The U.S. EPA's SunWise Progr
                                A Roadmap
                                In this document, you'll find.
                                • The SunWise Story
                                • A Study in Sun Safety Awareness
                                • Information on How SunWise
                                Saves Lives and Money
                                • Lessons in Program Effectiveness
                                • Skin Cancer Facts
                                • How Schools and Community
                                Organizations Can Become SunWise
                                • Publications and References

       The  SunWise  Story
          © Launched nationwide during the 2000-2001 school year, this award-winning program
             is available to schools and informal education organizations, to promote sustained
             sun-safe behaviors in children.

          © As of 2008, more than 18,000 schools and one million students are SunWise.

          © Schools and partners receive a free SunWise Tool Kit with over 50 standards-based,
             cross-curricular activities, a UV-sensitive Frisbee® for experiments, story and activity
             books, posters and more.

          © The program is flexible and activities fit into what an educator is  already doing. The
             time commitment can be as little as one to two hours during the entire school year.
A Study in Sun

Safety Awareness

Starting with a "pilot group" in 1999, the SunWise
Program has undergone routine evaluations to
determine its effectiveness on student sun safety
knowledge, attitudes, practices, and intended
practices using student responses to surveys.

© Teachers leading SunWise lessons have also completed
  program evaluations, in which three out of four have noted
  improvements in their own sun protection behaviors.

© The most recent study, conducted in 2006-2007, took the
  evaluation of changes in students' sun safety behaviors
  one step further by analyzing the human health benefits of
  SunWise (e.g., fewer skin cancer cases and mortalities),
  then comparing these benefits to the program's costs.1

© The study found that using SunWise to teach
  children about sun safety saves lives and money.1

© The study is unique because few studies to date have
  analyzed the benefits of school-based health programs
  in economic terms. This is the first study to review the
  cost-benefit of a school-based sun safety program.

© The study results were published in the May 2008
  issue of Pediatrics, the official journal of the American
  Academy of Pediatrics and one of the leading
  publications for pediatric research. The full article,
  entitled "Economic Evaluation of the U.S. Environmental
  Protection Agency's SunWise Program: Sun Protection
  Education for Young Children," is available online at
SunWise Saves

Lives and Money

The newest evaluation of SunWise assessed
student survey responses from 1999-2005 to
determine program effectiveness, benefit-to-cost
ratio, and cost-effectiveness.

© Teachers can bring about modest changes in students'
   sun protection behavior, such as wearing sunscreen or
   a hat more frequently, by taking 1-2 hours each year to
   use activities in the free, standards-based and cross-
   curricular SunWise Tool Kit. These modest changes can
   lead to significant health benefits in the future.1

© As a result of teaching SunWise to children between
   the years 1999-2015, EPA estimates that more than
   50 premature deaths and 11,000 cases of skin
   cancer will be prevented.1

© By increasing federal spending by just a few pennies per
   person more over the next seven years, the SunWise
   Program could save 20 more lives and prevent more
   than 4,000 more cases of skin cancer.1

© Every federal dollar invested in SunWise saves $2-$4
   in public health costs, such as medical care costs and
   productivity losses associated with skin cancer.1

© The larger the investment in SunWise, the greater the
   number of reduced skin cancer cases and mortalities, and
   the more cost-effective the program becomes.1

© $1  spent on  SunWise  saves

    $2-$4  in public health costs.

Lessons in Effectiveness
Surveys of children and teachers have taken place since the inception of the program in 1999. From
1999-2002, two special efforts evaluated the effectiveness of the SunWise classroom lessons on
student knowledge, attitudes, practices, and  intended practices using student responses to identical
pre-test and post-test surveys.
  As part of the first survey effort, students completed
  pre-test surveys between autumn and early spring and
  post-tests immediately after being taught the SunWise
  lessons (spring to early summer).2

  A large school district also served as a control group for
  this study (the students at these schools did not receive
  SunWise education between the pre- and post-tests). 2

    •  Among the more than 1 ,800 students aged
      5-12 that received a SunWise education, the
      percentage of students who knew the right
      number SPF of sunscreen to wear increased

  O  Results also showed a 4% decrease in students
      who thought people look healthier with  a
      suntan. 2
      Modest changes were observed in student
      practices from pre-test to post-test, and intentions
      to both play in  the shade and use sunscreen
      increased by 4% to 5%.2

