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This is to certify that the

thesis entitled
DEVELOPING AN EDUCATIONAL WEB SITE FOR YOUTH

REGARDING PROTECTION FROM ULTRAVIOLET RADIATION,

AND EVALUATING THAT WEB SITE
VIA THE INTERNET

presented by
Ji-Hyun Kim

has been accepted towards fulfillment
of the requirements for

Master of Arts Apparel and Textiles

degree in

 

40W @c/ébuwn

Major professor

Date May 8, 2000

 

0-7 639 MS U is an Affirmative Action/Equal Opportunity Institution

 

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moo chlMpfiS—p.“

DEVELOPING AN EDUCATIONAL WEB SITE FOR YOUTH
REGARDING PROTECTION FROM ULTRAVIOLET RADIATION,
AND EVALUATING THAT WEB SITE VIA THE INTERNET
By

J i-Hyun Kim

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Human Environment and Design

2000

ABSTRACT
DEVELOPING AN EDUCATIONAL WEB SITE FOR YOUTH
REGARDING PROTECTION FROM ULTRAVIOLET RADIATION,
AND EVALUATING THAT WEB SITE VIA THE INTERNET
By

J i-Hyun Kim

This study investigates the sun protection knowledge and practices of mid-
Michigan youths. In that regard this researcher (Kim) sought to ascertain pertinent details
of the relationship between those youths’ sun protective practices and predictor variables,
including: 1) sun protective knowledge scores, 2) sun protective practices of parents, 3)
sun protective practices of friends, 4) ultraviolet (UV) overexposure experiences, and 5)
indirect experiences regarding skin cancer. The survey for this study was implemented
using a printed- and an online questionnaire.

Based on analysis of data collected and review of literature, the research team
planned educational material about UV protection. This researcher created a Web site to
disseminate sun protection information for youths, their parents, and other concerned
adults. The Web site comprises five sections: sun facts, skin cancer, sun protection, a
sun-wise quiz, and a Web evaluation. The Web site was tested via different platforms
and browsers, to ensure its functionality.

The Web site was evaluated online by youths and adults, to measure the
appropriateness of its informational, functional and aesthetic aspects. Results indicated
that, in all aspects mentioned above, the Web site was perceived as appropriate for youth.
This provides also a set of potential guidelines for future Web development, and for

related educational materials.

To my parents
for their love, support, encouragement,
and, most of all, for their belief in my ability

to achieve my goals.

ACKNOWLEDGMENTS

The author most gratefully acknowledges the support and encouragement she
received throughout this endeavor. Special thanks to Dr. Ann Slocum, this author’s
advisor and director of research, for her deep interest, encouragement, assistance, and
funding from the Michigan Agricultural Experiment Station project, “Sun Protective
Knowledge, Attitudes, & Practices of Youth, A Web-Based Research and Education
Approach.” Special thanks also to Dr. Sally Helvenston for her interest, support, and
understanding. In addition, gratitude is expressed to Assistant Professor Joanne
Schultink, for her interest, support, and assistance.

The author also extends appreciation to Mr. Brian Winn and Dr. John Locke in
the Department of Telecommunication, for their interest and technical assistance in the
development of the Web site for this project, and to the Department of Human
Environment and Design for Graduate Assistantships, and in respect of a University
Graduate Fellowship for this thesis.

The author is most grateful also to her family members, including her grandfather
for his encouragement and support of this pursuit of higher education, and her sister, who
is also her best friend, for understanding, encouraging and steadfastly supporting the
whole endeavor from afar.

Also, thanks to the author’s friends for all their fine encouragement and support.

TABLE OF CONTENTS

Page
LIST OF TABLES ................................................................................ vii
LIST OF FIGURES .............................................................................. viii
CHAPTER I. INTRODUCTION ....................................................................................... 1
Negative effects of UV radiation .................................................................. 1
Justification ......................................................................................................... 4
Why a Web-based approach? ........................................................................ 5
Statement of Problem .......................................................................................... 6
Research Objectives ............................................................................................ 6
Research Questions ............................................................................................. 7
Operational Definitions ....................................................................................... 8
CHAPTER 11. REVIEW OF LITERATURE .................................................................. 10
Ways of Reducing UV exposure ....................................................................... 10
Clothing as a Protection against the Sun ..................................................... 10
Hats for UV Protection ................................................................................ 13
Sunscreens ................................................................................................... 14
Recent Studies about Sun Protective Practices or Knowledge of Youth 15
Web-Based Research & Education ................................................................... 18
Using Internet for Education ....................................................................... 18
Recent UV protection Web Sites ................................................................ 19
Web Design & Evaluation Guidelines for Youth Audiences ...................... 20
Identifying Internet Environment of Users ................................................. 22
Design Process Model ....................................................................................... 24
CHAPTER III. METHODOLOGY ................................................................................. 30
Phase 1: Sun Protective Baseline Data Collection ............................................. 31
Instrument Development ............................................................................. 3]
Selection of Participants .............................................................................. 31
Data Collection Procedures ......................................................................... 32
Data Analysis .............................................................................................. 33
Measurements of Variables ......................................................................... 33
Phase II : Creating a Web site ........................................................................... 35
General Web Developing Environment ...................................................... 35
Design criteria of creating a web site .......................................................... 37
Organization of the Web Site ...................................................................... 39
Testing and Revision of the Web Site ......................................................... 41
Phase III : Evaluation of the Web Site .............................................................. 42
Instrument Development ............................................................................. 42

Samples and Data Collection ...................................................................... 43

Data Analysis .............................................................................................. 44

CHAPTER IV. ANALYSIS AND FINDINGS ............................................................... 45

Phase I : Analyses of Baseline Data Collection ................................................ 45

Demographic Information ........................................................................... 45

Youths’ Knowledge Regarding Sun Exposure ........................................... 46

Sun Habits and Protective Practices of Youth ............................................ 48

Tendency of Parental Sun Protective Practices ........................................... 50

Influence of Peers’ Sun Protective Practices .............................................. 52

Direct / Indirect Experiences of Youth ....................................................... 52

Internet Accessibility and Preference of Youth .......................................... 54

Phase II: Results of Creating a Sun Wise Web site .......................................... 54

Sun Facts ..................................................................................................... 54

Skin Cancer ................................................................................................. 55

Sun Protection ............................................................................................. 55

Sun Wise Quiz ............................................................................................. 56

Web Evaluation ........................................................................................... 57

Results of Testing and Revision of the Web Site ........................................ 57

Phase III : Analysis of Online Web site Evaluation .......................................... 58

Demographic Information ........................................................................... 58

Information Aspect of the Web Site ............................................................ 59

Aesthetic Aspect of the Web Site ................................................................ 61

Functional Aspect of the Web Site .............................................................. 62

Variations of the Web Evaluation ............................................................... 64

Internet and Browser Usage ........................................................................ 68

CHAPTER V. SUMMARY AND DISCUSSION OF FINDINGS ................................. 69

Summary ........................................................................................................... 69

Limitations of the Study .................................................................................... 70

Discussion of the Findings ................................................................................ 70

Phase I : Discussion of Baseline Data Collection ....................................... 70

Phase II : Discussion of Creating an Sun Wise Web site ............................ 73

Phase III : Discussion of the Online Web Site Evaluation .......................... 75

Recommendations for Future Research ............................................................ 79
APPENDICES

Appendix A — Recruiting Letter to 4-H Parent for Baseline Data Collection .. 82

Appendix B — Printed Survey Questionnaire for Baseline Data Collection ..... 84

Appendix C - Outline of the Web Site Content ................................................ 87

Appendix D — Outline of the Sun Wise Quiz .................................................... 89

Appendix E — Sun Wise Web site ..................................................................... 91

Appendix F - Recruiting Letters for Online Web Evaluation ........................ 126

BIBLIOGRAPHY ........................................................................................................... 132

Vi

 

LIST OF TABLES

Table Page
1. Differences of Sun Protective Knowledge between Two Age Groups ...................... 46
2. Mean Total Knowledge Score by Age Group ............................................................ 47
3. Percent Reporting Outdoor Activities and Sun Protective Practices .......................... 48
4. Mean Weighted Protection Practice ........................................................................... 48
5. Youths’ Responses about Parental Practices of Sun Protection ................................. 50

6. Youth’s Total Weighted Sun Protection Scores in Relation to Peer’s Use of
Sunblock .................................................................................................................... 52
7. Difference of Youths’ Sun Protection Score in Relation to Sunburn Experience ...... 53
8. Youth’s Total Weighted Sun Protection Score in Relation to Indirect Skin Cancer
Experience ................................................................................................................. 53
9. Informational, Aesthetic, and Functional Mean Scores of Youth in Relation to
Demographic Variables and Browser Usage ............................................................. 65
10. Informational, Aesthetic, and Functional Mean Scores of Adult Groups in Relation

to Their Demographic Information and Browser Usage ........................................... 66

Vii

 

LIST OF FIGURES

Figure Page
1. Three possible flow formats of design process ........................................... 25
2. A Systematic process for developing strategic communication programs ........... 27

3. Activity/information flow process for the development and evaluation of UV

protection Web site ........................................................................... 28
4. Mean weighted protection practice by age group ....................................... 49
5. Previous knowledge about sun safety of adults and youth ............................ 59

6. Adult responses on whether information on the Web site is easy for kids to

understand .................................................................................... 60
7. Youth responses on aesthetic aspect of the web site ................................... 61
8. Adult responses on aesthetic aspect of the web site .................................... 61

9. Comparison of two group responses in relation to satisfaction of downloading

time ........................................................................................... 62
10. Percentage of youth visiting links ....................................................... 63
11. Percentage of adult visiting links ........................................................ 63

viii

CHAPTER I

INTRODUCTION

Sunlight is the source of all life in the world. It lights and warms the world and
delivers the solar energy which living organisms require for survival. For example,

plants make their own food using sunlight and give off oxygen through photosynthesis.

 

Then human and other animal bio-chemistries utilize the oxygen to live, and also
consume plants and other organisms. Sunlight also provides psychological and
physiological benefit in several ways: being outdoors in bright or clement weather
generally elevates moods; sunlight assists in production of vitamin D in skin cells, which
is absorbed by the body and used in calcium uptake from the intestinal tract, and that
calcium is essential for healthy bone growth and development; vitamin D also suppresses
the growth of skin cancer.

These benefits are acquired by UV radiation exposure which is not excessive
(Hilfiker, Kaufrnann, Reinert, & Schmidt, 1996; Garland, White, Shaw, & Gorman,
1990). However, large amounts of UV radiation exposure have detrimental effects on
human health, and may cause skin cancer, eye cataracts, and other ailments (Hilfiker et
al., 1996; Garland et al., 1990).

N_egative effects of UV radiation

Human exposure to UV radiation has been shown to be strongly associated with

damage to the skin, ranging from aging of the skin (wrinkling at a rate more rapid than,

or to a degree greater than, normal skin aging) to skin cancer. UV radiation is an

invisible component of sun energy. With reduced ozone protection, increased levels of
UV radiation reach the earth’s surface thus increasing the risk of skin cancer, eye
cataracts, premature aging, and lesser immunity to disease via reduced immunity of skin
cells (Truhan, 1991). Additional damage occurs each time a person is exposed to UV
radiation, and more intense exposure, such as sunburn, may increase rapidly the
possibility of skin cancer (Farmer & Naylor, 1996).

UV radiation comprises three regions of the electromagnetic spectrum: UVA (320

 

to 400nm), UVB (290 to 320nm), and UVC (200 to 290nm). The last-mentioned, UVC,
is totally absorbed by the atmosphere and does not penetrate the ozone layer to reach the
earth’s surface. The remaining two, UVA and UVB, are the causes of concern (Threlfall,
1992; Truhan, 1991).

UVA causes little visible reaction on the skin, but recent research indicates it
decreases the immunity response of skin cells. UVB is believed to be the cause of skin
cancer and eye cataracts. Moreover, some patients undergoing drug therapy and
treatment may have photochemical response to UV radiation (Threlfall, 1992; Truhan,
1991) so would need special protection against UV radiations.

Skin cancer is a disease in which cancer cells are found in the outer layers of the
skin. Of all cancers, it is the most common. There are two general types of skin cancer:
non-melanoma, and melanoma.

Non-melanoma skin cancer includes basal cell skin cancer, and squamous cell
skin cancer. It is associated with cumulative sun exposure. Squamous and basal are the
most common, and usually may be removable by excision or by topical treatments.

Melanoma skin cancer is associated with short, intense sun exposure (Truhan,

1991). It is less common, but much more serious than, non-melanoma skin cancers and
can result in death if not detected and treated early (American Cancer Society [ACS],
1999). An estimate of skin cancer incidence in 1999 in the United States suggests
approximately one million new cases of non-melanoma, and 44,200 new cases of
malignant melanoma (ACS, 1999). Estimated new skin cancer cases have increased
steadily: In 1970, 112,000 cases; in 1980, 400,000 cases; in 1990, 600,000 cases; and in
1999 one million cases (ACS, 1967; ACS, 1968; ACS, 1970; ACS, 1980; ACS, 1990;
and ACS, 1999).

Although skin cancer occurs mainly in adulthood, increasing evidence shows that
skin cancer takes several decades to develop, and that UV radiation exposure during
childhood is the main reason (Holman, Armstrong & Heeman, 1986; Marks, Jolley &
Lectsas, 1990; Weinstock, Colditz, Willette, Stampfer, Bronstein, Mihm, & Speizer,
1989).

Melanoma accounts for about four percent of skin cancer cases, but causes about
79% of skin cancer deaths (ACS, 1999). The number of new melanomas diagnosed in
the United States is increasing. Since 1973 the melanoma incidence rate (i.e. the number
of new melanomas diagnosed per 100,000 people each year) has more than doubled from
6 to 13. In 1999 about 7.300 people in the United States were expected to die of
melanoma. In the 19305, a child born in the United States had a 1 in 1,500 chance of
contracting melanoma. With the erosion of the ozone layer, by the year 2000 this risk
estimate had increased to 1 in 90 (Truhan, 1991; Capjack, Kerr, Davis, Fedosejevs,

Hatch, & Markee, 1994).

 

Justification
Intense sun exposure prior to age 20 significantly increases the risk factor for all
types of skin cancer. In addition, 50% to 80% of one’s lifetime exposure to UV radiation
occurs before the age of 18 to 20. Some evidence suggests that the risk of developing
malignant melanoma may be doubled if a person has had one or more severe sunbums in
childhood (Lew, Sober, & Cook, 1983; Mackie & Aitchwason, 1982; Weinstock, etal.,

1989).

 

This research is of particular importance because it may lead to a greater
sensitivity to the importance of UV protection in earlier life, and provide information
about sun protection. so that the public may gain improved knowledge in this regard.
Attitudes and behavior to minimize skin cancer risks and/or overexposure to the sun may
thus improve.

In designing the UV protection web site, this researcher may provide to other
researchers, teachers and educators also an introduction (or a reminder) of the efficiency
of the lntemet for educational purposes. A greater understanding of this new
communication medium and its efficiency as an educational information channel for
youth and their parents, may be achieved also. The unique characteristic of the Web
allows this researcher to disseminate educational material about UV protection to all who
are willing to access this information, no matter where they are, globally. No pure
distance barrier exists in access. Users can simply search for information and access it,
whenever or wherever, with the proper lntemet connection and computer.

For this study, the youths and parents/ leaders of 4-H youth programs in mid-

Michigan are the main target audience for UV protection information. Disseminating

information over the lntemet allows maximum publicity and accessibility: once users
have proper lntemet connections, they can access the information whenever and
wherever they wish. Therefore, others in addition to the target audience are expected to
participate in the activities regarding UV protection information over the Internet.

Why a Web-based apmgaglfi

In the past few years, the Internet and the World Wide Web (Web) have grown
phenomenally. The lntemet is Often referred to as the global network of computers. The
Web has become an incredibly powerful and efficient tool for accessing and
disseminating information (Sanders, 1999). It is apparent that the Web is an environment
where both information sources and information users abound and is a commrmication
channel of which educators should increasingly make use (Sanders, 1999).

Many are the potential benefits to using technologies in education. Negroponte,
Resnick and Cassell (1997) suggested that digital technologies would radically change
how children learn, what they learn, and with whom they learn. They proposed that
digital technologies would encourage children to become more active and independent
learners. Due to the “global connectedness” of digital technologies. students will become
part of global knowledge communities collaborating with others around the world
(Negroponte, Resnick & Cassell, 1997). Using the lntemet, students can be exposed to a
wider range of information and experts around the world, whenever they want and
wherever they are. One of the primary advantages of the Web is that it is compatible
with the way students now prefer to learn (Owston, 1997). This preference of children,
for using the lntemet for education, may increase their learning efficiency and influence

their behavior. Papert (1993) called the computer the “children’s machine,” because

 

numerous students in K-12 public schools, colleges and universities are so familiar with
computer technology. He also mentioned that “it was an integral part of their world: they
played with, were entertained by, and learned with the computer and tended to be
more visual learners than previous generations because their world was rich in visual

stimuli.”

Statement of Problem

The first purpose of this research is to provide an analysis of baseline data on
mid-Michigan youths’ sun protection knowledge and practices. This researcher sought
the relationship between their sun protective practices and predictor variables.

The second purpose of this research is to design a UV protection web site, and to
disseminate educational material about sun protection for youth, for their parents and for
other adults. The web site information content will be based on analyses of the youths’
sun protective knowledge, attitudes, and practices and on a review of literature.

The third purpose of this study is to implement an online evaluation survey of the
UV protection web site, for the purpose of enhancing the site and for providing web
design and evaluation guidelines for future study. In the long run this will be helpful in

developing online educational materials for youths and adults.

