Teaching Kids to Reduce the Risk of Skin Cancer

"The bulk of our lifetime exposure to UV rays occurs in childhood, and just one sunburn in childhood can double the risk of skin cancer later in life." - Kristin Nord, MD

Singing in the Sunshine?

Skin cancer is the most common form of cancer, and in most cases is attributable to harmful exposure to the sun’s ultraviolet (UV) radiation. The bulk of our lifetime exposure to UV rays occurs in childhood, and just one sunburn in childhood can double the risk of skin cancer later in life. Sun safety skills, including adequate use of sunscreen, represent a critical element of primary skin cancer prevention efforts. However, proper use of sunscreen requires both knowledge and skills, and recent research suggests that most adults do not adequately apply sunscreen - typically neglecting some areas of exposed skin, and reapplying too infrequently.

Research on children’s skills with independent use of sunscreen is non-existent, and we think that lack of independence with this important self-care skill represents a formidable barrier to children’s use of sunscreen during school hours. Younger elementary students (i.e., kindergarten) are particularly vulnerable in this regard. This is cause for concern, particularly in sunny climates (e.g., California) where elementary school youth commonly spend 300 to 500 minutes each week out-of-doors during school hours.

To address this research gap, a collaborative research team from the Stanford Departments of Dermatology and Psychiatry and Behavioral Sciences worked to create and evaluate a developmentally appropriate tool applicable for in-class use for teaching the youngest of elementary school students effective and independent sunscreen application using less than five minutes of classroom time. Employing a song-based video-guided intervention that features similarly aged children modeling systematic application of sunscreen (starting with the face, moving to neck, shoulders, arms, and legs), this team evaluated gains in sunscreen related application skills in four classrooms of kindergarten students (N = 96) using video, audio-only, and no-intervention conditions in a randomized controlled trial. Results of the trial are being calibrated presently, but the students and teachers have already provided qualitative feedback expressing enthusiasm with the program. We believe that song-based, video-guided instruction represents a quick, easy, efficient and likely effective means of bringing routine sunscreen use into the classroom.

Forget singing in the rain. Turns out, when it comes to sun safety skills, children should be singing before they go out into the sunshine!

Sun Safety Skills for Elementary School Research Team:

Faculty Mentors: 

  • Kristin Nord, M.D. (Dermatology)
  • Marlyanne Pol-Rodriguez, M.D., (Dermatology)
  • Julie Weitlauf, Ph.D. (Psychiatry and Behavioral Sciences)


Statistics and Data Management Team:

  • Ying Lu, Ph.D.,
  • M. Brad Cannell, M.P.H., Ph.D.


Resident and Medical Student Researchers:

  • Gordon Bae, M.D.
  • Leandra Barnes, M.D.
  • Gun Ho Lee
  • Katie Ransohoff, M.D.

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