Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Julie Koch


Skin cancer is a common, potentially life threatening disease notably on the rise among young Americans. A substantial portion of lifetime exposure to ultraviolet (UV) radiation, the greatest modifiable risk factor for skin cancer development, occurs during childhood and adolescence. Schools infrequently integrate sun safety education into the classroom and many lack essential sun safety policies. The purpose of this EBP project was to implement a multifaceted educational intervention providing middle school students with the knowledge behavioral skills needed to minimize the risk of developing skin cancer. The Health Belief Model and ACE Star Model of evidence-based practice guided this project. A convenience sample of seventh and eighth grade science students attending a local middle school in Northwest Indiana during the fall of 2012 were recruited. Interventions included two 50-minute educational sessions utilizing PowerPoint, video-clips, nurse practitioner led discussion, in-class group activities focusing on the impact of UV radiation, and appearance-focused evaluations with a skin viewing device. Informational packets for parents and school policy recommendations for administrators were developed and distributed. Questionnaires were administered to participants immediately before, immediately following, and one month following implementation of the project. Three major outcomes were evaluated: knowledge of sun safety, intentions to practice sun-protective behaviors, and attitudes toward sun-protection. While 169 students received the educational component of the program, only 125 students ages 12-14 years (M = 12.8) participated in the completion of all three questionnaires. The project demonstrated significant improvements in students’ knowledge on sun safety and UV radiation (p < .001), attitudes toward tanning and skin cancer (p < .001), and self-reported intentions to change sun-protective behaviors (p < .001). Improvements were maintained over time from pre-test to post-test two. School nurses, administrators, and community leaders can use findings from this project to initiate policy revisions supporting a sun safe environment and the implementation of sun safety education across all grade levels.