Research Objectives
The objectives of the research are:
1. To describe the trends of mid-Michigan youths’ sun exposure knowledge and

practices and the relationship between their sun protective practices and other

internal and external variables specifically their: sun protective knowledge scores;
sun overexposure experiences; parents’ behavior regarding UV radiation; sun
protective practices of friends; and indirect experiences about skin cancer;

2. To create a UV protection web site, based on the analyses and a review of
literature about web development, and to disseminate sun protection information
to the public, specifically to youths associated with the 4—H youth program in
mid-Michigan;

3. To evaluate the web site through online questionnaires, and to analyze the
informational, aesthetic and functional appropriateness of the web site based on
evaluation data collection. Based on that analysis, this researcher will formulate

guidelines for development and evaluation of an educational web site.

Research Questions

The following research questions will be tested using the survey:
flawsis of baseline da_ta
1. Is there a relationship between sun protective knowledge score and age?
2. IS there a relationship between sun protective knowledge scores and average weighted
sun protection scores of youths?
3. Does a youth’s perception toward parent’s behavior with respect to sun protection
seem to influence youth’s sun protective practices?
4. Does peer behavior influence youths’ behavior regarding sun protection?
5. Is there a difference in behavior between youths severely sunbumed the previous

summer, and youths who were not sunbumed?

 

6. If youths know someone who has skin cancer, is their behavior in relation to sun
protection more positive than others who do not?

figuration of the web site

7. IS information on the web site perceived to be appropriate for youth?

8. Are the graphics and design of the web Site perceived as aesthetically appealing and
adding interest to the contents?

9. Are the functions (navigations, downloading time) of the web Site positively
perceived?

10. Are the links perceived as useful in providing more information?

11. Does evaluation vary with demographic background and with level of prior

knowledge on sun safety?

Operational Definitions

1. Total knowledge score of youths: Questions about sun protective knowledge were
recoded and summed to obtain the total knowledge score of youths regarding sun
protection. Range of total knowledge scores was from 0 to 10. Higher total
knowledge scores indicate that youths are more knowledgeable about sun
protection.

2. Average weighted protection score of youths: Four responses about youths’ sun
protection practices, the frequency of using protection actions, were weighted on
the basis of a 30 day month. The sum of these answers was divided by four to
obtain the average weighted protection score. The average weighted protection

score indicates the average practices of sun protection per month — across four

activities: wearing sunglasses, wearing a hat, using sunblock, and wearing a long-

sleeved shirt. The theoretical range of youths’ average weighted protective practice

score was 0 to 30 and its actual range was 0 to 22.5. A higher score means more
frequent use of sun protection.

Targeted youth audience in the development of the educational material was those
in grades 5 through 8 in the 4-H youth program in mid-Michigan.

Informational mean score: To create an adult informational mean score of the web
evaluation, five responses regarding the informational aspect of the web site were
summed and averaged. For youth informational mean score, three responses were
averaged. Both informational scores indicate the satisfaction and appropriateness
of the contents on the web site for youth audience aged 10 to 13.

Aesthetic mean score: This researcher created the aesthetic mean score by
averaging the design/ graphic responses about the web site. Six responses were
averaged for the adult aesthetics mean score and three responses were averaged for
the youth aesthetic mean score.

Functional mean score: Responses, related to downloading time and ease of
navigation, were averaged to create the functional mean score. Two responses

were averaged for developing the functional scores of both adults and youth.

 

CHAPTER II

REVIEW OF LITERATURE

The review of literature consists of three major sections. The first discusses the
means of reducing UV overexposure. Use of clothing as a means of protection from the
sun overexposure, and clothing factors which determine its protective value, are
illustrated. Use of sunscreen and headwear are addressed. Recent studies about sun
protective knowledge and practices of youths are reviewed.

The second section discusses Web-based research and education, which includes
lntemet use for education and lntemet environment of current users. The review of
literature includes discussion and review of recent UV protection web sites and web
design and evaluation guidelines.

The third section reviews design process models for web development and
evaluation. Koberg and Bagnall’s (1981) design process model is reviewed and adapted
for the general web development process model. The P process model of Porter, Novelli,
and associates (1983) is reviewed and adapted to specify the implementation procedure of

web development.

Ways of Reducing UV exposure

Clothing as a Protection against the Sun

When people choose long-sleeves shirts, slacks, and skirts rather than sleeveless

or short-sleeved shirts, shorts, and miniskirts, greater protection from UV radiation is

10

 

 

afforded because more skin surface is covered. Although many people know the value of
covering their body while exposed to UV radiation, they do not cover up because of
thermal discomfort or restricted movement associated with covering their body.

The UV radiation protection of a fabric depends on factors such as fabric
construction, fabric finishing and color, existence of UV absorbers, fiber type and fabric
weight.

First, the weave or construction of the fabric is the main factor that affects the
transmission of UV radiation; closely woven fabrics transmit less UV radiation than
loosely woven ones (Gies, Roy, Elliott, & Zongli, 1994). Bech-Thomsen, Wulf and
Ullman (1991) stated that direct transmission and scattering through the interstices are
more important than transmission through the fibers of the fabric. Woven fabrics usually
have higher cover factor than knit fabrics because the yarns in woven fabrics can lie
closely together, minimizing the Spaces between yarns (Capjack, Kerr, Davis,
Fedosejevs, Hatch, & Markee, 1994).

Second, any mechanical finish which causes the yarn to shorten and the fabrics to
shrink closes spaces between the yarns. Dye pigments that absorb UV as well as visible
light should decrease UV radiation transmission and increase the fabric protection factor
(Pailthorpe, 1993). In similar fabric construction, darker shades (black, navy blue, and
dark green colors) generally increase the fabric sun protection factor (SPF) value.

Third, absorption and related transmission also can be modified in a controlled
way with UV absorbers (Reinert, Fuso, Hilfiker, & Schmidt, 1997). UV absorbers are
essentially colorless compounds that absorb in the spectral region 280-400nm. These

have been used to protect paints, plastics, and fibers from photo-degradation. Fabrics can

11

be coated with UV absorbers to increase SPF value. Specially engineered UV absorbers
such as Rayosan® c, designed for cellulose and nylon, and Rayosan® p, specially
designed for polyester, are available (Australasian Textiles, 1994).

A fourth factor is the fiber of which a garment is made. Polyester fibers are
known to absorb more UVB and UVC radiation than cotton or nylon fibers. Davis,
Capjack, Kerr, & Fedosejevs (1997) found that all white cotton, linen, acetate, and rayon
samples in their experiments had a SPF of less than 15. Davis et a1. (1997) stated that
polyester fabrics consistently had higher SPF values and offered higher protection than
any other fiber types in comparably constructed fabrics. But polyester fabrics are not
considered to be comfortable for wear in warm weather. They suggested that polyester
blends offer significantly better protection than cotton alone. It provided increased
absorbency and thus increased comfort for clothing worn in warm weather. Other studies
state the reason why polyester fabrics increase absorption of UV light might be that
polyester contains benzene rings in the polymer chains (Davis et al., 1997; Reinert et al.,
1997).

Weight of material is a factor regarding UV radiation transmission. If the
construction of the fabric is identical, the thicker and weightier fabric transmits less UV
radiation (Gies et al., 1994). UV protection could be significantly improved by
increasing the warp and weft densities. For example, pigmented viscose filament yarn
(Enka Sun) made it possible to achieve viscose fabrics with very good UV protection,
fully meeting requirements for very high wear-comfort and low fabric-weight (Hanke,
Hoffman, Altrneyer, Bohringer, Schindler, Schon, Wuppertal, & Klotz, 1997).

Lowe, Bourget, Hughes, and Sayre (1995) compared the UV protection offered

12

by normal summer weight clothing and specially engineered UV protective clothing
(Solumbra®). Both tests in vivo, involving light irritation of fabrics placed on human
skin, and in vitro, with instruments measuring UV light that passes through fabric, were
used to measure UV protection of tightly woven or knitted garments. Lowe et a1. (1995)
found that summer clothing fabric’s opaqueness to visible light may have little
relationship with its ability to block UV radiation, although a loose weave may allow
more visible and UV light through. A high level of UV radiation may still be transmitted
through opaque cotton fabrics. Most summer clothing fabrics in their study appeared to
offer inadequate, less than 15 SPF, sun protection for UV sensitive patients or high
exposure activities. Only specially engineered UV protective clothing (Solumbra®) was
found to offer adequate UV protection to individuals under medical conditions and who
have a history of skin cancers. They stated that the broader protective capabilities of
fabrics exceed the UVA protective capabilities of all topical sunscreen products.

People wearing special UV protective garments can reduce the risk of skin cancer.
Also they can enjoy the appropriate amount of sunlight, and not be fearful of venturing
outdoors. However, UV protective garments may be considered too expensive and, in the
budgetary calculations of some, this cost implication might offset protective advantage
(Capjack et al., 1994).
_H_ats for UV Protection

Hats can be worn to protect face and neck. A few studies have focused on hats for
sun protection. Keeling, Klaus, Pathak, and Sober (1989) compared military baseball
caps with full-brimmed jungle hats and found both protected forehead and nose, but the

full-brimmed hat offered greater protection, from both direct and reflected radiation, for

13

chin, cheeks, ears, and neck. Diffy and Cheeseman (1992) studied the protective value of
28 hat styles in relation to UV exposure. Hats with a wide brim, at least three inches,
provided reasonable protection for the nose and cheeks.
Sunscreens

Protection from harmful effects of UV radiation is recommended through the use
of sunscreen, wearing protective clothing or avoidance of exposure. Sunscreen can
effectively protect skin from UV radiation. Sunscreens are rated according to the amount
of time, or amount of UVB energy, it takes to produce a skin reddening reaction through
the screen, compared with the amount of time or energy required to produce the same
reaction without sunscreen. For example, if a sunscreen has a sun protection factor (SPF)
of 15, it will take an individual fifteen times as long to develop a skin reddening reaction
as it would if not using a sunscreen. It is important to note that a sunscreen’s SPF can be
decreased by external variables such as humidity, wind, temperature, application
thickness, adherence potential of the base, and activities which involve perspiration or
water immersion (Groves, 1973). For someone participating in water activities,
reapplication of sunscreen is highly recommended to obtain the proper protection from
UV radiation, even though the sun protection product is indicated as waterproof or
sweatproof. Studies confirm that single applications of an SPF 25 sunscreen were
fi'equently inadequate to prevent skin reddening, and that multiple applications were
required to completely suppress skin reddening, even from a single day’s sun exposure
(Farmer & Naylor, 1996).

Sunscreen may also cause eye and skin irritation and may be perceived as oily,

greasy, or unattractive. It must be continuously reapplied while exposed to UV radiation.

14

It is not recommended for infants younger than six months (Campbell & Birdsell, 1992;
Robson & Diffey, 1990; Threlfall, 1992).

Teenagers at highest risk of skin cancer, those with sensitive skins or a positive
family history of skin cancer, were not more likely to use sunscreen than other teenagers
(Banks, Silverman, Schwartz, & Tunnessen, 1992). The cost of sunscreens may deter
their regular use, especially where youth are concerned (Cockbum, Hennridus, Scott, &
Sanson-Fisher, 1989).

Recent Studies about Sun Protective Practices or Knowledge of Youth

Some studies about UV protection made particular reference to adolescents’
practices and knowledge. LaBat, DeLong, Gahring, Getting, Amir-Fazli, and Lee (1996)
found that there were significant differences in fifth and sixth grade students’ pretest and
posttest after completing the “Sun Smart Program” developed by the faculty, specialists,
and a county extension educator of the University of Minnesota. LaBat et a1. (1996)
delivered the program to 1,500 fifih and sixth grade students and also evaluated the
intervention. They concluded: First, although subjects knew the risk of sun exposure,
they still perceived that being tanned was attractive. Second, subjects preferred sun
protection methods which did not interfere with their appearance. Third, the intervention
program was effective in changing subjects’ knowledge, beliefs, and attitudes about sun
exposure. Fourth, both males and females indicated their willingness to modify their
behaviors to protect themselves from the sun.

Banks, Silverrnan, Schwartz, and Tunnessen (1992) conducted a study of the
“attitudes of teenagers toward sun exposure and sunscreen use”. Banks et al. (1992)

surveyed 220 adolescents who visited multi-physician offices in a Washington DC.

15

 

suburb, to determine the frequency of their sunscreen use. The study took place in late
spring to early summer 1989. Mean age of participants was 15.2 years and ranged from
12 to 19. Most teenagers in that study stated that they spent most weekends in the sun;
however only 9% of the teenagers always used sunscreen, while one third never did. The
results of their study indicated that 33% - 68% of adolescents had suffered at least one
painful, blistering sunburn despite understanding the potential dangers of sun over-
exposure. Their results showed that teenagers were more likely to use sunscreen if their
parents had insisted on their using it in early childhood, and also if their close fi'iends
used sunscreen. Banks et al. (1992) stated that the reasons teenagers gave for not
regularly using the sunscreen, were that they rarely burned or that they forgot to bring it
with them.

Grob, Guglielmina, Gouvernet, Zarour, Noe, and Bonerandi (1993) studied
sunbathing habits of youths and teens in Marseilles (France) and found that less than 40%
of 199 adolescents, age 13 to 14, used adequate sun protection measures, and that more
than 60% of adolescents took inadequate or no precautions against sun exposure. The
main reason adolescents sunbathed was embellishment of appearance. Most mothers in
their study, in answering why they exposed their preschool children to the sun, responded
it was because it was good for their health (Grob et al., 1993). Also many adolescents
and mothers were well informed, but considered the risk of sun exposure to be
exaggerated by the media (Grob et al., 1993 ).

F ritschi, Green, and Solomon (1992) researched knowledge, attitudes and
behaviors of Australian adolescents toward sun exposure. Fritschi et al. (1992)

conducted a cross-sectional study of a random sample of 972 students aged 13 to 15 from

16

three different locations in Australia. A standard questionnaire and a diary to describe
the activities of the previous weekend were administered to the students in early 1990
(southern hemisphere seasons are opposite to northern hemisphere’s). Fritschi et al.
found that most adolescents spent more than two hours per weekend in the sun during the
time of peak UV radiation, from lla.m. to 3 pm. (Daylight Saving Time), despite their
high knowledge of the sun’s harmful effects on the skin. They found no correlation

between adolescents’ attitudes, and knowledge or behavior towards sun protection.

 

Buller, Callister, and Reichert (1995) studied UV protection practices by parents 5:
of young children in Arizona. Buller et al. (1995) sought to describe and evaluate
parents’ UV protection knowledge, sun protection practices for themselves and their
children, and use of health information sources. They conducted the study using a self-
administered questionnaire during April 1993. Their participants were 205 adults, aged
19 to 56, who had children aged 13 or less. The majority of their sample was Caucasian.
More than half the participants were female. They found that parents did not consistently
practice comprehensive sun protection for themselves nor for their children. Only 42%
of parents used sunscreen most of the time or always and less than one third of them wore
protective clothing such as long-sleeved shirts, long pants, and hats most of the time or
all of the time. According to Buller et al. (1995), parents’ most frequent UV protection
strategies consisted of applying sunscreen to children and warning them not to get

sunbumed; however, parents less frequently limited their children’s sun exposure.

17

Web-Based Research & Education
Usig lntemet for Education

Since the lntemet was introduced, questions about its abilities, boundaries or
limitations have been raised. Although anticipated effectiveness or results of the use of
the lntemet has not been proved, applications or uses of the lntemet have been rapidly
spread to all social divisions including education. The Web is a new digital media with
various fimctions. The Web environment allows display of all types of digital files, such
as text, graphics, audio, or video over the Internet (Sanders, 1999). Moreover, the Web is
a hypertext environment, which simply means that any one file may be linked to any
other file, thereby allowing access by a click of the mouse (Sanders, 1999). The Web
environment provides to us a rich multimedia environment accompanied by easy
accessibility to information search. The lntemet allows users to connect to a virtually
limitless information resource. The number of lntemet hosts and users has been
increasing dramatically in the199OS (Hamilton, 1998; Owston, 1997).

When users access information, the users’ geographical locations are non-issues
because data files were linked from sources worldwide (Sanders, 1999). Special software
called Web browsers allows users to graphically view and interact with information over
the lntemet. Web browsers such as Netscape Navigator® and Microsoft's lntemet
Explorer® have made it remarkably simple to "surf“ the Web. The keyword search
capability of powerful search engines and directories such as Yahoo, AltaVista, and
WebCrawler allows users to locate information on countless topics.

Educational institutions have been quick to exploit the rich, multi-sensory,

interactive nature of the Web (Owston, 1997). The number of schools accessing the web

18

and publishing web sites is growing rapidly. It was estimated that nearly 82 % of all K-
12 public schools in the United States are online (Hamilton, 1998) and 98% of all schools
own computers (Coley, Cradler & Engel, 1997). A visit to the University of Minnesota’s
College of Education Web site, known as Web 66, showed how extensively schools are
using the Web (Owston, 1997). Owston stated that “although it is impossible to tell how
many of them make regular use of the Web for teaching and learning, it is probably safe
to say that if a school is motivated enough to establish its own Web site and list it with
Web 66, it is making use of the Web in its classroom too.”

On the other hand, all kinds of information are available over the Internet, not
only educational materials, but also inappropriate or harmful materials for children.
Sherman (1998) claimed that the lntemet might not be always appropriate for children
and the impact of the Web for children is unknown yet. In addition, there is such a vast
amount of information available over the lntemet, not all of which is always accurate or
true. Therefore, parents or guardians should carefully guide children toward appropriate
information sources for educational purposes.

Recent UV protection Web Sites

This researcher reviewed and selected web sites regarding skin cancer information
and prevention, to provide more detailed information for users through hyperlinks.

