Characteristics of swimming pools with high rates of objectively measured sunscreen use.

BACKGROUND A combination of verbal reports, observations, and physical assessments can improve understanding of prevention programs. OBJECTIVE Skin swabbing techniques were used to detect the presence of sunscreen as part of a sun protection measurement study at 16 swimming pools. Three pools demonstrated much higher sunscreen use (>95%) than the others (47.1%). This paper compares these three pools to the other 13 to examine whether they have common features and if different sources of data can help interpret the findings. METHODS Data were collected from skin swabs detecting the presence of sunscreen; observations of participants; observations of pool environments; and surveys. RESULTS Pool observations showed a higher use of shade structures, sun safety signs, and other supporting items at the three high-sunscreen use pools. These three pools had significantly more year-round and long-term employees than did the other 13 pools. LIMITATIONS Sunscreen characteristics could not be determined using the swabbing technique. Publicity about the study, or the weather, may have influenced behaviors at the pools. CONCLUSIONS Supportive environments were associated with consistent high levels of sunscreen use. This study also confirms the importance of using multiple data sources to interpret findings.