A systematic review 1 including 85 studies was abstracted in DARE. The weaknesses of study methodology included the lack of a concurrent control group, poor reporting of the participants and the intervention, short length of follow-up (less than 3 months in half of the studies) and a reliance in most of the studies on self-reporting of outcomes. Primary school settings (20 studies): the interventions were consistently associated with an increase in covering-up behaviour; the median relative increase was 25% in studies with concurrent control groups and 70% in before-and-after studies. Recreational or tourist settings (11 studies): 3 studies demonstrated a positive effect on the adult sun-protective behaviour of wearing protective clothing, though evidence on adult incidence of sunburn was inconsistent. There was insufficient evidence to determine the effectiveness of these approaches in child care centres, secondary schools and colleges and occupational settings, or of interventions oriented towards health care settings and providers, parents or caregivers of children, media campaigns alone, or community-wide multicomponent interventions.
Comment: The quality of evidence is downgraded by limitations in study quality and by indirectness (no direct outcome, i.e. incidence of skin cancer, was measured).
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