The American Cancer Society (ACS) web site provides various kinds of
information regarding cancer. This includes all kinds of skin cancer information among
which are two specific sections, on melanoma and non-melanoma. In each they
specifically explain what it is, types of skin cancer, statistics of skin cancer, prevention

and risk factors, detection and symptoms, treatments, and cancer drugs. Skin cancer

19

information for children is provided. On the UV protection page for youth, they provide
UV exposure information, protection methods, skin cancer information, and a sun quiz
(ACS, 1999).

The Northeast Dermatology Associates (NDA) (1997) provides UV protection
information on its web site. Information on the site is similar to that of the ACS. Its
site’s information about medical treatment for skin cancer is well organized.

The Environmental Protection Agency (EPA) has proper information about UV
protection on the EPA web site. Especially, information about the UV index targets
youth and their parents. EPA presents what an UV index is, how it is calculated and
previous lists of UV indexes on its web site (EPA, 1999).

Overall those sites regarding UV protection provide a good quality of information
about skin cancer and related topics. However, eye-catching interactivities are not easily
found. Youths usually are believed to have Shorter concentration spans than do adults,
and graphics and animation may encourage youths to obtain information on the site.
Therefore, this researcher believes that supporting graphics and graphic animation
quizzes would benefit pertinent sites.

Web Design & Evaluation Guidelines for Youth Audiences

When creating a web site for youth, guidelines to provide educational information
in an appropriate way need to be considered.

First, the web sites for youth should have title and purpose statement at the
beginning of the site, to enable users to find brief information about each section and
each link (Maddux & Johnson, 1997; Alexander & Tate, 1999). The organization

associated with the web site should be identified (Maddux & Johnson, 1997).

20

Second, the web site Should use the youths’ levels of language, content, design,
and prOper length (Maddux & Johnson, 1997; Clark, Knupfer, Mahoney, Kramer,
Ghazali, & Al-Ani, 1997). The best length for a given page is no more than two or three
screen for youth audiences (Maddux & Johnson, 1997).

Third, the web site should provide simple and easy navigational interface
(Harbeck & Sherman, 1999). This allows users to access the information more easily and
faster. Also, links to the home page from every internal page should be provided. This is
for users who find a specific internal page by using a search engine and do not have the
options of using the BACK button to return to the home page (Maddux & Johnson, 1997;
Alexander & Tate, 1999).

Fourth, the overall design and layout of the page should be consistent and
appealing (Clark et al., 1997; Kristof & Satran, 1995). “Consistent” does not mean
uniform, but rather unity (Kristof & Satran, 1995). Maintain one chosen theme
throughout the site but allow some variations on each section or heading as long as it
associates with other design components.

Fifth, the use of graphics is focused on increasing users’ engagement
interactivities, and interesting users in the contents (Kristof & Satran, 1995). The size and
numbers of images on a web page should be determined considering reasonable
downloading time (Clark et al., 1997; Niederst, 1999).

Sixth, use 8-bit color depth for designing the web site and use the web safe color
palette when creating graphics for the web site (N iederst, 1999). The color scheme of the
web site also should be harmonious (Clark et al., 1997; Kristof & Satran, 1995).

Seventh, a web site should be tested in other browsers to ensure the appearance

21

 

and functions of the site remain as intended (Maddux & Johnson, 1997; Niederst, 1999;
Clark et al., 1997). Because appearance of the web site will differ from browser to
browser, it is important that authors view the web pages in as many different browsers as
possible. At least, pages should be viewed in the two most popular browsers, Netscape
Navigator® and Microsoft lntemet Explorer® (Maddux & Johnson, 1997; Niederst,
1999)

Identifyinglntemet Environment of Users

This researcher reviewed recent statistics of the most frequently used operating
system, browser, connection speed, and monitor resolution, to calculate and understand
the current lntemet environment of common users.

According to StatMarket (1999), 94 % of lntemet users use Windows (Windows
98, Windows 95, Windows NT, or Windows 3.x) as their operating system, and only 2.98
% use Mackintosh (Mac). Windows is the operating system of the so-called PC or
personal computer.

StatMarket (1999) browser usage statistics indicated that, of lntemet users, three
quarters use Microsoft lntemet Explorer® (lntemet Explorer) and less than a quarter use
Netscape Navigator®. According to StatMarket (1999), the top 93.18% of lntemet users
used browser version 4.0 or above of lntemet Explorer® or Netscape Navigator®.

Currently for lntemet access, modems with dial-up connection speeds of 14.4
Kbps, 28.8Kbps, 56.6Kbps, and network speed T1 (1,544Kbps), 10 Mbps and 100Mbps
are available (N iederst, 1999; Ryder, 1997). Most users have dial-up connection speed of
14.4Kbps, 28.8Kbps and 56.6Kbps to access the lntemet (N iederst, 1999). The

environment of dial-up connection users is an important concern, because those who use

22

Ethernet - LAN connection instead of modems, have a much faster connection speed.
When people use the 28.8 Kbps modem they may expect that 3.5Kbytes of data is
delivered in a second, when using 14.4Kbps modem, 1.8Kbytes of data is and using
56.6Kbps modem, 7Kbytes of data is transferred in a second (Ryder, 1997). Many still
use 28.8Kbps for accessing the lntemet and usually it takes 0.5 to 1 second to download 1
Kbytes of image (N iederst, 1999).

The primary thing for determining the likely size of the web page is to look at the

 

maximum amount of space provided by the computer monitor (Siegel, 1996; Niederst, i
1999). Computer monitors come in a variety of standard sizes, such as 13”, 14”, 17”,
19”, 20” and 21”, typically indicated in inches. A more meaningful measurement is
monitor resolution — the total number of pixels available on the screen (N iederst, 1999).
Monitor resolution is related to but not necessarily determined by monitor size, and it can
be changed by users. For PC monitor resolution, 640 x 480, 800 x 600, 1024 x 870, 1280
x 1024, and 1600 x 1200 (height x width in pixels) are available. For notebook
computers, 600 x 800 is commonly set as the default. High monitor resolution may allow
the screen to contain more or bigger information, including graphics, than lower
resolution; in other words, resolution can be counted as a container (N iederst, 1999). A
web site designed based on monitor resolution setting 800 x 600 (pixels), is not
appropriately viewable to users who have monitor resolution 640 x 480; that
incompatibility necessitates scrolling left to right to view the site. Millions of 640 x 480
monitors are still in use, particularly in schools, households or other institutions without

the budget to upgrade (N iederst, 1999).

23

Design Process Model

This researcher reviewed two conceptual models in planning the UV protection
web site. The first conceptual model, ‘design process’, developed by Koberg and Bagnall
(1981), is used in some apparel design classes. The second model, P process, developed
by Porter, Novelli and Associates (1983), is used in hypermedia design classes for a
media project framework.

Koberg and Bagnall presented (1981) the Design Process in their book, The
Universal Traveler: a soft system guide to creativity, problem solving, and the process of
design. They developed the design process as a way of problem solving and noted “The
design process is a sequence of events which demands creative, constructive behavior
from its participants. Its activity is to improve existing condition and to find clear path
out of dilemmas”. The ‘design process’ describes a series of steps, which must be
experienced before completing the design process: acceptance, analysis, definition,
ideation, selection, implementation, and evaluation (For the illustration of the design
process, see Figure 1).

In the acceptance phase, designers accept the problem and state the initial
objectives about the problem (Koberg & Bagnall, 1981). Statement of the problem and
the rationale of the research would be identified in this phase.

In the analysis phase, the designer needs to observe and find the related
information on the problem and also gather facts and opinions about it (Koberg &
Bagnall, 1981). Collecting and analyzing the data of users, and reviewing literature can
be included in the analysis phase. This phase is important because it narrows the general

statements, so as to establish a good definition of the problem. The ideation phase is to

24

 

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search all kinds of possibilities to reach the goals (Koberg & Bagnall, 1981). Designers
may find ways, techniques and procedures to reach objectives and to discover alternative
routes. Making an index of potential plans for resolving the problem may also be done in
this phase.

The idea selection phase is to choose the best ways and procedures from what the
designer has gathered to achieve the goals (Koberg & Bagnall, 1981). It is also to
compare goals and objectives with the means for achieving them and to determine the
way which best fits those needs or demands.

Implementation is actually using the selected ways to achieve the goals, in other
words, taking action on the chosen idea (Koberg & Bagnall, 1974).

The P process was developed by Porter, Novelli and Associates (1983), as a
framework for developing strategic communication programs and it was adapted for the
hypermedia design class as a framework to develop a media project. It has specific,
detailed procedures on development and implementation. The P process consists of 6
levels of procedures (For illustration of the P process, see Figure 2).

For this study, this researcher combined two design processes. Mainly the
Koberg and Bagnall (1981) design process was adopted as web developing framework
and the implementation phase of the P process was adopted (For the adopted design
process model, see Figure 3).

The design process of Koberg and Bagnall (1981) fits the web developing
process. However, the implementation phase is not specific enough. P Process model is
similar to the process model developed by Koberg and Bagnall (1981); it focuses more on

development and implementation. Therefore, the implementation phase of the design

26

 

 

 

   

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dissemination, which were adapted from the P process (See Figure 3).

29

 

CHAPTER III

METHODOLOGY

This study was designed in conjunction with a project developed and directed by
Ann C. Slocum, Ph. D. and Joanne Schultink, M. S., Department of Human Environment
and Design, at Michigan State University. The Michigan Agricultural Experiment
Station (MAES) provided the financial support for the project, Sun Protective
Knowledge, Attitudes, & Practices of Youth, A Web-Based Research and Education
Approach (MAES 9438). That project contributed to one of the objectives of NC 170,
Occupational Safety and Health Through the Use of Protective Clothing.

The project is divided into three phases. Discussion of method is arranged thus:

Phase one involves collecting and analyzing the baseline data of youths’ sun
protection knowledge and practices. Selection of participants, instrument development,
data collection procedure, data analysis, and measurements of variables are discussed in
this phase.

Phase two covers developing information on UV protection and designing a Web
site to disseminate this educational information via the lntemet. Web development
enviromnent settings and web design and development criteria based on the literature
review are illustrated in this phase.

Phase three discusses implementing and analyzing the online evaluation survey.
Sampling design, instrument development, data collection procedure, and data analysis

are discussed in this phase.

30

Phase 1: Sun Protective Baseline Data Collection

In order to deliver the information about UV protection to youth and parents / 4-H
leaders, baseline data were collected on youths’ sun protection knowledge, behavior and
practices. Data were collected in mid-Michigan from January through July 1999.
Instrument Development

A two-page questionnaire was developed for youths aged 10 to 13, by a team of
faculty and students in 1998-1999. The questionnaire contains items measuring youths’
knowledge about sun exposure and skin cancer, youths’ sun protection practices, parents’
sun protection practices, peers’ sun protection practices, and indirect experience of skin
cancer. Questions 2 through 7 were adapted from Gahring (1996). The questionnaire
was developed in two versions; one was a printed version, the other was an online
version.

The online questionnaire for youths was entered in a survey program available
through the Faculty Facility for Creative Computing, and responses were sent to a server
on campus from which they were retrieved into the SPSS statistical program package.
The online questionnaire was accessed through the home page of one of the project
directors, Dr. Ann Slocum (for the printed version of questionnaire, see Appendix B).
Selection of Participanfi

Intended participants for this study were 4-H youths in 5th to 8th grades living in
mid-Michigan. Middle school students were chosen as a target group because they are
more exposed to outdoor activities and also participate in the 4-H youth program. Those
youths are considered old enough to take responsibility for protecting themselves.

. Because Michigan State University Extension provides an established vehicle for

31

providing educational programs to youth who participate in the 4-H Youth Programs, the
survey was distributed through the selected 4-H Youth Programs network during
February 1999.

Systematic variation in characteristics of the participants may exist because of the
convenience sampling. Therefore care Should be exercised in generalizing the results of
this study to a population beyond that from which the participants were drawn.

Dia Collection Procedures

The printed questionnaire for 5th and 8th graders was distributed to parents or
guardians during February 1999 with an explanatory letter which contained the elements
of informed consent. The letter for parents indicated that responses would be treated
confidentially and that the results would be aggregated and reported as group findings.
Parents chose whether to involve their child in the study. Questionnaires were returned
in a self-addressed, business reply envelope that accompanied.

Online responses were obtained at a 4-H event at MSU in March 1999. Families
of youth registering for one 4-H class that involved using computers, were contacted.
Signed written consent forms were obtained from a parent or guardian of youths who
participated in this survey before implementing the survey. After responding by clicking
in the appropriate boxes, participants clicked the “Send” button, and online responses
were sent electronically to the server in the Computer Center at Michigan State
University.

Data Analysis
Data from the printed questionnaire were entered in SPSS, and accuracy of data

input procedure was double-checked through manually matching the responses of the

32

survey with the SPSS data. A researcher and student team completed the work in August
1999.

Data from the online questionnaire were imported to SPSS. Descriptive statistics,
such as frequency distributions and means were performed. Cross-tabulations,
correlations, and t-test were used to analyze the data. Data were analyzed using the
following measurements of variables.

Measurements of Variables

 

Theses variables were created to analyze the data.
1. Youth’s knowledge about sun exposure and skin cancer

Part 1 of questionnaire, Sun Facts, consisted of the questions about the youths’
knowledge about sun exposure and skin cancer. Responses to the true / false questions
were recoded as a dichotomous variable: “0” = “Incorrect” and “1” = “Correct”. A total
knowledge score was created by summing correct responses to the first 10 questions.

Part 2 of questionnaire, Sun Habits, consisted of two subparts: one for measuring
youths’ sun protection practices, and the other for measuring parents’ sun protection
practices.
2. Sun protection practices of youth

Youths were asked how frequently they used four protective practices: wearing
sunglasses; wearing a hat; using sunblock; and wearing a long-sleeved shirt. Frequency
of using protection practices was reported as “Never”, “About once a month”, “About
once a week”, and “Every day”. The response on each question was weighted based in a
30-day month so that a response of “Never” was scored as zero, “About once a month” as

one, “About once a week” as four, and “Every day” a score of 30. The weighted score

33

for the four items was summed and averaged to get a protection score.

The weakness of this measurement is that the responses of youths about their sun
protection practices are not based on their actual recorded data but based on their
estimation of sun protection frequencies.

3. Sun protection practices of parents

To measure parents’ sun protection practices, youths were asked to respond
whether or not their parents use sun protection when they go outside. Three items of sun
protection, using sunblock, wearing a long-sleeved shirt, and wearing a wide-brimmed
hat were asked for both mother and father. The responses on those questions were treated
as a nominal variable: “0” = “No”, “1” = “Yes”. The number of protective practices used
by parents, were summed to create a total sun protection practices score for parents. The
total sun protection practices scores of parents ranged from 0 — 6 and were treated as
interval variables. The weakness of this measurement is that we did not ask youths to
respond how often their parents use sun protection practices, and these data are based on
youths’ perceptions regarding their parental sun protective practices, which might be
different from the actual parental sun protective behavior.

Part 3 of the questionnaire, Background, consisted of three questions about
experiences, Internet use, and demographic information. Three experience questions,
whether they know someone who has skin cancer, whether their friends use sunblock,
and whether they suffered severe sunburn the previous year, were asked and these were

treated as nominal variables.

34

 

Phase II : Creating a Web site

This researcher designed the Web site based on the guidelines from the review of
literature, such as Maddux and Johnson (1997), Harbeck and Sherman (1999), and some
web site design references. Also this researcher used Web development software,
Macromedia® Drearnweaver 2 to design and develop the Web site, including making the
online evaluation form. Generally the graphics for the web site were developed using the
graphic development software, Adobe® Photoshop 5. Graphic and animation software,
Macromedia® Flash 4 was used to create the Sun Wise quiz and graphics for the quiz.

In ideation and idea selection phases of design process model, considering the
users’ environment in relation to lntemet access, this researcher determined which
medium would be used to disseminate the information over the lntemet. Based on
current statistics and the literature with respect to users’ lntemet environment, the
environment of developing a web site was decided.

Generfleb Developing Environment

To develop a web site, generally four things are considered before starting the
task. Those are: operating systems. browsers, lntemet connection speeds, and monitor
resolutions.

The review of literature regarding lntemet users’ environment indicates that,
primarily, web design procedures are mainly via the Windows 98 environment, and
viewing is via Microsoft lntemet Explorer browsers, because most lntemet users use
Windows (94%) as an operating system, and Microsoft lntemet Explorer (75.45%) to
browse the lntemet (StatMarket, 1999). To maximize the acceptability of the UV

protection web site to users, it was viewed and tested on both PC and Macintosh

35

 

platforms using two major browsers, lntemet Explorer® and Netscape Navigator®.

The top proportion of lntemet users (72.09%) adopted Microsoft lntemet
Explorer® browser version 4.0 or above and 21.09 % of users adopted Netscape
Navigator® browser version 4.0 (StatMarket, 1999). These statistics indicate that most
lntemet common users (93.18%) use browser version 4.0 or above. More interactivities,
such as roll over images and layering images, are supported by setting the browser 4.0 or
above as target browser. In light of this, this researcher determined to design the UV
protection web site based on lntemet Explorer® 4.0 browser (Netscape Navigator® 4.0
browser was also highly considered and tested).

Most users use modems with dial-up connection speed of 28.8Kbps or 56.6Kbps
to access the lntemet (Ryder, 1997). Kbps stands for kilobytes per second. This
researcher designed the web site, considering the appropriate download time based on
users who have 28.8 Kbps modem speed.

Furthermore this researcher considered screen- or monitor- resolution, which
relates to clarity of image, in design of the web site, because the wide range of displays
and viewing conditions influence decisions regarding web development. At the time this
study was conducted, web designers usually regard as a design standard a monitor
resolution of 640 by 480 pixels for common users, because this setting might be the safest
way to prevent users from having to scroll horizontally to view a wider design; another
factor is that there are millions of 640x480 monitors still in use in schools, households,
and other institutions (N iederst, 1999). Accordingly, this researcher followed the general
rule and based her web site design on a monitor screen resolution 640 x 480 pixels

standard.

