Sun protection policies and environmental features in US elementary schools.

OBJECTIVE To assess current sun protection policies and the receptiveness to new policies at elementary schools in the United States. DESIGN A cross-sectional telephone survey. SETTING General educational community. PATIENTS OR OTHER PARTICIPANTS In 1998, a random sample of 1000 public elementary schools in the United States was selected (proportional to population size) from 27 metropolitan areas chosen from the 58 US cities regularly reporting the UV index in 1997. A final sample of principals from 412 elementary schools completed the survey. INTERVENTION None. MAIN OUTCOME MEASURES Only 3.4% of schools had a sun protection policy. The most common reasons for not having a policy included the principal's lack of awareness (n = 113) or organizational barriers in the school districts (n = 77). Most principals (84.2%) said that students were outdoors during midday hours. Many principals (48.3%) were willing to adopt a sun protection policy. Most schools (72.8%) had shade structures but the majority (67.3%) reportedly covered less than one fifth of the grounds. Most principals (76.4%) were willing to increase the amount of shade structures. CONCLUSIONS The low frequency of sun protection policies and shade structures calls for national efforts to change policies and environments to increase sun protection at US schools. Research is needed to demonstrate the efficacy of these changes.