Skin cancer prevention for children: a critical review.

Increasing sun protection for children may reduce their risk for skin cancer, so many health authorities recommend comprehensive sun safety for children. Sun protection of children in North America and Europe is generally lower than desired and lower than in Australia. This article provides a critical review of evaluations on the effects of 24 sun protection programs for children under age 14. Programs are classified based on the target population, setting, and features. Most programs improved sun safety knowledge, but changes in sun protection attitude and behaviors were smaller. Multiunit presentations were more effective than short-duration presentations. Peer education was effective but needs further evaluation. Some programs for parents have been shown to increase sun protection for children. Strategies to improve sun safety policies need further study. A few community-wide programs have effectively improved sun protection. Future research should address innovative strategies and issues of design and measurement. There is no gold standard for measuring sun protection behavior, but self-report, prospective diaries, and observational techniques show small positive correlations.