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
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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
www.pediatrics.org/cgi/content/full/121/57e1074.
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.
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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
by25%.2
O Results also showed a 4% decrease in students
who thought people look healthier with a
suntan. 2
O
O
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
decrease
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
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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
in1930.8
© 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
at: www.epa.gov/sunwise/becoming.html.
© 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:
www.epa.gov/sunwise/becoming_pa rtner.html.
© For more information, schools and partners may visit
the SunWise Web site at: www.epa.gov/sunwise.
SunWise is in all 50 states!
Percentage
of K-8 Schools
Registered with
SunWise
• 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: www.ehjournal.net/content/2/1/13.
5. American Cancer Society. Cancer Facts and Figures 2008. Available at
www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf.Accessed
April 11,2008.
6. American Cancer Society (ACS). 2008. Available at www.cancer.org/
docroot/PED/content/ped_7_1_What_You_Need_To_Know_About_Skin_
Cancer.asp?sitearea=&level=>. Accessed April 10,2008.
7. American Academy of Dermatology. 2008 Skin Cancer Fact Sheet. Available
at www.aad.org/med 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, SA.et 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)
EPA-430-F-08-007
www.epa.gov
May 2008
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