Background. Childhood and adolescence represent a critical period for cumulative ultraviolet (UV) exposure, with a substantial proportion of an individual’s lifetime UV dose acquired before adulthood. Children engaged in organised outdoor sport are exposed to repeated, prolonged solar radiation during peak-irradiance hours, yet data on their sun protection and on parental awareness in this setting remain scarce, particularly in Croatia. Aims. To assess sun protection habits, knowledge, and attitudes among parents of children engaged in organised outdoor sport in Osijek, eastern Croatia, to examine the relationship between parental knowledge, attitudes, and the photoprotective behaviour adopted for the child, and to identify subgroups in which protection was least adequate. Methods. A cross-sectional, questionnaire-based study was conducted between 10 and 26 May 2026. A purpose-designed, self-administered online questionnaire was distributed through registered sports clubs to parents of children aged up to 18 years enrolled in organised sport. Parental knowledge (six items; overall score range −6 to +6) and attitudes (five-item Likert scale) were assessed, together with the sun protection measures used for the child. Non-parametric tests (Mann–Whitney, Kruskal–Wallis with Conover post-hoc, chi-square, Fisher’s exact) and Spearman’s rank correlation were used; internal consistency was assessed with Cronbach’s alpha. Statistical significance was set at P < 0.05. Results. A total of 139 parents were included (99 mothers, 71.2%; graduate education 52.5%). Boys comprised 69.8% of the children, and football (45.3%) and athletics (34.5%) were the most common sports. Parents habitually used a higher protection factor for their children than for themselves (SPF 50 for 71.2% of children versus 48.9% of parents). Nevertheless, only 13.7% of children always used sunscreen during outdoor activity and 8.6% never did; the highest proportion of children who never used sunscreen was found among those training outdoors daily or only rarely. The median overall knowledge score was 3 (IQR 2 to 4), with a specific deficit regarding the meaning of the SPF value (31% correct, 45% incorrect). The attitude scale showed excellent internal consistency (Cronbach’s α = 0.90). A significant positive correlation was found between knowledge and attitudes (Spearman’s ρ = 0.36; 95% CI 0.21 to 0.49; P < 0.001), but higher knowledge and more favourable attitudes did not reliably translate into adequate protective behaviour for the child. Mothers protected themselves more than fathers (P < 0.001), whereas no parental-sex difference was observed in protection of the child (P = 0.21). Fairer skin phototype was associated with more frequent sunscreen use (P = 0.047). Conclusions. Although parents demonstrated generally sound knowledge and favourable attitudes and prioritised protection for their children over themselves, a substantial proportion of children engaged in regular outdoor sport remained inadequately protected, and a clear dissociation between knowledge, attitudes, and behaviour was evident. Improving factual knowledge alone is unlikely to be sufficient; effective primary prevention will require targeted, multifaceted interventions that address specific misconceptions, engage both parents, and involve sports clubs and coaches, situated within the broader framework of skin cancer prevention and early detection.
Assessing Sun Protection Habits and Parental Awareness in Pediatric Athletes: Opportunities for Preventive Interventions
Situm Ceprnja, Z. (Author). 2026
Student thesis