      This compared very favorably with control schools
      where no improvements in attitudes or practices
      were noted. 2
    in sunburning
    rates,  particularly
    frequent burns.
                                                   As part of the second survey effort, a separate group of
                                                   students received the pre-test and two post-tests from
                                                   their school nurses: one post-test immediately after
                                                   being taught SunWise and another the following fall to
                                                   determine if students retained the SunWise lessons and
                                                   maintained their SunWise behaviors.3'4

                                                   O 477 children completed the second set of post-
                                                      tests, which indicated that students maintained
                                                      their gains in knowledge and attitudes.3 4

                                                      In addition, an 11% decrease insunburning
                                                      rates, particularly in frequent burns, was noted
                                                      from summer 2000-summer 2001.3'4

Skin Cancer Facts

SunWise aims to prevent skin cancer by
changing the sun protection behaviors of
children and their caregivers.

© In 2008, an estimated 8,400+ people will die
   of melanoma.5

© Approximately half of all cancers in the U.S. are skin
   cancers. One  in five Americans will develop skin
   cancer during their lifetime.6

© This year alone, more than one million new cases
   of skin cancer will be found in the United States.6

   O  The number of people diagnosed with melanoma,
       which is responsible for approximately 75% of all
       skin cancer deaths,  is rising at an alarming rate. It
       is projected that for persons born in 2008, one in
       58 will be diagnosed with melanoma7—that's
       about 20 times higher than it was for persons born

© Exposure to ultraviolet (UV) light is the  number-one
   preventable risk factor for skin cancer. Taking simple
   steps now to prevent overexposure  lowers one's risk.

© In a majority of studies, researchers have found a
   positive relationship between childhood sunburns
   and the subsequent risk of melanoma.9
How Schools  and
Community Organizations
Can  Become SunWise

© Schools may register to receive a free Tool Kit online

© SunWise also partners with science centers, museums,
   parks, camps, and other informal education facilities
   to expand and reinforce the SunWise message. By
   working with multiple organizations within a community,
   SunWise Communities takes the program from the
   classroom into the community at large. Partners may
   register to receive a free Tool Kit at: rtner.html.

© For more information, schools and partners may visit
   the SunWise Web site at:
SunWise  is in  all 50 states!
                                                   of K-8 Schools
                                                   Registered with

                                                    • 4-10%

                                                    D 11-17%

                                                    • 18-24%

                                                    • 25-35%

                                                    D 36-75%
SunWise Evaluation Publications

and Other  References Cited

 1.  Kyle, J.W., et al. 2008. Economic Evaluation of the U.S. Environmental
    Protection Agency's SunWise Program: Sun Protection Education for Young
    Children. Pediatrics 121(5), e1074-e1084.
 2.  Geller.A.C., etal. 2002. The Environmental Protection Agency's National
    SunWise School Program: Sun protection education in U.S. schools
    (1999-2000). Journal of the American Academy of Dermatology. 46(5), 683-689.

 3.  Geller, A., et al. 2003. Evaluation of the SunWise School Program. The
    Journal of School Nursing. 19(2), 93-99.
 4.  Geller, A.C., etal. 2003. Can an hour or two of sun protection education keep
    the sunburn away? Evaluation of the Environmental Protection Agency's
    SunWise School Program. Environmental Health: A Global Access Science
    Source 2003,2(13). Available online at:
 5.  American Cancer Society. Cancer Facts and Figures 2008. Available at
    April 11,2008.
 6.  American Cancer Society (ACS). 2008. Available at
    Cancer.asp?sitearea=&level=>. Accessed April 10,2008.

 7.  American Academy of Dermatology. 2008 Skin Cancer Fact Sheet. Available
    at ia/background/factsheets/fact_skincancer.html.
    Accessed April 16,2008.
 8.  Rigel, D.R.J. Friedman, A.W. Kopf, 1996. The Incidence of Malignant
    Melanoma in the United States: Issues as We Approach the 21st Century.
    Journal of the American Academy of Dermatology. 34(5), 839-847. May 1996.
 9.  Oliveria, al. 2006. Sun Exposure and Risk of Melanoma. Arc Dis
    Child. 91:131-138.  doi: 10.1136/adc.2005.086918.
                                                                                  Office of Air and Radiation (6205J)
                                                                                  May 2008