Effect of the SunSafe Training Program on the attitudes, knowledge, and behaviour of Australian high school students towards sun safety: a prospective study

The SunSafe Student Ambassador Program (SSSAP) uses the peer-to-peer learning environment to educate high-school students about sun-safety.To assess whether the SSSAP improves knowledge, attitudes, and behaviours towards sun-safety in high-school students, and whether this is sustained at three months.An assessment survey was delivered pre-, post-, and three months after participation in the SunSafe program in 2019.218 participants were matched as having completed both the pre- and post-presentation survey. Immediately post-presentation the total composite score for all knowledge questions increased from 11.8/18 (standard deviation [SD] 3.5) to 13.8/18 (SD 4.7), p <0.0001. There was strong evidence for an improvement in one attitude-based question "Is it healthy to have a tan?" (p=0.0035), and evidence for one behaviour question, "using sunscreen daily" (p=0.0230). After three months, 235 students were matched to their pre-presentation survey. The composite score of all knowledge questions improved from 11.2/18 (SD 3.5) to 12.1/18 (SD 4.5), p=0.0029. There was evidence for an improvement in the attitude questions "Do you feel better when you have a tan?" and very strong evidence for "Is it healthy to have a tan?" (p=0.0278 and p<0.0001, respectively). At three months, there was evidence for a reduction in time outdoors on a weekday (p=0.0363).The SSSAP was associated with improvements in knowledge, attitude, and behaviour towards sun safety immediately and at three months post-presentation. Further research is required to determine whether these positive effects are sustained and whether they ultimately reduce skin cancers.