Results of a Randomized Trial on an Intervention Promoting Adoption of Occupational Sun Protection Policies

Abstract

Purpose: To evaluate an intervention promoting adoption of occupational sun protection policies by employers in a randomized trial. Design: A randomized pretest–posttest controlled design with 2-year follow-up was conducted in 2010 to 2013. Setting: Local government organizations in Colorado who had outdoor workers in public works, public safety, and/or parks and recreation. Participants: Ninety-eight local government organizations (n = 51 municipalities, 10 counties, and 37 special districts). Intervention: Organizations were randomly assigned to receive a policy and education intervention comprised of personal contacts and theory-based training and materials or to an attention control group. Measures: Occupational policy documents were coded for sun safety content by a trained research assistant blind to condition. Analysis: Policy scores were analyzed with logistic and Poisson regression models using imputation. Results: At posttest, more organizations in the intervention group had a sun protection policy than in the control group (odds ratio [OR] = 4.91, P < .05; intent to treat: OR = 5.95, P < .05) and policies were more extensive (χ2 = 31.29, P < .01; intent to treat: χ2 =73.79, P < .01) and stronger (χ2 = 24.50, P < .01; intent to treat: χ2 = 51.95, P < .01). Policy adoption was higher when the number of contacts and trainings increased ( P < .05). Conclusion: The intervention had a large effect on adoption of formal sun protection policies, perhaps because of its fit with legal requirements to maintain safe workplaces. Personal contacts with managers were influential on adoption of occupational policy even in this age of communication technology and social media.