36

 

Desigmcfiteda of creating a web site

1.

Target group of the web site is 4-H youth aged 10 ~13. The researcher considered
users’ age, level of language, complexity and length of contents in proposing the
content.

Contents of the web site included information regarding the questions which elicited a
lower rate of correct responses from the baseline data analysis. For example, the
statistics of skin cancer, the relationship between weather and the possibilities of
being sunbumed, the relationship between skin tone and hair color, and the

possibilities of getting skin cancer.

. Use of graphics focused on engaging youth in the contents of the site. The sizes and

numbers of images on a web page should be determined with consideration of
reasonable downloading times. For facilitating the users’ engagement with the
contents, the researcher used at least one graphic for each page. For example, for the
sun fact page, a smiling sun, wearing sunglasses, was used to convey the importance
of wearing sunglasses to protect eyes from sun exposure. To visualize the rapid
increase of new cases of skin cancer, this researcher developed a graph based on the
review of literature about skin cancer statistics and presented it on the skin cancer
page. For the sun protection page, photographs of youths wearing head wear and ski
goggles, and graphics of sunscreens, were used.

The overall design and layout of the web page were made consistent through the use
of color, page layout, and fonts. To control page layout, a table with fixed width of
600 pixels was utilized and it was center aligned. This allows consistent appearance

of the site, and provides better readability via line length control, regardless of

37

 

monitor size or monitor resolution. The colors of each table background were
matched with those of each page background. The tints or shades of page
background color were used for table background color to create variety, but balance
and unity of colors were considered closely. Different color schemes were used for
each section. The borders of table were set up as invisible.

5. This researcher generally used 8-bit color depth for designing the web site and used
web safe color palette (216 possible colors) when creating graphics for the web site.
Over the entire Web site, blue, violet, orange and yellow were mainly used for.
general backgrounds and table backgrounds. The families of those colors, i.e. tint or
shade colors of those four, were also used to create variety while balance and unity
was preserved. The color of each table background matches the color of each page
background.

6. To provide easy navigation for users, the navigation bar was set at the top of each
page; this achieved a consistent appearance, and gave navigation control to users.
Links to other pages were given at the bottom of each page. A navigation bar was
consistently positioned at the top of each page to provide random accessibility of
information to users. The bar consists of a “Home” button, a “Menu” button, and an
“E—mail” button. By clicking the menu button, users can access the menu page to
select other sections. By clicking the email button, users are provided with an email
composition box. At the bottom of each page, links to other sections are provided to
allow direct accessibility to any section from any other section (For the Sun Wise
Web site, see Appendix E).

7. To provide users with brief information about each section and each link, the

38

 

researcher used “layers” whereby a short description sub-heading of each section is
given for users’ understanding. These are accessed by users’ physical interaction,
namely: moving their cursors over the title images of each section on the menu page.
When users move the mouse beyond the image, the image-associated message about
the section disappears.

8. Proportional fonts, Verdana or Arial of l4pt or larger, were mainly used for
readability. Some typography on the web site was developed as graphics, to give
more interactivities to users. Major headings of the web site were fully created as
graphics, to control the appearance of typography.

Organization of the Web Site

The content of the Sun Wise Web site was divided into five sections: sun facts,
skin cancer, sun protection, sun wise quiz, and web evaluation. The content of the site
was developed and revised by the researcher and faculty in research meetings.

Throughout the web development, the researcher referred to technical tips from these

references: Visual Quickstart Guide Dreamweaver 2 for Windows and Macintosh

(Towers, 1999) and Web Design in a Nutshell (N iederst, 1999). Especially for the quiz,

this researcher obtained many helpful tips from the reference Visual Quickstart Guide

Flash 4 for Windows and Macintosh (Ulrich, 1999).

Each page was developed via the design criteria and outline of contents.
Sun Wise Quiz development

The Sun Wise quiz and graphics of the quiz were created by the researcher from
December 1999 to March 2000, using the graphic animation software, Macromedia®

Flash ,4. It was chosen as an authoring tool for developing an interactive quiz because it

39

 

enabled the researcher to develop more interactivities for users. To view and participate
in the quiz, users need Flash 4 plug-in, which can be downloaded from the Macromedia®
web site. Links to the Macromedia® company web site were provided on the home page,
introduction page, menu page, and Sun Wise Quiz page. Contents and the graphics in
this quiz were mainly developed and created for youths aged 10 - 13. A research team of
faculty and the researcher revised the content of the quiz.

Most graphics for the quiz were developed in F lash® 4 to reduce the graphic file

 

size. Reduction of file size leads to shorter downloading time of the quiz file, so may
increase user satisfaction.

The quiz consists of three parts: one introduction scene, seven questions about sun
protective knowledge and practices, and an ending scene. The questions were developed
and designed based on the data collection analysis (For the outline of the quiz, see
Appendix D). Layout of each question is consistent (i.e. layout and font). The question
comes first, with or without animated graphics, then multiple choices appear
successively. In each question, three or more graphics describe the question or multiple
choices.

F urtherrnore when quiz takers finish the quiz, the ending scene appears to give
them the choice of either going back to restart the quiz, or advancing to participate in the
web evaluation. At any time during the quiz, users may go to the menu page by clicking
the menu button provided at the top of the quiz page, or, by clicking links at the bottom
of the quiz page, going directly to other pages which are provided.

Testingand Revision of the Web Site

Testing of the web site was done on both PC and Macintosh platforms in March

40

2000. Tests were implemented via research in both 102 Human Ecology Computer Lab,
where PCs are available, and in 134 Communication Arts and Sciences, Digital Media
Arts and Technology (DMAT) lab, where Macintosh platforms are available. The
researcher tested the web site using both Microsoft lntemet Explore® and Netscape
Navigator® browsers.

Accordingly this researcher could assmne a high proportion of lntemet users use
PC. To maximize the acceptability of the web site to target audience, testing the web site
on both platforms, PC and Mac, and using two major browsers, Microsoft Internet
Explorer® and Netscape Navigator® is required, because what users look at depends on
what kind of browsers and monitor resolution they use (N iederst, 1999). These tests
supported considerations of reliability of appearance and interactive functions of the web
Site on each browser, and reduce unpredictability factors in which the web site does not
appear as its designer intended.

Appearance of the web site, such as overall design, layout, color, and fonts, was
checked based on the reviewed literature and web design criteria (N iederst, 1999; Siegel,
1996; & Pirouz & Weinman, 1997). Navigations and other technical functions (i.e.,
links, downloading time, layering, and survey format) of the web site were tested based
on the literature (Alexander & Tate, 1999; Niederst, 1999; Maddux & Johnson, 1997;
Siegel, 1996).

The sun safety project site, Sun Wise Web site, was launched on the AF S space of
research project director, Dr. Ann Slocum for disseminating the educational information,
and for implementing the web evaluation (For the Sun Wise web site, see Appendix E or

visit the URL, http://www.msu.edu/user/aslocum/sun/sunwisehomepagehtm).

41

 

Phase III : Evaluation of the Web Site
Instrument Development

This researcher developed online questionnaires for youth and adults to evaluate
the Web site. These were edited and critiqued by the research team and went through
several revisions from October 1999 to February 2000. Questionnaires covered the
appropriateness of contents, graphics and overall design of the Web site, points
emphasized in the review of literature (Clark et al., 1997; Harbeck & Sherman, 1999;
Maddux & Johnson, 1997). Participants of this web evaluation are able to evaluate the
Web site and submit the evaluation forms online.

Two versions of the online web evaluation questionnaire were developed, one for
elementary and middle school youths, and the other for adults. The youth web evaluation
questionnaire consists of sections about contents, design, graphics, and functions on the
web site; youths also were asked to indicate their previous knowledge level about sun
protection and their demographic information. The researcher developed five faces
ranging from frowning to smiling, whereby youths would answer each question. (For
youth online web evaluation questionnaire, see Appendix E). Adults were asked: (1) to
evaluate the contents of the web site from a child’s perspective, (2) to evaluate the
design, graphics and links/accessibility of the web site from their own adult perspective,
and (3) to indicate their previous knowledge and experience regarding sun safety, and
their demographic information (For adult online web evaluation questionnaire, see
Appendix E). Both web evaluation forms were provided with text field panels, for
respondents to provide comments and suggestions about the web site. Before their

participation in the web evaluation they were informed that their answers are anonymous

42

and will be aggregated with those of others.

The online web evaluation questionnaires for youth and adults were entered in a
survey program available through the Faculty Facility for Creative Computing.
Responses were sent to a campus server from which they were retrieved into SPSS on a
local computer. The online web evaluation questionnaires were a part of the web site and
were accessed from the main menu of the site.

Samplesfi and Data Collection

Youths, their parents, and adult leaders/staff of the 4-H youth program were
recruited through the 4-H network to participate in visiting and evaluating the Web site.

Packets of explanatory letters regarding the sun wise web site evaluation were
mailed to 132 leaders of 4-H Youth program in March 2000. A packet consists of one
explanatory letter for the leader and three letters for parents. A pre-stamped follow-up
postcard was attached to each letter. The 4-H youth program leaders were asked to
participate in the web evaluation and also to distribute the letters to parents asking them
to participate in visiting and evaluating the web site and also encouraging their children
to do so. A total of 396 explanatory letters and pre—stamped follow-up post cards were
mailed to leaders for distributing and recruiting parents affiliated to the 4-H youth
program. Letters to parents contained elements of why they are being contacted, why
they need to be concerned about UV protection, and a request that they participate in the
online web evaluation. In the follow-up pre-stamped postcards, 4-H leaders and parents
were asked to return information about whether they completed the online questionnaire,
or whether they have difficulties regarding the lntemet connection or the web site. The

online web evaluation, for middle school youth, were self-administered and guided by

43

parents or guardians.

Twenty-five 4-H staff were contacted by mail, and 18 faculty in apparel and
textiles were contacted by mail or electronic mail, for reviewing and evaluating the site.
Fifteen undergraduate students were recruited in a protective clothing class, and 73
graduate students in the Department of Human Environment and Design were contacted
by electronic mail.

Both youth and adult online evaluation responses were electronically sent to the

 

server in the Computer Center at Michigan State University, after participants responded
by clicking in the appropriate boxes for answering questions and the “Send” button.
Data Analysis

Numeric data were directly imported into SPSS but string data were coded into
numeric values manually by this researcher. Frequency distributions, means, cross-
tabulation, and one-way ANOVA were used to explain respondent tendencies towards the
web site. For analysis of web evaluation, information score, aesthetic score, and
functional score were created by summing and averaging questionnaire items for each
topic (For viewing the results of analysis of the evaluation of the web site, see the

Chapter V: Analyses and Findings: Phase III).

44

CHAPTER IV

ANALYSIS AND FINDINGS

This chapter reports investigation findings. This researcher analyzed survey
responses from the baseline data collection in phase one. Youths’ sun protection
knowledge and practices were correlated with parents’ sun protective practices and
direct/indirect experiences of youth. Also youths’ attitudes toward the use of the lntemet,
and lntemet access environment, were reported.

The result of the web site development was illustrated in phase two. Pretest of the
site was reported according to this researcher’s self-testing at three different places with
different platforms.

Online web evaluation responses were analyzed in phase three. Youths’
responses were compared with adults’, to describe correspondences with the aesthetic and

functional aspects of the web site.

Phase I : Analyses of Baseline Data Collection
DemogLaphic Information
In the initial data collection, 84 youths in mid-Michigan provided information
about sun protective knowledge and practices, either online or in paper format. The
questionnaire was developed with youths aged 10 ~13 in mind. Nearly half of the
respondents were between 7 and 12 years of age; 28.5 % of them were between 13 and 15

years of age; and 21.4% of them were 16 to 18. They were predominantly Caucasian

45

 

(92.2%, n = 77) and female (83.3%, n = 84) with a mean age of 12.83 years (N = 82).

Youths’ Knowledge Regarding Sun Exposure
Over half (58.3%) of the 84 youths correctly answered 8 or more of the 10
questions about “Sun Facts”. Youths under 12 showed lower scores on all sun fact

questions, than the whole group (See Table l). The lowest proportion of correct answers

Table 1. Differences of Sun Protective Knowledge between Two Age Groups

 

Sun facts Questions Valid % of correct answer

 

Whole group ' Age 512 Age >12
(N=82) (N=40) (N42)

1. Can the sun’s rays make your skin 91.7 % 82.5% 100%
look older and more wrinkled by the
time you’re 50?
2. Do more people get skin cancer than 59.5 % 55.0% 64.3%
any other kind of cancer?
3. Can you get a sunburn when it’s 67.9 % 45.0% 88.1%
cloudy?
4. Are tanning salons bad for your Skin? 84.5 % 75.0% 92.9%
5. Are people with red or blonde hair 61.9 % 45.0% 76.2%
more likely to get sunbums than other
people?
6. Can people die from skin cancer? 90.5 % 82.5% 97.6%
7. Can anyone get skin cancer? 97.6 % 95.0% 100%
8. Can the sun do anything that hurts 97.6 % 95 .O% 100%
your eyes?
9. When is the sun the strongest? 94.1 % 92.5% 95.2%
10. Good sun block has an SPF number. 94 % 87.5% 100%

Which SPF number would protect you
the most?

 

I Two respondents did not indicate their age.

46

of youth arose from questions about the influence of clouds (# 3), about personal coloring
(# 5), and about the incidence of skin cancer (# 2). Therefore, those ideas were
emphasized to reinforce the information in the educational material.

The mean knowledge score was 7.7 out often questions. This result paralleled
the study of Fritschi et al. (1992), which reported Australian adolescents had 76.3%
correct answers on knowledge questions.
Research Question 1: Is there a relationship between sun protective knowledge score and
age?

Correct responses of question 1 through 10 were summed to create a knowledge
score (For questionnaire of baseline data collection, See Appendix B). There was a
difference of the means for the two age groups. Older youths, 13 to 18, were more
knowledgeable about sun exposure or related facts about skin cancer than those 12 years

or younger (See Table 2).

Table 2. Mean Total Knowledge Score by Age Group

 

 

Age group N I Mean SD.
Whole group 84 7.74 1.55
Age 3 12 40 6.88 1.57
Age >12 42 8.48 1.02

 

‘ Two respondents did not indicate their ages.

When the total knowledge score was correlated with age, the results were
statistically Significant at .01 level of significance (r = 0.558), indicating that older youths

had higher knowledge scores than younger youths.

47

 

Sun flabits and Protective Practices of Youth

Eighty percent of youths responded that they played outside every day, but their

sun protective experience and practices were very limited. For example, less than a third

of youths wore sunglasses, sun blocks, and hats everyday. A large proportion (30% -

70%) reported never using protection or using it only once a month (See Table 3).

Table 3. Percent Reporting Outdoor Activities and Sun Protective Practices

 

 

On a sunny day in the summer, how Everyday About once at About once a Never

 

often do you: week month

Play game or sport outside (N=83) 79.5% 18.1% 2.4% 0%
Wear sunglasses (N=8l) 30.9% 38.3% 16.0% 14.8%
Wear a hat (N=81) 17.3% 30.9% 22.2% 29.6%
Wear sunblock (N=83) 27.7% 42.2% 19.3% 10.8%
Wear a long-sleeve shirt (N=80) 0% 22.5% 17.5% 60%

 

Table 4. Mean Weighted Protection Practice

 

Whole group (N = 82 I)

 

 

Questions , a - WW

Mean S. D.
Wear sunglasses 10.95 12.89
Wear a hat 6.64 10.86
Use sunblock 10.19 12.42
Wear a long-sleeved shirt 1.08 1.62

 

VT There were two missing data.

The frequency of using protective action was weighted on the basis of 30 days a

month. The mean number in Table 4 indicates the average number of days using sun

48

protection per month. For example, the average practice of youths using sunglasses was
about 11 days per month. Youths indicated that they rarely wore long-sleeve shirts on a
sunny day. The differences in sun protection practices between two age groups, age 12

or less and over 12, are illustrated in Figure 4.

 

Playoutdoor . (a . . 6

 

Sunglasses L. ~. M 4. n14.“ , . x 13.67

I l 1
1 l .
I 1 f f ‘.
l ‘ i [a - .. -_.... -..__ _i
Hat ”37.74! T i : I Age 12 or less 1
i i
‘ i

 

ll! Age over 12 I

.1

 

 

Sunblock .. 11.79

 

 

I Long-sleeved shirt H185“; ; I
' a '

5 1 0 1 5 20 25 30
days per month

Figure 4. Mean Weighted Protection Practice by Age Group

As shown in Figure 4, younger youth were more likely to go outside and play
games every day (82.5%, N = 39) than older youth (76.2%, N = 42), but they were not as
likely to use sunglasses and sunblock as those aged 13 —18. They were more likely to
wear a hat in the sun than youths over 12. Except for wearing a hat, youths 12 or
younger showed lower sun protection practice scores than youths aged over 12.

Mean total protection score (an average of the four practices) of younger youth

49

was 5.94 (N = 36), and that of older youth was 8.06 (N = 40). The researcher used T-test
to compare the difference of mean scores between those age groups; however, the result
was not statistically significant (t = 1.71, p = .091 ).
Research Question 2: Is there a relationship between sun protective knowledge scores
and average weighted sun protection scores of youths?

When youths’ knowledge scores were correlated with their total weighted sun
protection scores, the results were statistically insignificant. This is consistent with
Fritschi, et a1. (1992) who found that there were no associations between attitudes and

knowledge or behavior of Australian adolescents toward sun protective practices.

Tendency of Parental Sun Protective Practices

Youths’ responses about their parents’ practices with respect to sun protection
showed that their mothers were more likely to wear sunblock (73.8%) rather than long-
sleeve shirts or brimmed hats, and their fathers were more likely to wear brimmed hats

(71.4%) rather than sun block or long sleeve shirts (See Table 5).

