate sun damage on participants. An identical and anonymous questionnaire, consisting of 30 questions, was given to participants before and immediately following the implementation of the SunWise program. This DNP project focused on three main outcomes: (1) knowledge of sun safety, (2) perceived attitudes of sun safety and protection, and (3) intent to practice sun-protective behaviors. Project Findings: Pre- and post-questionnaires were completed by 15 adolescent participants of varying ethnicities. The Exact Fisher test was used to calculate statistical significance (p=<0.05). Significant improvement was noted for knowledge variables: ways to keep sun-safe (p=0.006), minimum UV Index number to attain a burn (p=0.008), sun protection on a cloudy day (p=<0.001). Intentions to play in the shade increased from 33% to 80% (p=0.025), and intentions to wear sunscreen increased from 40% to 87% (p=0.021). There were no significant findings for changed attitude and perception among these variables: wanting to tan (p=0.427), tans look healthy (p=0.169), and rating the effort (easy, hard) to protect from the sun (p=0.324). Concluding the session participant comments included, “I realized I need to wear more sunscreen, “I liked the sun relay race”, “the presentation was cool and good”, and “nothing needs to be changed”. One participant suggested, to shorten the presentation. All but one participant, felt they knew more about UV light and sun protection after the presentation. Conclusion: Brief, sun protection education in the middle school setting can improve knowledge and intentions to change current sun practices among adolescents. | |
