0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Research Letter |

Portable Shade Structure Use at a Youth Soccer Camp FREE

Sheila Krishna, MD1; Eric Ambrecht, PhD2,3; Ian A. Maher, MD1,2
[+] Author Affiliations
1Department of Dermatology, Virginia Commonwealth University Health System, Medical College of Virginia, Richmond
2Department of Dermatology, St Louis University, St Louis, Missouri
3Center for Outcomes Research, St Louis University, St Louis, Missouri
JAMA Dermatol. 2014;150(9):1011-1012. doi:10.1001/jamadermatol.2013.10502.
Text Size: A A A
Published online

More than 3 million nonmelanoma skin cancers (NMSCs) are diagnosed annually in the United States.1,2 The incidence of malignant melanoma (MM) has increased annually by 2.4%.3 Open field activities in youth are a major source of sun exposure, which leads to skin cancer later in life.46 Few studies exist on the use of shade structures in open field sports, particularly soccer. In this pilot study, we assess the rate of use of portable shade structures among soccer-playing youths.

The Virginia Commonwealth University (VCU) institutional review board approved this study, waiving participant written informed consent. A summer soccer camp for boys and girls in metropolitan Richmond, Virginia, consisted of 15 3-hour periods of play over 10 days, of which 8 periods were observed (rainfall forced cancellation of the other 7). Shade tents donated by Virginia Commonwealth University Medical Center and the Sun Safe Soccer program of the American Society for Dermatologic Surgery were erected within 10 yards of the field. Coaches neither encouraged nor discouraged use.

Research assistants followed written protocols and recorded tallies of the number of players using the shade tents during the breaks. Two minutes after a rest period began, 2 data collectors independently counted the children beneath the shade structures and recorded the mean value. Rest periods ranged from 5 to 10 minutes. The UV index and temperature, accessed from the US Weather Service at Richmond International Airport, were recorded for the times at which the counts were made.

The overall mean percentage of children using shade structures per rest session was calculated, with stratifications by age and week. Pearson correlation coefficients were calculated to assess the association between a session’s UV index and temperature and shade structure use. A generalized linear model was created to estimate overall shade structure use, controlling for the potential confounding variables of group, week, UV index, and temperature.

Seventy-eight rest sessions were observed on 7 different days (Table). The mean number of children observed during each session was 80.9. The mean (SD) percentage of children using shade structures was 71.4% (37.8%) across all rest sessions. The mean (SD) outside temperature was 84.3°F (2.7°F) (range, 79°F-93°F). Two recordings were below 80°F, at 79°F. There was no correlation between temperature and shade structure use (P = .19). However, there were differences in shade use by camper group: older campers (14-18 years) who attended the afternoon sessions (51.2%) were less likely to use shade structures than younger campers (8-18 years) in the morning sessions (76.6%) (P = .02). There were also differences in shade use between week 1 (98%) and week 2 (66%) (P = .01), which correspond with differences in cloud coverage as noted by data collectors. Controlling for camper group and week, the adjusted mean percentage of children using shade structures was 79.7% per rest session.

Table Graphic Jump LocationTable.  Players’ Use of Shade Structures During Youth Soccer Camp Rest Sessions

In this pilot study, we examine the rate of use of commercially available shade tents in soccer-playing youths. We observed a mean adjusted use rate of 79.7%, which suggests that shade structures will be used if they are provided and sufficient time is allowed for use. Our study is limited by the small sample size, single club, and location in the southern United States. However, our findings suggest that inexpensive, portable shade structures at sporting events encourage sun protection, which could be augmented by providing sunscreen there as well. Larger, multicenter studies are needed to confirm the utility of shade structures to decrease UV exposure in a meaningful way and to inform policy makers, recreation facility managers, and architects of the public health value of shade structures for open field sports activities.

Corresponding Author: Ian A. Maher, MD, Department of Dermatology, St Louis University, 1755 S Grand Blvd, St Louis, MO 63104 (maheria@slu.edu).

Accepted for Publication: December 17, 2013.

Published Online: July 30, 2014. doi:10.1001/jamadermatol.2013.10502.

Author Contributions: Drs Ambrecht and Maher had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Krishna, Maher.

Acquisition, analysis, or interpretation of data: Krishna, Ambrecht, Maher.

Drafting of the manuscript: Krishna, Ambrecht, Maher.

Critical revision of the manuscript for important intellectual content: Krishna, Ambrecht, Maher.

Statistical analysis: Ambrecht, Maher.

Obtained funding: Maher.

Administrative, technical, or material support: Ambrecht, Maher.

Study supervision: Maher.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported in part by the Sun Safe Soccer program of the American Society of Dermatologic Surgery.

Role of the Sponsor: The sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We are indebted to the Virginia Commonwealth University medical students who assisted with data collection.

Rogers  HW, Weinstock  MA, Harris  AR,  et al.  Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol. 2010;146(3):283-287.
PubMed   |  Link to Article
Stern  RS, Weinstein  MC, Baker  SG.  Risk reduction for nonmelanoma skin cancer with childhood sunscreen use. Arch Dermatol. 1986;122(5):537-545.
PubMed   |  Link to Article
Whiteman  DC, Whiteman  CA, Green  AC.  Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies. Cancer Causes Control. 2001;12(1):69-82.
PubMed   |  Link to Article
Balk  SJ; Council on Environmental Health; Section on Dermatology.  Ultraviolet radiation: a hazard to children and adolescents. Pediatrics. 2011;127(3):e791-e817.
PubMed   |  Link to Article
Mahé  E, Beauchet  A, de Paula Corrêa  M,  et al.  Outdoor sports and risk of ultraviolet radiation-related skin lesions in children: evaluation of risks and prevention. Br J Dermatol. 2011;165(2):360-367.
PubMed   |  Link to Article
Robinson  JK, Rademaker  AW, Sylvester  JA, Cook  B.  Summer sun exposure: knowledge, attitudes, and behaviors of Midwest adolescents. Prev Med. 1997;26(3):364-372.
PubMed   |  Link to Article

Figures

Tables

Table Graphic Jump LocationTable.  Players’ Use of Shade Structures During Youth Soccer Camp Rest Sessions

References

Rogers  HW, Weinstock  MA, Harris  AR,  et al.  Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol. 2010;146(3):283-287.
PubMed   |  Link to Article
Stern  RS, Weinstein  MC, Baker  SG.  Risk reduction for nonmelanoma skin cancer with childhood sunscreen use. Arch Dermatol. 1986;122(5):537-545.
PubMed   |  Link to Article
Whiteman  DC, Whiteman  CA, Green  AC.  Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies. Cancer Causes Control. 2001;12(1):69-82.
PubMed   |  Link to Article
Balk  SJ; Council on Environmental Health; Section on Dermatology.  Ultraviolet radiation: a hazard to children and adolescents. Pediatrics. 2011;127(3):e791-e817.
PubMed   |  Link to Article
Mahé  E, Beauchet  A, de Paula Corrêa  M,  et al.  Outdoor sports and risk of ultraviolet radiation-related skin lesions in children: evaluation of risks and prevention. Br J Dermatol. 2011;165(2):360-367.
PubMed   |  Link to Article
Robinson  JK, Rademaker  AW, Sylvester  JA, Cook  B.  Summer sun exposure: knowledge, attitudes, and behaviors of Midwest adolescents. Prev Med. 1997;26(3):364-372.
PubMed   |  Link to Article

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

297 Views
0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
Jobs
×