Table 5. Youths’ Responses about Parental Practices of Sun Protection

 

 

 

What do your mother or father usually do Mother Father
when going outside in the sun? _-.. __-..-...-._.._--
Yes No Yes No
Use sunblock 73.8% 26.2% 25.0% 75.0%
Wear a long sleeve shirt 21.4% 78.6% 32.1% 67.9%
Wear a hat with a brim 32.1% 67.9% 71.4% 28

 

50

It may be that mothers find using sunblock natural because they are used to
applying make-up. Fathers may be more likely to wear long sleeve shirts because they
work outdoors longer or have more outdoor activities than mothers. It may also be that
the use of hats by fathers is not related to sun protection, it may be their sartorial custom
or habit of wearing a baseball cap.

Research Question 3: Does a youth’s perception toward parent’s behavior with respect to
sun protection seem to influence youth’s sun protective practices?

To obtain sun protective scores of each parent, the researcher summed the
numbers of sun protective items that each used outside. There was no statistically
significant correlation between total mean weighted protection scores of youths and sun
protection scores of their mothers (r = .124, p = .286) or between the mean weighted
protection scores of youths and sun protection scores of their fathers (r = .186, p = .108).

These results might be because youths may not accurately report parent actions
toward sun protection. It may be that the measurements were not precise enough to
capture a relationship between them. A detailed measurement about parents’ and youths’

sun protective behaviors might show a relationship.

Youth perceived that their parents had a low rate of using sun protection. This
study did not ask parents about their use of protection practices or whether they
encouraged their children to use sun protection. Informing youths and their parents of the
importance of sun protection simultaneously, may increase the effectiveness of

educational material.

51

Influence of Peers’ Sun Protective Practices
Research Question 4: Did peer behavior influence youths’ behavior regarding sun
protection?

One-way ANOVA was also used to compare differences in the average total
protection scores between those whose friends used sunblock when going outside, and
those who did not. Results showed that there was no statistically significant difference
between the scores of youths’ sun protective practices (F = .410, p = .524). However,
when friends used sunblock, the mean protection score was slightly higher. ‘

Table 6. Youth’s Total Weighted Sun Protection Scores in Relation to Peer’s Use of
Sunblock

 

 

Answer Nl Mean SD.

Youths whose friends wore 45 7.43 5.37
sunblock

Youth whose friends did not 30 6.60 5.61

wear sunblock

 

I There were 9 missing data.

Direct / Indirect Experiences of Youth

The direct influence of sun overexposure experience and indirect experience with
respect to skin cancer were analyzed in relation to protection practices.
Research Question 5: Is there a difference in behavior between youths severely
sunbumed the previous summer, and youths were not sunbumed?

Researchers used the one-way ANOVA to compare the total weighted sun

protection scores between youths who suffered a bad sunburn the previous year and those

52

 

who did not. There were no statistically significant differences between the scores (F=
2.953, p= 0.090). But there was a trend for youths who had a bad sunburn experience to
practice more protection (See Table 7).

Table 7. Difference of Youths’ Sun Protection Score in related to Sunburn Experience

 

 

 

Answer IN] I 2.154%" S-D-
Youth who had a bad sun burn 41 8.15 5.86
last year
Youth who did not have a bad 33 6.00 4.65

sun burn last year

 

I There were 10 missing data.

Research Question 6: If youths know someone who had skin cancer, is their behavior in
relation to sun protection more positive than others who do not?

One-way ANOVA was used to compare the difference on the two protection
scores. There was no statistically significant difference on the protection scores of
youths, between those who knew someone who had skin cancer and those who did not (F

= 1.432, p = .235). But the trend was in the anticipated direction. Those who knew

Table 8. Youth’s Total Weighted Sun Protection Score in relation to Indirect Skin Cancer
Experience

 

 

Answer N] Mean S‘D'
Youth knew someone who had 22 8.24 5.34
skm cancer
Youth did not know someone 52 6.58 530

who had skin cancer

 

' There were 10 missing data.

53

someone who had skin cancer had higher score indicating that they took more protective
action (See Table 8).
Youths aged 12 or less also showed lower scores on “Do you know anyone who

has skin cancer?” (17.5%, N = 40), than the whole group (26.2%, N = 82).

lntemet Accessibility and Preference of Youth

Base line data showed that three quarters of youths usually accessed the lntemet
at school (75.0%, N = 84) and that they also liked to use the Internet (78.6%, N = 84).
These were the potential sample group that may visit the UV protection web site and may
give their feedback and comments through web evaluation. Only 44 % of youths were
able to access the lntemet at home; from these we should be able to obtain a sample to
provide feedback about the web site, with their parents. Fifteen percent of respondents
reported that they did not use the lntemet. Only two participants said they did not like to

use the lntemet.

Phase II: Results of Creating a Sun Wise Web site
The results of the developed Web site are shown in Appendix E. The Sun Wise
Web site consists of five sections: Sun Facts, Skin Cancer, Sun Protection, a Sun Wise
Quiz and a Web Evaluation.
Sun Facts
The Sun Fact section consists of four sub-sections: what UV radiation is; positive
and negative effects of UV radiation; factors influencing UV radiation; and UV index.

In the UV radiation section, this researcher discussed the characteristics of UV

54

radiation and what it can cause. In the effects of UV radiation section, both positive and
negative effects of UV radiation are mentioned. Factors influencing amount of UV
radiation are time of the day, season of year, weather condition, and ozone condition of
the region.

The UV index, prediction of the next day’s level of UV exposure, indicates the
degree of caution which should be observed outdoors. The researcher provided a link to
the Environment Protection Agency for more information about the UV index.

Skin Cancer

The Skin Cancer section consists of four sub-sections: what skin cancer is,
statistics of skin cancer, signs and symptoms of skin cancer, and medical treatments of
skin cancer.

More detailed information about types of skin cancer, melanoma and non-
melanoma can be found on the links to the American Cancer Society web site, provided
for adults. For youth users, a link to the sun protection information page on the American
Cancer Society web site is provided. The researcher briefly discussed signs and
symptoms of melanoma, ABCD rules and medical treatments for skin cancer.

Sun Protection

The Sun Protection section consists of three sub-pages; general tips for UV
protection, UV protective clothing, and sunscreen and sunblock. There are links to the
information for adults prepared by other research team members.

In the general tips page, the relationship between sun overexposure and risks of
getting skin cancer are discussed. This researcher discussed the necessity of awareness of

sun exposure, and of available methods of protection from overexposure. General tips

55

for sun protection were provided on this page.

In the UV protective clothing page, clothing, hats, and sunglasses are discussed.
The researcher recommends tightly woven and dark colored clothing for summer,
especially a long-sleeved shirt. The general idea of covering one’s body for sun
protection is emphasized. The wearing of a wider brimmed hat (at least 3 inches) shading
one’s face, nose, ears, and back of neck, is recommended. For selection of appropriate
sunglasses for eye protection from the sun, those with labels indicated 95-99% UVA and
UVB protection are recommended.

In the sunscreen and sunblock page, this researcher provided information on
sunscreen and sunblock, tips for selecting a sunscreen, and appropriate application tips
and dosages of sunscreen. Description of the SPF can be obtained by users’ mouse-over
movements on images on the page; there are both photographs of sunscreen and sunblock
or SPF rated sunscreen bottle graphics.

Sun Wise Quiz

The layout of each question is consistent in appearance. The question comes first
with or without the graphics, and then choices appear successively. In each question,
three or more graphics describe the question or multiple choices. Most of the graphics in
this quiz are interactive by the users’ mouse-over movement, and showing short
descriptions about the answer. These physical interactions of users are required to obtain
the results of their choice and confirm the right answers.

Furthermore, interactive buttons, which are located at the bottom of the quiz, have
navigational functions to lead users to previous or next questions by users’ mouse-

clicking actions. When they complete the quiz, they have choices at the ending scene of

56

the quiz: to go back and restart the quiz, or advance to participate in the web evaluation.
At any time during a quiz, users may go to the menu page by clicking the menu button of
the navigation bar, provided at the top of the quiz page, and/or to click the links at the
bottom of pages, to go directly to other pages. This navigation bar was provided on each
page for users’ random access to information.

Web Evaluatfiion

In the web evaluation section, two types of evaluation forms are offered, one for
youths, the other for adults. The youth’s web evaluation consists of questions about the
informational, aesthetic, and functional appropriateness, and their satisfaction with those
aspects. Viewers also are asked to indicate their previous knowledge level about sun
protection and their demographic information.

Adults are asked to evaluate the informational aspects of the web site from a
child’s perspective, then to evaluate the aesthetic (design and graphics) and filnctional
(links/accessibility and download time) aspects of the web site from their own
perspective. They also are asked to indicate their demographic information. Both web
evaluation versions provide a text field to provide comments and suggestions about the
web site. Furthermore, before they participate in the web evaluation, users are told that
their answers are anonymous and will be aggregated with those of others.

Results of Testing_and Revision of the Web Site

The functional aspects (i.e. navigations, links, downloading time, layer, and
survey format) and aesthetical aspects (i.e. overall design, layout, color, and properties of
fonts) were evaluated. Most functions and appearance of the site were shown as the

researcher intended for web development, on both platforms using lntemet Explorer®

57

 

4.0, while some visual inconsistencies with this researcher’s intention were shown on
both platforms using Netscape Navigator® 4.0. For example, the background image of
the table on the menu page looked scattered and incomplete because the table structure
interfered with it. This researcher handled this problem by eliminating the rows and

columns of the table. The revised web site was updated on March 28, 2000.

Phase III : Analysis of Online Web site Evaluation

Researchers contacted a total of 273 adults: 132 4-H leaders, 25 4—I-I staff, 18
professionals in Apparel and Textiles, 15 undergraduate, and 73 graduate students, for
them to participate in this web evaluation. Three packets for leaders were returned by
post office. Seven parents and three leaders reported that they did not have the lntemet
access through the follow-up post cards. There were 49 adult responses and 53 youth
responses.
Demoggphic Information

Fifiy-three youths participated in the online web evaluation. The questionnaire
was developed with youth aged 10 —1 3 in mind. Sixty-two percent of respondents were
10 to 13 years of age; 19% of them were ages 7 to 9; and 18.8% of them were between 14
and 17 years of age. The average age of respondents was 11.61 years. Almost two-third
of them were Caucasian (66.0%, n = 53), and about one quarter was Asian (24.5%, n =
53). More than a half of the young respondents were female (58.5%, n = 53).

Forty-nine adults provided responses via the online web evaluation. They were
respectively college students (49.0%), concerned parents (18.4%), 4-l-I leaders (14.3%),

faculty (10.2%), and 4-H staff (8.2%). They are predominantly female (87.8%) and

58

Caucasian (73.5%).

Most youth said that they had no previous knowledge (22.6%) or did not know
much (45.3%) about sun safety. In contrast 61% of adults reported being somewhat
knowledgeable, while an additional 20% reported they were very knowledgeable (See

figure 5). Some 28.6% of adults reported that they had read about, or had attended a

 

 

 

 

 

 

 

 

 

program on, sun safety.
70 i
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Figure 5. Previous knowledge about sun safety of adults and youth I

Information Aspect of the Web Site
Research Question 7: Is the information on the web site perceived to be appropriate for
youth?

Ninety-five percent of youths visited the Sun Protection and Sun Wise Quiz
sections; and about 80% of them visited the Sun Facts and Skin Cancer sections on the
web site. Most adults visited all four sections of the web site.

Ninety-eight percent of youth either strongly agreed (58.5%) or agreed (39.6%) to

59

the question of the easy of understanding information on the web site. More than half the
youth and about 75% of adults reported that the Sun Protection section provided the most
usefirl information. Twenty-eight percent of youths answered that Sun Wise Quiz was
the most useful.

Most youths indicated that they enjoyed the Sun Wise Quiz (92.3%: agree or
strongly agree, n = 52) and that the Sun Wise Quiz helped them understand the
importance of sun protection (94.2%: agree or strongly agree, n = 52).

Most adults responded that the information was easy for children age 10 to 13.
All three sections, i.e. Sun Facts, Skin Cancer, and Sun Protection were perceived as

providing information that would be easy for youth to understand (See Figure 6).

I
1
l
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l

  

 

Sun protection

‘ 13%|
1 lEElStroinglyragree» i
5 3 IAgree

f g ~ mew/urn NEW

‘ o Disagree

5 "Stronglydisssreei
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0% 20% 40% 60% 80% l 00%

 

1

i

l

1 Figure 6. Adult responses on whether information on the web site
i is easy for kids to understand

About 87.5% of adults reported that the information on the web site helps children
understand the connection between UV protection and skin cancer. Also most of them
agreed that the information on the web site is helpful for them to teach children about sun

safety. All nine adults who looked at the web site with a child reported that children

60

seemed to learn how to protect themselves from the sun while they were browsing the
web site.
A_esthetic Amt of the Web Site
Research Question 8: Are the graphics and design of the web site perceived as
aesthetically appealing and adding interest to the contents?

Most youths and adults showed that they were satisfied or pleased with the design
and graphics, and they perceived that the layout and color of text helped to convey the
main message of the site. Most adult respondents reported the graphics supported and

added interests to the contents (See Figures 7 and 8).

Design ,, , _, f ._
L fDStrongly agree ! 3
‘ llAgw i:
Text FNCUMI i :
f iDDisagree : i
‘ l'SF’°F‘§'¥‘l‘$"8T99i ;
1 Graphics . ‘ ‘ ’ 83‘ i :

 

0% 20% 40% 60% 80% l 00%

Figure 7. Youth responses on aesthetic aspect of the web site

: Consistent design
D Strongly agree
‘ I Agree

Neutral

E El Disagree

Appealing text

3

l
i ,
i l
i _
Pleasing page layout 1

5! §trsnslysj§asrse ;

 

Appropriate graphics

0% 20% 40% 60% 80% 100%

Figure 8. Adult responses on aesthetic aspect of the web site

61

Functional Aspect of the Web Site
Research Question 9: Are the functions (navigations, downloading time) of the web site
positively perceived?

More than 80% of adult and youth respondents reported that the navigational
buttons were obvious and easy to use to browse the web site. Both groups reported that

downloading time of the graphics was reasonable (See Figure 9).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 9. Comparison of two group responses in relation to
satisfaction of downloading time

I l 1

Youth 679 f ”My i. Strongly agree i l

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i 1 )2 Neutral 1 i

; 1 l E Disagree i 1

Adults s31; 1!,SFQUEIYfiiSagreel }

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Research Question 10: Are the links perceived as useful in providing more information?
About three quarters of the youths reported that they visited the link, “Sun
protection for children” provided by the American Cancer Society and about 40 % of
youths visited the link, “UV index” provided by the Environmental Protection Agency.
Less than 20 % of youth visited the link, “Treatments for skin cancer”, “Melanoma skin
cancer”, and “Non-melanoma skin cancer (See the Figure 10).” Most youth (83.0%, n =

53) reported that information on the links was useful.

62

| 7 V 7 '71

UV index
Sun protection for kids

9
l
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Melanoma skm cancer . . . I
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Treatments for skin cancer

 

0% 20% 40% 60% 80% l 00%

1 Figure 10. Percentage of youth visiting links

F orty-two to 63% of the adults visited each of the links, which were provided on
the web site (See Figure 11). Most adults (97.7%, n = 49) reported that information on

the links was useful.

1 UV index 1
l

|

Sun protection for kids ,, _, ,, l
Elvisited 1

1mm visit

’1
. .
Melanoma skin cancer 2

1
t
z
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a
Non-melanoma skin cancer :
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l Treatments for skin cancer
1
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0% 20% 40% 60% 80% l 00%

‘ Figure 11. Percentage of adult visiting links

63

Variations of the Web EVW
Resegch Question 11: Does evaluation vary with demographic background and with
level of prior knowledge on sun safety?

The researcher averaged the sum of the responses to questions in each section:
content, design and graphics, and navigation and downloading time, to create
informational score, aesthetic score, and functional score. A higher score indicates a
more positive response.

The researcher used one-way ANOVA to see if the evaluation differed by youths’
age, sex, ethnicity, and browser. No statistically significant differences on those scores
were found; however, some trends were in the anticipated directions. Youths aged
between 10 to 13 showed slightly higher information mean score than the other two age
groups, those under 10, and those over 13. Caucasians youth showed a slightly higher
aesthetic score than others. Youths who used lntemet Explorer® had a slightly higher
score on the aesthetic aspect of the web site than those who used Netscape Navigator®
(See Table 9).

4-H leaders, staff and professionals in apparel and textiles showed lower
information mean scores and functional mean scores than did concerned parents and
college students indicating a less positive evaluation by leaders and professionals. The
differences of informational score and functional score among these groups were
statistically significant (See Table 10). When the informational mean score was
compared with each level of previous knowledge, youths with the lower level of previous
knowledge evaluated the information on the web site more positively. When

informational scores were correlated with their levels of prior knowledge, the results

 

were statistically significant at the 0.01 level (r = -.382, p = .007).

Table 9. Informational, Aesthetic, and Functional Mean Scores of Youth in Relation to
Demographic Variables and Browser Usage

 

 

Information Aesthetic Function
Age
7 —- 9 (n = 10) 4.40 4.53 4.15
10 — 13 (n = 32) 4.63 4.66 4.13
14—17(n= 10) 4.40 4.64 4.14
F 1.24 .28 .0]
Significance (p) .30 .75 .98
Sex
Male (n = 22) 4.53 4.64 4.09
Female (n = 30) 4.54 4.62 4.16
F .01 .01 .34
Significance (p) .92 .91 .56
Ethnicity
African American (n = 2) 4.50 4.50 4.25
Asian (n= 12) 4.56 4.56 4.12
Caucasian (n=35) 4.50 4.64 4.13
Hispanic (n=1) 4.67 4.33 4.50
Others (n=2) 5.00 5.00 4.00
F .46 .57 .26
Significance (p) .76 .68 .90
BrowserI
Netscape Navigator (n =14) 4.50 4.53 4.07
lntemet Explorer (n =18) 4.67 4.76 4.28
America Online (n = 5) 4.53 4.83 4.10
F .52 1.92 1.31
Significance (p) .60 .16 .28

' There were 16 missing data.

