Sun-protection awareness, habits, and recommendations of USA Swimming coaches.

Swimming is the 5th most popular sport in the United States, and many of its athletes train outside. This study aimed to examine the sun-protection habits and recommendations of USA Swimming coaches and perceived sunscreen use among their athletes. We performed a cross-sectional survey of USA Swimming coaches. We evaluated associations between coach sun-protection habits, coach discussing sunscreen use with athletes, and the outcome of perceived sunscreen use among athletes using multivariate ordinal logistic regression. A total of 2729 coaches responded to the survey and were included. Most were women (59.8%), were White (93.1%), were aged 35-64 years (58.0%), and reported having coached outside (89.7%), and 12.0% reported a history of skin cancer. The majority (76.8%) of coaches discuss sunscreen use with their athletes. In multivariable analysis, increased perceived sunscreen use among athletes was associated with increased coach sun-protection habits with a dose-response relationship and was associated with binary discussion of sunscreen use with athletes (OR = 2.37, 95% confidence interval = 1.93-2.89) and, in a separate model, with frequency of discussing sunscreen with athletes with a dose-response relationship (statistically significant OR = 1.62 for yearly to OR = 5.17 for daily). These findings suggest a potential role for swimming coaches in improving sun protection of athletes.