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Table 1 Extracted data from intervention studies included in the review

From: Interventions to decrease skin cancer risk in outdoor workers: update to a 2007 systematic review

Author, date, design, duration Population & sample size Intervention Results summary Limitations Evidence levela
Stock et al., 2009 [18] n = 148 (97.3% retention at 12 months) 2-component intervention; photo taken with UV filter camera, and educational video on sun protection and either skin cancer or photoageing Significantly great increase in sun protection score (combined self-reported use of sunscreen, hat, long-sleeves; and objective skin tanning measure) at 12 months in groups #3-5 (+9%; +21%; +14% respectively) compared to control (−17%) & group #2 (−11%) Small sample size per group; limited variation in gender/ethnicity II
Randomised controlled trial (RCT) Workers for Iowa Department of Transportation (DOT) 2 x 2 + 1 factorial design
#1: control- no intervention
#2: no UV photo, ageing video
#3: no UV photo, skin cancer video
#4: UV photo, ageing video
#5: UV photo, skin cancer video
2- and 12-month follow-up 100% male, 97% white, mean age 46.5 years  
Malak et al., 2011 [32] n = 194 2 day training course on skin cancer prevention, identifying skin cancers and sun protection methods + reinforcement posters around village + distribution of wide-brimmed hats No significant difference in proportion using sunglasses, hats, or long-sleeved shirts No control group; retention rate not stated; self-reported data; culturally specific sample e.g. preference for scarfs prevents use of hats IV
Pre-post test Farmers living in a village in western Turkey Significant increase in proportion of those using sunscreen (+9.5%; p = 0.001) and shade umbrella (+75.2%; p < 0.001); and decrease in proportion of those working in the sun at peak UV periods (−15.3%; p = 0.003)
6-month follow up 44% male, 58% dark-skinned, mean age 39.1 years
Woolley et al., 2008 [12] n = 47 Case condition (n = 26): Employees in a workplace with long-standing mandatory sun protection policy No significant differences in sun burns in past month; level of tanning on right hand or forearm, number of solar keratoses on right forearm, or usually wearing a wide-brim hat or sunscreen while at work Limited power due to small sample size, did not adjust for potential covariates e.g. length of time spent working for organisation III-2
Case control Road workers and construction workers in Queensland, Australia Control (n = 21): Employees in a workplace where sun protection is voluntary Mandatory workplace employees had fewer solar keratoses on dorsum of right hand (0.3 vs 4.0, p = 0.006), less previously excised self-reported skin cancers (0.5 vs 3.5, p = 0.008), and were more likely to usually wear a long-sleeved shirt at work (81% vs 29%, p < 0.001)
Single timepoint 89% male, mean age 42 years
Anderson et al., 2008 [33] n = 4,007 (39% retention) Intervention: n = 13 ski areas received Go Sun Smart (GSS) Health Communication Campaign: advice/training to wear sun protection (sunscreen & protective lip-balm, hat, protective eyewear) delivered through workplace communication channels using 23 items including posters, magnets, website, newsletter articles, training programs for managers At 6-month follow up, significantly less reported sunburn > =1 over past summer in intervention group (50%) compared to control (53%, p = 0.01) Fluctuating study population due to nature of the organisation; low retention rate; implementation of program varied per ski area III-2
Pair-matched group-randomised before and after controlled design Ski area employees, in 26 ski areas in Western USA and Canada. Control: n = 13 ski areas did not receive GSS Significantly better sun protection scale (combined average of sun protection behaviours: sunscreen; lip-balm; protective clothing; hat; sunglasses/goggles; limit time in sun; stay in shade; have sunscreen, sunglasses and hat with them at all times; watch skin closely to avoid sunburning) in intervention group compared to control (3% adjusted difference, p = 0.04)
3- and 6-month follow-up 64% male, 96% white, average age 34 years
Mayer et al., 2007 [34] n = 2,662 (82% retention) Intervention: 35 postal stations (n = 1,257) received SUNWISE sun safety program: provision of wide-brim hats and sunscreen, sun safety educational sessions and visual cues prompting sun safe reminders Significant increase in proportion who always use sunscreen at 2-years in intervention group (+12%) compared to control (+3%)   II
RCT Letter-carriers at 70 US postal stations in 3 geographic regions in Southern California, USA Control: 35 postal stations (n = 1,405) did not receive SUNWISE sun safety program. Significant increase in proportion who always wear a wide-brim hat at 2-years in intervention group (+13%) compared to control (+1%)
3-month, 1- and 2-year follow-up 70% male, mean age 43.0 years
Andersen et al., 2012 [35] n = 2228 Intervention (n = 33 ski areas): BDS (Basic Dissemination Strategy) + EDS (Enhanced Dissemination strategy) of Go Sun Smart (GSS) No significant differences in sun protection scale or sunburn history between BDS and EDS groups No pretest or adjustment for baseline levels of sun protection III-2
Cluster-randomised post test only Employees at 68 U.S and Canadian ski areas Control (n = 35 ski areas): BDS only of GSS sun safety program. Employees at organisations where 9+ of the 23 GSS items were used scored significantly higher on the sun protection scale compared to those where <4 GSS items were used (3% difference, p < 0.05)
Disseminated over a single ski season in three waves (2004, 2005, 2006) 64% male, mean age 35.7 years, 93% white     
  1. a.Based on Australian National Health and Medical Research Council (NHMRC) evidence hierarchy [36].