 

65

Table 10. Informational, Aesthetic, and Functional Mean Scores of Adult Groups in
relation to Their Demographic Information and Browser Usage

 

 

Information Aesthetic Function
Who they are
Concerned parent (n = 9) 4.71 4.72 4.06
College student (n = 24) 4.23 4.50 4.29
4-H leader (n = 7) 4.06 4.45 3.79
4—1-1 staff (n = 4) 3.60 4.00 3.25
Professional in A&T (n = 5) 3.96 3.96 3.90
F 3.35 1.83 3.13 ’
Significance (p) .02 .14 .02
Ethnicity
African American (n = 3) 4.13 4.44 4.33
Asian (n = 10) 4.24 4.55 4.00
Caucasian (n = 35) 4.21 4.42 4.04
F .03 .18 .30
Significance (p) .97 .84 .74
Browser
Netscape Navigator (n = 21) 3.98 4.09 3.89
lntemet Explorer (n = 19) 4.46 4.73 4.16
America Online (n = 3) 4.13 4.72 3.67
Others (n = 2) 3.90 4.67 4.75
F 2.38 5.40 1.78
Significance (p) .08 .003 .17

 

As shown in Table 10, adults who used lntemet Explorer® or America Online®
browsers had higher aesthetic scores than those who used Netscape Navigator®
browsers. One-way ANOVA was used to compare the differences of aesthetic mean
scores among those who used lntemet Explorer®, Netscape Navigator®, and AOL®

browsers to view the web site, and the results showed there was statistically significant at

66

 

the 0.01 level.

The adult responses were not significantly different from youth’s responses. Both
groups’ responses showed that they are generally satisfied with the contents, design,

graphics, and functions of the web site.

lntemet and Browser Usage

The youth respondents reported they used respectively lntemet Explorer (48.6%,
n = 37), Netscape Navigator (37.8%, n = 37) to browse the site. America Online was the
third most used browser (13.5%, n = 37) in this study, while adult respondents reported
they used Netscape Navigator (46.6%), lntemet Explorer (42.2%), AOL (6.6%) and
others (5.1%).

About 60% of adults reported that they frequently use the lntemet for obtaining
information, while 30% reported that they sometimes seek information via the lntemet.
Only four adult respondents reported that they do not use the lntemet much. Follow up
postcard responses showed that six of the contacted parents and three leaders of the 4-H
youth program did not have an lntemet connection at home and could not participate in

the online web evaluation.

67

CHAPTER V

SUMMARY AND DISCUSSION OF FINDINGS

This chapter includes the purpose of the study, the limitations of the study, the

conclusions of the findings, and implications for further research and practice.
Summary

The primary purpose of this study was to develop an educational web site on sun
protection for 4-1-1 youth. As a first step, the research team investigated the knowledge
and practices of youth in mid-Michigan regarding protection from the sun. Eighty-four
4-I-I youths participated in this procedure. This researcher intended to ascertain the
relationship between their sun protective practices and predictor variables such as their
sun protective knowledge scores, the sun protective practices of their parents, the sun
protective practices of their friends, their previous UV overexposure experiences, and
their indirect experiences concerning skin cancer.

Based on the analysis of baseline data and a review of the literature, the
researcher developed an educational web site to disseminate information about sun safety
to youths, their parents, and other concerned adults via the Internet. The web site consists
of five sections: Sun Facts, Skin Cancer, Sun Protection, a Sun Wise Quiz and a Web
Evaluation for youths and adults. In addition, external links were provided for further
information, including: UV index, sun protection for children, skin cancer information,
and treatments for skin cancer. Testing of the web site was carried out by the researcher

to ensure the appearance of the site on a different platform and browser prior to

68

implementing the web evaluation. An online evaluation of the Web site was conducted
to measure the appropriateness of the informational, functional and aesthetic aspects of

the site. Both youth and adults responded.

Limitations of the Study

Generalizations of the findings of phase I are limited to the population represented
by the respondents: 4-H youth who were recruited through the 4-H network in mid-
Michigan. However, it is reasonable to expect some commonality among youths living
in similar subdivisions across the United States.

Evaluation of the web site is limited to a convenience sample of those youths and
adults who are recruited through the 4-H network, and selected undergraduate and
graduate students. A purposive sample of professionals in apparel and textiles was also
invited to make a critical review of the appropriateness of the web site materials for

youths.

Discussion of the Findings
P_h_ase I : Discussion of Baseline Datagollection
Eighty-four youths aged seven through 18 completed the survey about sun
protection knowledge and practices, either online or through a printed questionnaire.
Nearly three quarters of the respondents were between age seven and 15. The majority of
the subjects were Caucasian and female.
Youths aged 12 or less had a lower level of sun protective knowledge and sun

protective practices than those over 12 years of age. There was a statistically significant

69

correlation between youths’ age and sun protective knowledge, however; there was no
association between youths’ knowledge scores and practices scores. This is consistent
with previous findings of Fritschi, Green, and Solomon (1992).

Most youth respondents reported that they played outside every day; however;
their sun protection practices were very limited. Only about 30% of youths responded
that they wore sunglasses or sunscreen every day. A long-sleeved shirt was the most
unlikely worn item by youth. Youths aged over 12 were more likely to wear sunglasses
and sunblock than those who were age 12 or less. Other studies also have reported low
use of sun protection practices by adolescents. Banks et al. (1992) reported only nine
percent of youths (N = 213) in their study used sunscreen all the time, and 33% never
used sunscreen. Labat et al. (1996) found that 16.6% of youths (N = 1047) in their study,
in grades 5 and 6, answered that they always wore sunscreen, 12.6% of them (N = 1047)
stated they always wore a hat for outdoor activities, and 0.8% of them (N =1047)
indicated they always wore long sleeved shirts in the sun. The results of the frequency of
wearing long sleeved shirts for sun protection in this study, contrasts with those of
Fritschi et al. (1992) who stated that Australian adolescents, who on summer weekends
spent long periods in the sun, wore shirts for the majority of the time spent outdoors.
They did not, however, use hats or sunscreen for more than half their total time in the
sun.

The researcher found some differences on the protection score of youths in
relation to their direct or indirect experiences, but the differences were not statistically
significant. Having a severe sunburn in the previous year, having friends who used sun

protection, and knowing someone who had skin cancer, did not explain the protection

70

"' - -l{0.l. ."

 

score. The researcher’s finding about friend’s use of sunblock is inconsistent with the
findings of Banks et al. (1992). They (1992) reported that having a best friend who
routinely uses sunscreen increases the chances that a teenager would use a sunscreen (odd
ratio = 3.0, p = .001 ). The reason for inconsistent results in this researcher’s study might
be that the number of observations was insufficiently large to show the difference
between two groups. A larger sample would have provided a better indication of the
relationship.

The widely held belief that adolescents spend long periods outdoors and do not
regularly follow recommended sun protection guidelines was confirmed in this research.
Therefore, educators and administrators of health program need to consider this to
develop programs or activities regarding sun protection and UV protection. This study
did not find an association between parents’ sun protective practices and youths’
practices although. Banks et al. (1992) reported that adolescents were more likely to use
sunscreen if their parents had insisted on its use in early childhood. Therefore, changing
parental attitudes and practices toward sun exposure, and providing sun safety
information, is important. It is a good idea to provide educational information for both
parents and youths to consider the importance of sun protection.

Statistically insignificant findings of the relationships between youths’ sun
protection knowledge score and protection practice score, and between youths’ protection
score and parental protective practice, pose questions for conducting research and
developing educational materials. Did youths estimate and report accurately the
frequencies of their practices and their parental practices regarding sun protection? Was

the measurement of this survey sufficiently sophisticated to obtain a good estimate of

71

f:

I’U

their sun protective actions? Did youths’ perceptions about their parental and peers’
protective practices match actual practices?

These questions might be resolved by developing a more precise measurement for
youths to report their activities regarding sun protection, perhaps using a dairy or daily
log chart, or having scales with more response categories. For example, youths who
participate in the study may be asked to log the length of time and number of their
protection practice items that they wore, such as sunscreen, long sleeve shirt or pants,
wide brimmed hat, and sunglasses for a given period, say a month in the summer season.
And youths may be asked to write in their sun protective journal their own experiences
and feelings about using those protective items. This might provide for a good way in
which to reflect on their sun protective behaviors, and might reinforce the importance of
sun protection according to their own protective experiences.

An alternative is implementing sun protective practice questionnaire surveys to
both youths and parents, to match youths’ reports with parents’ reports about their
practices, and investigate the similarity or differences of two responses, and the reasons
for those. In-depth interviews of parents and youths also may help research

understanding of their sun protective beliefs, attitude and practices.

flase II : Discussion of Crealiggan Sun Wise Web site

Developing a web site was a challenge. Planning the components of the web site,
information, design, and functions, was the most important stage for implementing actual
production of these components to fit the primal purpose. Graphics were created to add

interest to the contents and support them. The researcher created several ideations to

72

determine the final ones, and suggests that while developing graphics for the web site, a
designer should bear in mind certain guideline requirements: reasonably fast
downloading time and high interactivities. If the graphic is too large, it will take longer
to download and will lose some of the audience who are not willing to wait. Designers
should provide reasons for users to stay at the site and to return to it. Those reasons
might be quality of information, an aesthetically pleasing environment, and user-fi‘iendly
navigation tools.

This researcher prepared the design and evaluation criteria from her own
experiences and the literature review, which together suggest that web development
criteria for educational purposes should include the following aspects:

1. Identify target audience.

This researcher had baseline data of sun protective knowledge and practices of 4-
H youth. This was very useful to develop the contents of the web site. The things that
this researcher missed on the baseline data collection were target users’ preference in
relation to the lntemet environment. According to the lntemet environment of target
users, a researcher or designer may prepare his or her own design criteria for the web site.
Users’ connection types also affect the usage of graphics and this information was not
obtained in the first data collection.

2. Maintain a consistent look to the overall design and layout of the web site.

This researcher set the table width with 600 pixels and center aligned it to
improve the readability of text and to manage design and graphics consistently. The
overall design of the web site is a set of portals to convey the information to users, and it

is as important as the information itself because users will perceive the information via

73

the page design.
3. Provide easy navigation tools to access information.

This researcher provided control of access information to users, but also guided
them by means of a menu page. The top and bottom of each page has the navigational
tools which allows them random access and linear access. Whenever users go astray they
can come to the menu page and select the information. A site map also may provide
visual layout of the information hierarchies of the web site.

4. Test the web site prior to launching it over the lntemet.

A designer cannot totally control the user’s lntemet environment.
Notwithstanding provision of consistent appearance of typography using graphics, many
things are not controlled by the designer. The researcher discovered a few problems
viewing the web site, developed based on lntemet Explorer®, while using Netscape
Navigator®. This is why testing of the web site is important using other browsers.
Ensuring the aesthetic and functional aspects of the site is achieved before finally
publishing the site over the lntemet. The revision and update of the site can be followed

by the testing phase and these are invaluable to keep the web site current and accurate.

flag III : Discussion of the Online Web Site Evjaliation

Fifty-three youths and forty-nine adults participated in the online web evaluation.
More than half the youths are Caucasian and female. Adult respondents are
predominantly Caucasian and female. Most youth respondents reported that they did not
know much about sun safety, or knew nothing at all. Most adults reported being

somewhat knowledgeable or very knowledgeable. Most youths and adults visited all four

74

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sections of the web site before their web evaluation.
Informational aspect of the web site

The information on the web site was highly perceived by youths and adults to be
easy for youth. Both groups perceived the Sun Protection section as the most useful
information on the web site. This result may be explained by the fact that respondents
already perceive the significance of skin cancer and the causal link between sun
overexposure and skin cancer. Their previous knowledge might lead them to expect
some advice about a practical way to protect themselves from the web site.

Most adults reported that the information on the web site helps children
understand the connection between UV protection and skin cancer. Also they agreed that
the information on the web site is helpful for teaching children about sun safety. All nine
adults who looked at the web site with children reported that children while they were
browsing the web site seemed to learn how to protect from the sun. These parental
observations were too small in number to make a generalization; however, these results
indicate that youth who visited web sites with their parents might learn how to protect,
and suggest an educational value of the web site.

Aesthetic aspect of the web site

Most youths and adults reported that the design and graphics of the web site were
aesthetically pleasing and supported the contents, and that the properties of the text
successfully conveyed the main message of the site. This result was consistent with the
researcher’s primary purpose of using graphics and text criteria.

Most youths indicated that they enjoyed the Sun Wise quiz and that the quiz

helped them understand the importance of sun protection. Adults commented on the

75

' ~o ('1’

positive effects of using graphics and animations for educational purposes over the
Internet. This result was consistent with this researcher’s expectation about youths’
reactions towards, and satisfactions with, graphics and animation and this might support
expanded use of animation and graphics for the online education environment. Some
adults recommended that adding more graphics on the web site would achieve the
expectation of youth and then may help them learn more efficiently.

This researcher did not find statistically significant differences on the scores by
youths’ age, gender, ethnicity, and level of previous knowledge; however, some trend for
those scores were found. Most youths ranked highly the appropriateness of the
information on the web site. Youths aged ten to 13, target user group of the web site,
showed slightly higher information mean score than the other two age groups. This result
tends to confirm the appropriateness of the contents on the web site for the target users.

Prior knowledge of adults seems to influence adult rating of the appropriateness
of information on the web site. Adults who reported being knowledgeable ranked the
information on the web site as easy; and those who reported being somewhat
knowledgeable ranked it as highly easy for youth.

The differences in adult evaluation scores for information and function were
statistically significant among subgroups. 4-H leaders/staff, and professionals in apparel
and textiles had lower scores on information and function than did concerned parents and
college students. This difference may be due to the level of expectation or amount of
exposure to the web environment.

About 40% of youth and adults used lntemet Explorer to browse the site. Adults

who used lntemet Explorer or America Online browsers had higher aesthetic scores than

76

those who used Netscape Navigator browsers and the differences on these scores were
statistically significant, while youths did not show significant differences on the scores.
This result might be explained by the initial web—developing environment which this
researcher set up. Current literature at the time of planning the web development showed
that most current lntemet users used lntemet Explorer for browsing the web site. Based
on such literature, this researcher determined to use lntemet Explorer as the main browser
to develop the web site. During testing phase, this researcher found no functional
problems using both browsers; however, a few aesthetic problems using Netscape
Navigator were detected and revised, but not all were completely solved. The appearance
of the site mainly depends on the browsers and platforms that users use and it is
extremely difficult to check all kinds of browsers and platforms. This researcher suggests
that any researcher who designs and develops an web site should pay attention to testing
the site using as many browsers as possible to ensure the appearance of the site.

Most adults reported that they frequently or sometimes use the lntemet for
obtaining information. Only four adult respondents reported that they do not use the
lntemet much. Follow-up postcard responses showed that six contacted parents and three
leaders of 4-H youth program did not have the lntemet connection at home. This result
shows that many rural populations, including those in the 4-H youth program, have
utilized the lntemet technology to obtain information. Further research can find more

specific reasons and the lntemet environment of users to understand this tendency.

77

 

 

Recommendations for Future Research

The researcher suggests some pilot studies prior to developing an educational web
site. Before beginning web site development, it would be helpful to collect information
about users. First, collecting demographic information about target users, such as age,
education, belief and values toward the topic that researcher is focused to disseminate to
the users, may show researcher who the users are and what they believe. Second,
information regarding users’ lntemet environments, such as types of platform, browser,
monitor, and modem that they use, would give researcher some clues for determining the
web environment for development. Third, information of users’ preferences toward types
of multimedia, such as video, audio, graphics, and text would present researcher what can
be utilized to convey the contents and purpose of the web site to the users successfully.
The research team obtained demographic information of the users in the initial survey,
however, their lntemet environment and preferences regarding types of multimedia was
not gathered. Based on these baseline data, researcher may develop his/her own design
criteria, which should fit the goal of the web site. This suggestion also might be adopted
for other purposive web sites.

After developing a web site, self-pretest of the site on other platforms and
browsers are strongly recommended. Researchers may need to test the site with the
selected user group who are similar to the target group but who will not participate in the
actual evaluation of the site later. Feedback of testing may provide some suggestions for
revising the site.

The researcher asked the participants of the online web evaluation about which

browsers they used to visit the web site but did not ask about their platform preference.

78

 

 

The reason why such information needs to be indicated is that the aesthetic appearance of
the web site may depend on the platform and browser choices of users, i.e. those which
they use. A good idea is to identify users’ web environments in order to compare the
their responses. Differences between their responses may be explained by the differences
between their varying platforms, browsers or any other web environments; this
information and recognition may point towards the wisdom of revising the web site
accordingly.

Electronic mailing contact can be another way to recruit people to participate in
the online survey. On electronic mails, this researcher could provide the URL of the web
site and asked them to visit and evaluate it for future use. This would eliminate users’
efforts in typing the URL, and allow them to visit the site by one mouse click. Potential
respondents who have electronic mail address may be more likely to connect to the
lntemet regularly than others who do not have such addresses. Also this might increase

the response rate, compared to printed mail.

79

APPENDICES

80

 

APPENDIX A
RECRUITING LETTER TO 4-H PARENT

FOR BASELINE DATA COLLECTION

81

MICHIGAN STATE UNIVERSITY

 

COLLEGE Of HUIAN ECOLOGY EAST LANSING 0 KICI‘IIGAN 0 ems-less

DEW 0' WW MONIENT AND DESIGN

April 13, 1999

Dear Parent:

A special invitation.

