Application of DOI: The Pool Cool Skin Cancer Prevention Program

Study Description - a multicomponent skin cancer prevention program for use at swimming pool settings

Intended Audiences - children five to ten years of age (primarily taking swimming lessons), their parents, lifeguards and aquatics instructors at 28 pools in Massachusetts and Hawaii during the summer of 1999

Intervention Components

  • 1-hr. orientation and training and a leader's guide
  • 8 sun-safety lessons
  • A "big book" to make lessons more interactive
  • On-site interactive activities
  • Incentives to reinforce sun-safety messages
  • Provision of sunscreen, shade and signage, and promotion of sun-safe environments


  • Self-administered surveys completed by parents for themselves and their children at the beginning of the summer and 8 weeks later
  • Observations at the beginning, middle and end of summer
  • Monitoring forms completed by the aquatic staff
  • Tracked distribution of program incentives
  • Participation logs


  • Significant positive changes in sunscreen and shade use as well as a reduction in sunburns and improvements in hat use by parents
  • Improvements in the availability of sunscreen at pools, signage, and lifeguard shirt use