Background Ultraviolet exposure is the primary preventable risk factor in the development of both non-melanoma and melanoma skin cancers (Narayanan, Saladi & Fox, 2010). UV exposure accumulated during childhood and adolescence have a significant impact in increasing risk of skin cancer development in adulthood (Suman & Suman, 2019). Under 18- year-olds represent a key target population for education, as behaviour change at a younger age could result in long term reduction of high-risk UV exposure behaviours throughout the lifespan, consequently reducing skin cancer incidence (Williams, Olsen, Hayward & Whiteman, 2011). This systematic review focuses on the role of behaviour modification strategies as well as social and environmental factors in promoting sustained sun-safe behaviours. Research Design A narrative synthesis approach has been utilised to systematically review and analyse studies of preventative UV education programmes targeted at under 18-year-olds and their care givers. 9 studies have been included and were elected based on pre-determined inclusion and exclusion criteria. Included studies are randomised controlled trials and quasi-experimental studies, allowing comprehensive examination of programme efficacy across diverse settings and age groups. Findings This systematic review highlights consistent improvement in knowledge of UV risk and sun protection behaviours following educational interventions. Hanna et al (2022) and Norman et al (2007) demonstrated that interactive, peer-led and family inclusive approaches improved engagement and adherence to high-risk behaviour modification. Evidence for long term behaviour change was limited to three studies (Crane et al, 1999; Aulbert et al, 2009; Wu et al, 2019). These studies demonstrated evidence for improved longevity of positive intervention
outcomes when reinforcement and ongoing support are maintained following intervention. Additionally, structural modifications such as sunscreen access and shaded areas in conjunction with education were effective in promoting consistent sun safe practices (Crane et el, 1999; Aulbert et al 2009). Conclusion Preventative education programs are effective in improving knowledge and awareness of UV exposure risks among young people and their care givers. Education programmes including peer-led and family-based approaches show promise in modifying high-risk UV exposure behaviours. Evidence for long term behaviour change following sun safety education is limited, and further research is required in this area to demonstrate longevity in behaviour moderation. Future education models should include personalised messaging and mixed modality of education materials to maximise impact of this education. This systematic review contributes to understanding key elements of sun safety education and provides recommendations for future education programme development to enhance impact and prevent UV related skin damage in young populations.