We are developing of some exciting new 4-H educational material for kids ages 10-13 and for
teens/young adults on the theme of staying healthy in the sun. We plan to make the information
available through the Internet and other educational programs. The first step in developing the Web
site is to find out what kids/teens already know about sun exposure, and what experiences, opinions
and questions they have about the topic.

Why we chose sun exposure.

We chose sun exposure because potential health effects of over exposure can be serious, and
negafiveefi'ectsarebestpreventedwhenprecautionsbeginineariylife. Skincanceristhemost
commonly occurring cancer in the United States, and studies generally conclude that all three types
of skin cancer are related to sun exposure. Premature aging of the skin and increased incidence of
cataractshavealsobeenlinkedwithsunertposure. Kids/teensneedtobeawareofsunprecautions
because the effects of sun exposure accumulate throughout life, and the majority of one’s lifetime
exposure (50 to 80%) occurs prior to age 18.

What we are asking you to do.

Ifyou are willing to have your child complete the questionnaire, which will take approximately
lO-lS minutes, you can direct them to the Internet address below. While we hope that they will
answer all questions, they may skip questions or stop without finishing the questionnaire. Answers
aregivenbyclickingwiththelefimousebutton. Attheendthereisaplaceto clickto submit
answers. Responses will be anonymous—the questionnaires will not be linked to a name or e-mail
address- and will be combined with those of others. Ifyou have questions please contact us at one
ofthe addresses or phone numbers listed below.

The URL for the survey for kids ages 10-13 is:
http://www.msu.edul~aslocum/surveyflntro.htm

The URL for the survey for older teens and adults is:
http'J/www.msu.edu/~aslocumlsurveylfirstpg.htm

Thank you so much for your interest and your help,

Joanne Schultlnk Ann C. Slocum, PhD.
Aouw‘m M g . 41...»...

Enension Specialist Associate Professor

215 Human Ecology Bldg 214 Human Ecology Building

Phone: 517-355-7704 Phone: 517-355-3779

E-mail: joannes@pilot.msu.edu ' E-mail: aslocurn@pilot.msu.edu

MSU is .- N/o'nuriw Action/Equal Opportunity mus-tie.

82

APPENDIX B
PRINTED SURVEY QUESTIONNAIRE

FOR BASELINE DATA COLLECTION

83

5..

{Pal
Che

Yes

I

Sumac QM

@3033!

god I - 5m god;
Check yes or no

 

“MP‘WW'

Yes No
Can the sun’s rays make your skin look older and more wrinlded by the
time you’re 50?
_ _ Do more people get skin cancer than any other kind of cancer?
_ Can you get a sunbum when it’s cloudy?
Are tanning salons bad for your skin?
_ _ Are people with red or blonde hair more likely to get sunbums than other
people?
Can people die from skin cancer?
_ _ Can anyone get skin cancer?
__ _ Can the sun do anything that hurts your eyes?
Multiple choice
Circle the best answer to complete the sentence.
1. The sun is the strongest fi'om 2. Good sunblock has an SPF number. Which
A. 9 am. to 11 am. SPF number would protect you the most?
B. 10 am. to 2 pm. A SPF 2
C. 11 am. to 3 p.m. B. SPF 15
D. 3 pm. to 4 pm. C. SPF 8
D. SPF 12

84

god 2 - Sun We
Put a check (I) by your answer.

 

On a sunny day in the every about about never

summer, how often do you: day once a once a
week month

 

play games or sports outside
wear sunglasses

wear a hat

use sunblock

wear a long-sleeved shirt

 

 

 

 

 

 

 

 

 

 

 

Put a check (I) by all the answers that are true for your mom or dad. Ifyou are not sure,
leave it blank

 

What do your mother or MOTHER FATHER
father usually do when
going outside in the sun?

useasunblock
wearalongsleevedshirt
wearalntwithabrim

 

 

 

 

 

 

 

 

gods-6W

 

Put a check mark by your answer.
1. Doyoulmowanyonewhohusldncancer’lYes No
2. When your fiiends go outside on a sunny day in summer, do they put on sunblock?
Yes No Sometimes _ I don’t know

3. Did you have a bad sunburn, one where the skin peeled, last year? Yes No __
Check all that are true: .
IusetheIntemetatbome Iliketousethelntcrnet
Iusethelnternetatschool Ido not like to usethe Internet
I do not use the Internet
Age Grade: Sex: male female __
Ethnicity:

Afiican American Asian Caucasian _ Hispanic _ Native American __

85

APPENDIX C

OUTLINE OF THE WEB SITE CONTENT

86

APPENDIX C

OUTLINE OF THE WEB SITE CONTENT

A. Sun Facts section
a. What UV radiation is
b. The effects of UV radiation
c. Factors influencing UV radiation

(1. UV index

B. Skin Cancer section
a. What skin cancer is and types of skin cancer
b. Statistics on skin cancer
c. Visual symptoms of melanoma skin cancer

(1. Medical treatments for skin cancer

C. Sun Protection section
a. General tips for sun protection
b. UV protective clothing - clothing, hats, and sunglasses

C. Sunscreens and sunblocks — what those are, what to choose, and tips for

applying

87

APPENDIX D

OUTLINE OF THE SUN WISE QUIZ

88

APPENDIX D

OUTLINE OF THE SUN WISE QUIZ

Question

1.

2.

Higher SPF numbered sunscreen provides longer protection from the sun

More cover up the body, more protection you get

Darker colored clothing provides better protection from the sun
Wider brimmed hat provides better protection from the sun
The importance of year round protection from the sun

Be cautious about the reflection of the sunlight

Appropriate sunglasses for eye protection

89

APPENDIX E

SUN WISE WEB SITE

90

APPENDIX E — I
HOME PAGE

Welcome to Sun Wise Page!

-'—i ' .1

 

 

Click the sun to enter

Copyright (C) 2000 Michigan State University. All rights reserved.
Disclaimer, Indicia. & Project Credits

 

This site is best viewed using Microsoft Internet Explorer 4.0 or above.
To enjoy the Sun Wise Quiz in this site,
you need to download the Flash 4 chm-in.

91

APPENDIX E — II
INTRODUCTION PAGE

Hello all,

This site was developed for everyone who wants to learn more about sun
safety. You will get information about sun facts, skin cancer, and sun
protection while surfing this site and more information can be found in
various links. The Sun Wise Quiz was developed with graphic animation. To

enjoy this quiz, you need to download the Flash 4 plug-in by clicking on the
link.

At the end of your visit, please complete the web evaluation. Your response
will be anonymous and will be very helpful to us in revising the site.

Thanks again for visiting the site. We hope you will be sun wise all year long.

«such:

Copyright (c) 2000 Michigan State University. All rights reserved.

Disclaimer. Indicia, & Project Credits

 

92

Let

 

APPENDIX E - III
MENU PAGE

nag; gent;
Welcome To Sun Wise Page!

 

sun facts

skin cancer

 

sun protection
sun wise quiz

web evaluation

C0pyright (c) 2000 Michigan State University. All rights reserved.

Disclaimer. Indm, & Project Credits

93

APPENDIX E-IV
SUN FACTS PAGE

 

sun facts .

UV Radiation - Invisible energy

UV (ultraviolet) radiation is an invisible part of the sun's
energy. There are different kinds of ultraviolet rays based on
their wavelength. Two types that reach the earth are UVA and
UVB. UVA rays go deeper into the skin, causing wrinkles and
skin aging. UVB rays cause burning and blistering on your skin.

 

Effects of UV radiation; Good news 8: Bad news

The sunlight is the source of the all life on earth. It lights

up the earth and gives the solar energy to plants and animals
to live. Also it assists in the production of vitamin D in skin
cells. This vitamin is essential for the growth and development

of healthy bones.

Doctors tell us that a small amount (10 - 15 minutes per
day) of sun exposure is good for health, but sun overexposure
can lead to a number of serious health problems, including
malignant melanoma, other skin cancers, eye cataracts,
weakening of the immune system, and premature aging of the
skin. With reduced ozone protection, increased levels of UV

radiation are reaching the earth's surface.

Factors influencing UV Radiation

Time of day: When the sun is highest in the sky, UV
radiation is intense.

Season of year: The sun is strong in summer, intermediate
In spring and fall, and lowest in winter. But even in winter,
Sun overexposure can occur because ice and snow reflect a

large amount of UV radiation.

Weather conditions: It is true that there is less UV radiation
on a cloudy day, but clouds cannot absorb one hundred
percent of the harmful rays. Sometimes clouds increase the

UV radiation through reflecting it.

94

Continued — SUN FACTS PAGE

Latitude: Generally, the further away from the equator, the
less amount of UV radiation.

Altitude: The amount of UV radiation increases significantly
with altitude because there is less atmosphere to absorb the UV
radiation.

 

Ozone conditions: Thicker ozone provides better protection a
from UV radiation and the thickness of the ozone layer varies by '
season and latitude.

UV index

In

 

The UV index, developed by the National Weather Service
and the Environmental Protection Agency, is a new component
for local weather forecasts that predicts tomorrow's likely levels
of exposure to UV radiation and also indicates the degree of
caution you should take outdoors. The UV index predicts UV
levels on a 0 to 10+ scale. The lower number means less
exposure.

More information on UV index, what it is, how it is
calculated, and UV crossword puzzle, is provided by the
Environmental Protection Agency Web site.

SunFacts I SkinCancer I SunProtection I SunWiseOuiz I WebEvaIuation

Copyright (c) 2000 Michigan State University. All rights reserved.

 

Disclaimer. Indicia. & Project Credits

 

95

APPENDIX E — V
SKIN CANCER PAGE

HOME MENU

skin cancer

What skin cancer is...

It is a disease in which cancer cells are found in the outer layers of
the skin and it is the most common of all cancers. There are two
general types of skin cancer: one is non-melanoma cancer, which
has been associated with cumulative sun exposure; the other is
melanoma skin cancer, which has been associated with short,

intense sun exposure.

- The American Cancer Society provides useful information on
sun protection for kids. UV exposure, skin cancer, sun basics
for kids, and sun quiz are available.

. More specific information about nonmelanoma skin cancer or
melanoma skin cancer are found in the American cancer

society web site.

Statistics of skin cancer

Nan Melanoma Skin Cancer Statistics

g £2130 cm
2 000cm

§

BOlZ‘r-DCO

60.1. cm

400.000

2 001100

 

0

 

Estimated new skin can

196? 3970 1950 ‘09“ 199‘?

Year

(Sources from the American Canc cr Society. 1 967.

1 968. 1 97 0. 1 980, 1 990. and 1 999)

96

The American Cancer Society
(1999) estimated that about 1
million cases of non-melanoma skin
cancer (basal cell skin cancer and
squamous cell skin cancer) and
44,200 new cases of melanoma
would be diagnosed in the United
States during 1999. Melanoma
accounts for about 4% of skin cancer
cases, but causes about 79% of skin
cancer deaths. The number of new
melanoma diagnosed in the United
States is increasing. About 7,300
people in the US were expected to
die of melanoma during 1999.

Continued — SKIN CANCER PAGE

Signs & Symptoms of melanoma
Asymmetry: One half of the mole does not match the other half.

Border Irregularity: The edges of the mole are ragged or
notched.

Color: The color over the mole is not the same. They may
be different shades of tan, brown, or black, and
sometimes red, blue, or white.

Diameter: The mole is wider than about V4 inch, although
doctors are finding smaller melanomas in recent years.

Some melanomas do not fit the ABCD rule described
above, so be aware of changes in your skin and see a
doctor if you have questions.

Medical treatments for skin cancer
Surgery: taking out the cancer in an operation
Chemotherapy: using drugs to kill cancer cells

Radiation therapy: using high-dose x-rays or other high-energy
rays to kill cancer cells

Biological therapy: using your body's immune system to fight
cancer

. You can find information about treatments for melanoma
skin cancer at Northeast Dermatology Associates web site.

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97

APPENDIX E — VI
SUN PROTECTION PAGE

"on W mu

sun protection

- General tips for UV protection
- UV Protective Clothing
- Sunscreen & Sunblock

- More Information about sun protection for adults

General tips for UV protection

Too much sun exposure can lead to skin disease, including skin
cancer!

Do you think tanned skin looks good? Many people do. Exercise and
activities outdoor are good, but just be careful not to get too much sun
exposure. Did you know sun overexposure can lead to skin diseases
including skin cancer?

According to scientists, 50 to 80 percent of your lifetime sun exposure
to UV rays occurs by the age of 18 to 20 years old. Therefore it is
important for young people to protect themselves from sun
overexposure.

General tips

- Stay out of the sun at midday (10 a.m.- 4
p.m.)

— Wear a wide (at least 3") brimmed hat.
- Wear sunglasses that provide 99-100%
protection from UVA and UVB.
_ - Cover your skin as much as you can with

. closely woven clothing. Long sleeved shirts are a
good idea, too.
- Use sunscreen/sunblock whenever you go
outside and reapply every 2 hours.

- Experts suggest Avoiding tanning beds and
parlors.

 

98

F7

Continued - SUN PROTECTION PAGE

- More information about tanning beds for adults.

- More information about sun protection for kids can be found at the
American Cancer Society web site.

Go to UV protective clothing " '

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99

 

”—1,!

 

APPENDIX E — VII
UV PROTECTIVE CLOTHING PAGE

Hang gnu w

 

 

sun protection
- General tips for UV protection

- UV protective clothing

- Sunscreen & sunblock

 

UV protective clothing

Scientists suggested that the best form of protection is
avoidance of UV rays and the use of UV protective clothing.
Avoidance may not be practical for most of people, especially for
kids and teens, who love to play outside.

For your UV protection, you can choose tightly woven,
dark color clothing from your wardrobe. Dark color may make
you hot but it provides you better protection because the dye
pigments absorb UV rays and also visible light. If you are
looking for more protection or you are sun sensitive, you can
wear specially engineered UV protective clothing, which is a
good way to enjoy outdoor activities and also protect ourselves
from UV rays.

- More information about UV protective clothing for adults.

Hats also can give you
protection. The most important thing
to consider is how much they will
shade you from the sun. The wider
brimmed hat (at least 3 inches) shades
your face, nose, ears and the back of
your neck and can give you more
protection than just a ball cap which
will just barely cover your face. But
remember, wearing any hat provides
sun protection!

 

100

continued — UV PROTECTIVE CLOTHING PAGE

The overexposure of UV radiation can
eventually lead to eye cataracts and other
optical problems. Sunglasses can provide you
with UV protection. But not all the sunglasses
are the same. Select sunglasses labeled 95-
99% UVA and UVB protection.

. More information about sunglasses for
adults.

 

Go back to General tips Sunscreen & Sunblock

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101

 

 

 

APPENDIX E — VIII
SUNSCREEN AND SUNBLOCK PAGE

HO E u . m1
sun protection

- General tips for UV protection
- UV protective clothinq
- Sunscreen & sunblock

Sunscreen & Sun block

 

Sunscreen can effectively protect your skin from UV rays, when
you cannot wear clothing for your protection; for example,
swimming at the beach or pool.

Sunscreen is usually a cream or lotion that is

—rated. Sunscreen reacts with chemicals
in your skin to offer you protection by
absorbing the UV rays. Since this chemical
reaction takes time to occur, you should apply
sunscreens 30 minutes before your outside
activities.

Sunblock is usually an opaque cream or paste
containing zinc oxide or titanium dioxide which
provides a physical shield from the sun.
Sunblock protects you by reflecting the UV rays
before they penetrate your skin.

 

Tips, Tips, Tips!

. Reapply sunscreen every 1-1/2 to 2 hour.

. The SPF of a sunscreen can be decreased by humidity,
wind, temperature, application thickness, sweat and water
activities. So, reapply sunscreen often under these conditions.

. Sunscreen can cause eye and skin irritation and may be oily or
greasy. It is not recommended for babies less than 6 months old.

102

 

continued — SUNSCREEN AND SUNBLOCK PAGE

What you should get!

 

Many dermatologists suggest {@for general use.
However, sunscreens come in lots of varieties. So, when
choosing a product, first consider how much protection you need.
If you have fair skin and light-colored eyes or a family history of
melanoma, you might need a higher SPF than someone with
olive skin or dark eyes. Some illnesses and medicine may
increase sun sensitivity and warrant a high-numbered SPF. Some
allergies could limit a sunscreen's effectiveness. You need to ask
a doctor if you have these conditions.

How much you need to apply (Minimum amount for teens):
. Face and neck (1/2 tsp)
. Arms and shoulders (1/2 tsp. to each side)
. Torso (1/2 tsp. to front and back)
. Legs and tops of feet (1 tsp. to each side)

Thickness of application is important. If not enough is applied to
the skin, SPF effectiveness could drop.

. More information about sunscreens for adults.

Go back to UV prgtggivg clothing

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103

 

 

 

APPENDIX E — IX

SUN WISE QUIZ PAGE

 

Welcome to the SunWise Quiz

We hope you will have fun during your
outdoor activities and remember, make sun.
wise choices!

snare-re

All graphics in the Sun Wise Quiz were created by Ji-Hvun Kim. March 7, 2000

If you are unable to view the quiz, you need to download the Flash 4 plug-in.

SunFacts I SkinCancer I SunProtection I SunWiseQuiz I WebEvaluation

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104

SUN WISE QUIZ - Question 1

 

ME ‘51 gnu

 

Question 1

which number of SPF will protect
you the most?

iSPFzm Laws“)

«err: isrso

 

1" You are unable to view the quiz, you need to download the Flash 4 plug-in.

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105

SUN WISE QUIZ - Question 2

wrong ‘ - ' ~ - , ‘ "EMA‘ITE‘:

Question 2

which of these can give you
the most protection ?

8:19

If I i] 53’

If You are unable to view the quiz, you need to download the Flash 4 plug-in.

