200 - Parental Sun Safety Practices for Children Amid Warming Summers: Findings from a Statewide Survey

Publication Number: 2192.200

Ashley P. Keese, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Annika Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Evanston, IL, United States; Carly Menker, University of Illinois College of Medicine, Chicago, IL, United States; MIchelle Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Marie Heffernan, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Early-life sun exposure substantially increases lifetime skin cancer risk, yet little is known about how parents engage in pediatric sun safety practices. Illinois' cool climate once limited UV exposure, but warmer temperatures and longer summers are expanding opportunities for cumulative exposure. Access to shade, protective products, and sun safety education varies by socioeconomic and racial factors, contributing to differences in skin cancer prevention behaviors. While clinical guidelines emphasize consistent sun safety practices, real-world adherence and equity gaps remain underexplored.

Objective: To characterize the prevalence and sociodemographic correlates of parental sun safety practices and identify gaps in comprehensive sun safety to inform pediatric prevention strategies.

Design/Methods: A cross-sectional survey of 1,078 Illinois parents was administered September-October 2024 through the Voices of Child Health in Illinois program. Weighting accounted for the probability and nonprobability sampling design. Six behaviors, including routine sunscreen use, reapplication every two hours, use of SPF 30+, sun avoidance, sunscreen delegation, and child empowerment, were examined individually and as a composite score to reflect overall engagement. The composite score was developed by assigning greater weight to higher-impact practices. Weighted logistic regressions assessed independent predictors of individual behaviors, and linear regression modeled adjusted mean differences in composite scores.

Results: Fewer than half of parents routinely applied sunscreen (42%). One in five reported reapplication every two hours. Most parents used SPF 30+ (82%), but significant variation emerged across race and ethnicity and socioeconomic status. Black parents reported less engagement across all behaviors and had lower composite scores than White and Hispanic parents (p < .001). More overall parental engagement was observed among those with younger children, from urban areas, with college degrees, and whose children had a primary care provider.

Conclusion(s): Parental engagement in pediatric sun safety practices is inconsistent. Results reveal geographic, racial and ethnic, and economic disparities, highlighting the inequitable burden of the health effects of climate change and differences in cultural risk perceptions. Pediatric clinicians can promote comprehensive photoprotection by integrating sun safety counseling and community health promotion as UV exposure increases in a warming climate.

Table 1. Weighted characteristics of survey respondents (N = 1,078)
Note. FPL =Federal poverty level.
There were no responses in the sample who reported their gender as ""Non-binary or third gender"" or ""An identity not listed""; 4 respondents did not list a gender.
Household child age was categorized as children 0-5 years (early childhood), all children 6-10 years (middle childhood), or ≥1 child 11 years or older (adolescence).

Table 2. Proportion of parents who selected each response option for the six sun safety practices (weighted %, unweighted n)


Figure 1. Variation in adjusted mean sun safety scores by parent and child sociodemographic factors
Note. Error bars indicate 95% CIs. LS-mean = least-squares mean. Scores were adjusted for parent race and ethnicity, parent gender, education, household income, child age composition, school type, urbanicity, and primary care provider (PCP) status.