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106

SUN WISE QUIZ - Question 3

 

 

Question 3

what color of long-sleeved
shirt will give you better
protection from the sun?

 

If you are unable to view the quiz, you need to download the Flash 4 plug-in.

SunFacts I SkinCancer I SunProtection I SunWiseQuiz I WebEvaluation

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107

SUN WISE QUIZ - Question 4

l' ‘ ~‘i .- " ‘ ‘ '.. _. ». . . in. . ‘._. ,.-, - ~,.-.- ... .- .'.._-, ,--.a,-¥i. -qv.-.‘.--_, «_.~.>'j.-.‘q . .*-‘e' “a
. .v

Question 4

Hearing a hat is a great idea for
sun protection.

which of these gives you better
protection from the sun?

 

f .
‘ \“.v

If you are. unable to view the quiz, you need to download the Flash 4 plug-in.

SunFacts I SkinCancer I SunProtection I SunWiseQuiz I WebEvaluation

 

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108

SUN WISE QUIZ - Question 5

 

 

Question 5

when do you need to protect
you from the sun ?

.r“ “‘5 -—..__\_\
At night mafia”;

1»??? spring summer
Sunny day only All season

fall winter

_s

A
. ' a
I

[:3

If you are unable to View the quiz, you need to download the Flash 4 plug-in.

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109

SUN WISE QUIZ - Question 6

 

Qlflstion 6

5“"/*
Snowaq‘sanda and uater--.
How are they alike?

Answer They are related to fun 8
outdoor activities and
also reflect UV rays.

So» when you go outside«
wear your sun protection
and have fun!!!

If You are unable to view the quiz, you need to download the Flash 4 plug-in.

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110

SUN WISE QUIZ - Question 7

   

Question 7

Hearing sunglasses provide
protection for your eyes-

Uhich of these can give you
the most protection ?

label indicating
“HZ of UVA 8 UVB label indicating
blocked UV blocked up label

«r.» ex ex

   

If you are unable to view the quiz, you need to download the Flash 4 plug-in.

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111

SUN WISE QUIZ - Ending Page

 

MW w
Congratulation!
You successfully finished your Sun
Wise Quiz.

If you want, you may start the quiz
again or you may go and participate
in. web evaluation now.

Thanks for visiting the SWO!
Be sun wise all year long~

" swa nan/N ”155

If You are unable to view the quiz, you need to download the Flash 4 plug-in.

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112

APPENDIX E - X

Online Web Evaluation Questionnaire

web evaluation

This Sun Wise Web site provides two evaluation forms, one for
KIDS and the other for ADULTS.

Kids Adults

Click the proper one for you !

§unFacts I SkinCancer I SunProtection I SunWiseQuiz I WebEvaluation
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113

Youth Web Evaluation Questionnaire

Welseme to our questionnaire on
Sun Wise Web site evaiuaaon i

This questionnaire is to evaluate the Sun Wise web site. We would like to
hear what you think about the web site. Your feedback will help us revise the
information and links for future users. It will take about 10 to 15 minutes and
answer the questions below.

Your answers to these questions are anonymous and will be combined with
those of others. If you have questions about this project or the web site,
please contact us.

Your help is greatly appreciated!
Ann Slocum, Joanne Schultink, & Ji-Hyun Kim

aSIOw®glotmsuedu joannes@pilot.msu.edu,& kimjihyu@pilot.msu.edu

s‘,

Click the sun to begin W

114

KIDS WEB EVALUATION FORM

Click above the face that shows how you feel about each question.

A v V
Strongly . Strongly
disagree Disagree Neutral Agree agree
u u ”

 

 

1 - Before you visited this web site, how knowledgeable were you about sun
protection?

(‘ (‘ F (‘

totally

very much some what not much uninterested

2 . Please click the sections you looked at.

l" l" l’ l—
. Sun . .
Sun facts Skin cancer . Sun wuse qunz
protection

If you did not visit the section, please go back to view the information in it
before answering the question. Click below the section to view it.

Sun

protection Sun Wise Qunz

Sun Facts Skin Cancer

3. It is easy for me to understand the information about sun facts, skin cancer
and sun protection.

f‘ F F f‘ f‘

H H H H H
A A ~- v V

4- I enjoyed the sun wise quiz.

(‘ (‘ f‘ (‘ F

115

f“

H
A

f“ F (‘ F

6. The most useful information was

(‘

Sun facts
Skin cancer
Sun Protection

Sun Wise Quiz

7 . I like the design (color, text and patterns) of the web site.

8. The layout and color of the text helped me get the main message of the

page,

(‘

I!
A

9- I like the graphics on the web site.

(‘

H
A

F (‘ (‘ (‘

H H H II

116

10. The web page came up quickly enough.

F f‘ F

H H H

A as

1 1 . The buttons were obvious and easy to use.

f“ (‘ F

H H H
A A -

1 2 . Please check the links you visited.
'— UV index
Sun Protection for Kids

Melanoma skin cancer

Non melanoma skin cancer

—l—|"l_l

Treatments for skin cancer

If you checked a link above, was that useful?

(~ (‘ (‘

Yes No Didn't work

1 3. I still have questions about

[— Sun facts

1—

Skin cancer

'— Sun protection

117

 

List questions

 

_;LJ J"

14. Please tell us which browser you used to view this site (i.e. Internet
Explorer, Netscape Navigator, AOL browser ...) and give any comments or
suggestion about the Web site.

 

t
and
.—

 

 

.u ..f'

Your age I 7 'I Click the pull-down list to check.
1 t .
Y0” grade 5 Click the pull-down list to check.
Your gender r Male F Female
Your
(‘ C‘ F F
ethnicity
African Asian Caucasian Hispanic Others
American

Be sure to click on the "Submit the evaluation" button below to
Submit your answers.

§ub

 

 

Thank you so much for your participation!

118

Adult Web Evaluation Questionnaire

311‘ 1'94

‘ Atytfs java ‘ \ Egg-sq: Sr-grrsrrt'v:x\t~s out. fag-5'- {f “- .143
J 94-4443.) «£9 dd L4auua-J-&JJJ Jul-1.23 ‘34}

J“ M £2.- ~ ,. ~ rr '25 .. H." 5* 5’-- 57-5— ...7
‘ .43} 14.4.3 $339 935% 333133-433

This questionnaire is to evaluate the Sun Wise web site. The site has

developed to disseminate recent information on sun safety for youth and
adults.

We would like to hear what you think about the Sun Wise web site. Your
feed back will help us revise the information and links for future users. It will
take about 15 minutes and answer the questions below. There are a total of
20 questions arranged in three sections; (1) evaluation of content, design,
graphic, and links/accessibility; (2) kids reaction about sun wise quiz; and
(3) your background. There is also a place at the end for you to submit

questions that you would like to have answered about sun safety or to
ma ke comments about web site.

Your answers to these questions are anonymous, your email address will
not be associated with your response, and your answers will be combined

Wlth those of others. If you have questions about this project or the web
Slte, please contact us.

Your help is greatly appreciated!

 

Ann Slocum Joanne Schultink Ji-Hyun Kim
Wpllot. msu. edu joannes@pilot.msu.edu kimjihyu@pmw
Associate Professor Extension Specialist Research Assistant

Human Environment & Design

Michigan State University
East Lansing, MI 48824

Click the sun to begin '

119

 

Adults Web Evaluation Form

Please click the check box(s) below to indicate which section(s) you looked at.
F F' l' l"

Sun Sun Wise

Sun Facts Skin Cancer Protection Quiz

Section 1. From a child perspective

Please tell us how you think a 10-13 year old would respond to this
site.

Content evaluation

1 . The information of the web site is easy for kids to understand.

3:233; Disagree Neutral Agree 5:32?er
Sun facts r r F F (‘
Skin cancer F f‘ F (‘ P
5“" r r r r r

protection

2. The information on the Web site helps kids understand the connection
between UV protection and skin cancer.

f‘ f‘ (‘ (‘ (‘
Strongly . Strongly
disagree Disagree Neutral Agree agree

3 . In general, I think the most useful section for kids is

(‘ Sun facts
F Skin cancer

C Sun protection

120

4. As adults (parents or 4-H leaders), the information on the Web site is
helpful for teaching kid(s) about skin cancer prevention.

(‘ (‘ (‘ (‘ (‘
Strongly . Strongly
disagree Disagree Neutral Agree agree

5 . You looked at the web site with child.

r Yes (‘ No -> go to question # 6

If yes, do you think the information in the web site helped
kid(s) to understand the importance of UV protection?

F r‘ (‘ (‘ F
(Strongly Disagree Neutral Agree Strongly
Isagree agree

If yes, did kid(s) seem to learn how to protect from the sun
while surfing in the site?

(‘ r‘ r‘ r‘ r
Strongly . Strongly
disagree Disagree Neutral Agree agree

6. Kids need to know more about

 

:J

 

.41.] .4“

Section 2. From your perspective

l’lease tell us your opinions about the web site.

Design Evaluation

121

7. The overall design (color, text and patterns) of web pages is consistent.

F F (‘ (‘
Strongly .
disagree Disagree Neutral Agree

8. The properties of the text (font, style, size, color, pattern, etc.) are

appeaHng.
(‘ (‘ (‘ (‘
Strongly .
disagree Disagree Neutral Agree

9. The page layout is consistent and pleasing.

(‘ (" (‘ (‘
Strongly Disagree Neutral Agree
disagree

Graphic Evaluation

10. I like the graphics on the web site.

(‘ (‘ (‘ (‘
Strongly Disagree Neutral Agree
disagree

11. The graphics add interests to the contents.

(‘ F (‘ (‘
Strongly Disagree Neutral Agree
disagree

12. The graphics was appropriate to support the contents.

(‘ (‘ (‘ (‘
Strongly Disagree Neutral Agree
disagree

122

F

Strongly
agree

 

. l
Strongly
agree

F

Strongly
agree

r

 

Strongly
agree

f“

Strongly
agree

(‘

Strongly
agree

13. Graphics are downloaded with reasonable speed.

F (‘ (‘ (‘ (‘
Strongly . Strongly
disagree Disagree Neutral Agree agree

Links and Accessibility Evaluation

14. The buttons (navigation tools) are obvious and easy to use.

(‘ (‘ (‘ (‘ r‘
Strongly . Strongly
disagree Disagree Neutral Agree agree

15. Please click the check box(s) next to the links that you visited.
UV index

Sun Protection for Kids

Melanoma skin cancer

Non melanoma skin cancer

7777-1

Treatments for skin cancer

16. Information on the links is useful.

r Yes F No r Did not work

Please tell us about your background

17. Were you generally knowledgeable about the topic of this web site, before
you visited?

F (‘ (‘ F

very much some what not much none

18. Have you read about or attended a program on Sun Safety?

(‘
r Yes No

123

 

19. How often do you use the Internet for getting information?

F (‘ (‘ (‘

Frequently Sometimes Not often Not at all

20. Please tell us which browser you used to view this site (i.e. Netscape,
Internet Explorer, AOL browser...) and any comments about the web site.

i1

 

 

_«u f

 

concerned arent v ,
YOU are... I D V J(Choose one from the pull-down list)

or other, please explain I

Your gender r Male r‘ Female
Your_ . (‘ p r r (‘
ethniCIty
”“93“ Asian Caucasian Hispanic Others
American

§ub J

Thank you so much for your participation!

124

.tI‘L’f-E ’1

APPENDIX F

RECRUITING LETTERS FOR ONLINE WEB EVALUATION

125

APPENDIX F — I

RECRUITING LETTER TO 4-H PARENT

MICHIGAN STATE UNIVERSITY

COUEGE OF HUMAN ECOLOGY EAST LANSING 0 marrow 0 «ON-I030
DEPARTMENT Of HUMAN MONK!“ AND DBIGN

March 24, 2000

Dear Parent,

We need your help!
We have developed a web site which contains educational material about sun safety. In

developing the project we used published studies and information collected last year about the sun
protective practices of youth in mid-Michigan. Before we advertise the web site and link it to the
4-H web page, we need some feedback from adults and young people. That is why we have
contacted you. We hope that you and your child can each take a few minutes to visit the web site
and fill out the on-line evaluation questionnaire.

Why we chose sun exposure.
We chose sun exposure because the potential health effects of over exposure can be serious,

and negative effects are best prevented when precautions begin in early life. Skin cancer, premature
aging of the skin and increased incidence of cataracts have all been linked with sun exposure. Kids
need to be aware of sun precautions becausethe effects of sun exposure accumulate throughout life,
and the majority of one’s lifetime exposure (50 to 80%) occurs prior to age 18.

How you can help
F irst, would you please visit the web site and complete the on-line adult evaluation form.

Second, would you ask your son or daughter to visit the web site and complete the evaluation form
for kids. Looking at the web site and completing the forms will take approximately 15-25 minutes.
All responses will be anonymous. Your answers will not be linked to a name or address, and they
will be combined with the response we receive from others. Your participation and that of your
child is, of course voluntary, but we do hope that you will help us. It is really important for us to
receive reactions so that we can make revisions. Also, please fill out the attached post card and drop
it in the mail so that we know about any problems you have in making connection. We would
appreciate an early response, by the 10‘ of April if possible. The URL for the web site is:

http:llwww.msn.edul~aslocurnlsnnlannwlsehornepage.htm

If you have any questions or concerns about this project please contact one of us. Our
addresses and phone numbers are listed below.

Thanks you so much for your interest and your help,

Joanne Schultink, M.S. Ann C. Slocum, Ph.D. Ji-Hyun Kim, B.S.
Extension Specialist Associate Professor Research Assistant

215 Human Ecology Bldg 214 Human Ecology Building 404 Human Ecology Bldg.
Phone: 517-355-7704 Phone: 517-355-3779 Phone: 517-355-3779

E-mail: joannes@pilot.msu.edu E-mail: aslocum@pilot.msu.edu E-mail: kimjihyu@msu.edu

UMb-WMfi-MWW

126

r

 

 

APPENDIX F - II

F OLLOW-UP POSTCARD TO 4-H PARENT

Please check one or more statements to describe your situation. Then drop
this pre-stamped post card in the mail for us.

Cl I/we completed and submitted the online web evaluation.
Where? U at home U at school/ work U at the library Cl other

C] We didn’t/couldn’t download the quiz (“plug-in”).

Cl I/we didn’t complete the questionnaire because
[:1 I don’t have access to the lntemet.
1:1 I tried but could not connect to the web site.
1:] Sorry, I didn’t have time.
D Kids are not interested.

Thank you so much again for your interest and your help!

127

 

 

 

APPENDIX F — Ill

RECRUITING LETTER TO 4-H LEADER

MICHIGAN STATE UNIVERSITY

corner OF HUMAN ECOLOGY EAST LANSING ' MAN 0 «.14-I”.

DEPARTMENT Of HUMAN ENVIONHHIT AND DESIGN

March 24, 2000

Dear 4-H Leader,

We need your help!
We have developed a web site for 4-H youth which contains educational material about sun safety. In

developing the project we used published studies and information collected last year about the sun
protective practices of youth in mid-Michigan. Before we advertise the web site and link it to the 4~H
web page, we need some feedback from adults and young people. That is why we have contacted you

Why we chose sun exposure.

We chose sun exposure because potential health effects of over exposure can be serious, and negative
effects are best prevented when precautions begin in early life. Skin cancer, premature aging of the
skin and increased incidence of cataracts have all been linked with sun exposure. Kids need to be
aware of sun precautions because the effects of sun exposure accumulate throughout life, and the
majority of one’s lifetime exposure (50 to 80%) occurs prior to age 18.

Three ways that you can help.
First, as 4-H leaders, we hope that you will visit the sunwise web site and complete the on-line adult
evaluation form. Your feedback will be very helpful to us in revising and enhancing the web site.
This will take approximately 15-25 minutes. Your response will be anonymous. The response will
not be inked to a name or address and will be combined with others we receive. Also, please
complete the enclosed post card and drop it in the mail. This will help us know if you had problems
using the system. The URL for the web site is:
http:l/wwwmsu.edul~aslocumlsnnlsunwisehomepage.htm

 

Second, please encourage your 4-H youth to look at the web site and complete the evaluation
questionnaire for kids. While we prepared the site with kids ages 10-13 in mind, response from kids
ofall ages is important.

Finally, please help us by distributing copies of the enclosed letter and post card to the parents of4-H
youth with whom you work. We would appreciate it if you did this quickly, as we would like to
receive most of the responses by the 10" of April. Feedback from parents, leadas and youth is
critical for us to know how to proceed with the project.

If you have any questions or concerns about this project please contact one of us. Our addresses and
Phone numbers are listed below. Thank you so much for your interest and your help,

Joanne Schultink, M.S. Ann C. Slocum, PhD. JiHyun Kim, 8.8.
A com a»... d. Ale-cw».

Extension Specialist Associate Professor R h ssistant

215 Human Ecology Bldg 214 Human Ecology Building 404 Human Ecology Bldg.

Phone: 517-355-7704 Phone: 517-355-3779 Phone: 517-355-3779

E-mail: joannes@pilot.msu.edu E-mail: aslocum@pilot.msu.edu E-mail kimjihyu@msu.edu
mu a .- w W w. Wh-

128

 

APPENDIX F — IV

RECRUITING LETTER TO 4-H STAFF

MICHIGAN STATE UNIVERSITY

correct 0' HUNAN ECOlOGY EAST LANSING 0 HICHIGAN 0 «cu-iota

DEPAI‘I'HENT 0' HUMAN ENVIRONMENT AND DESIGN
March 30, 2000 W

 

Dear 4-H Staff.

We need your help! ' L

We have deveIOped a web site for 4-H youth which contains educational material about sun safety. In ‘1
developing the project we used published studies and infomiation collected last year about the sun '
protective practices of youth in mid-Michigan. Before we advenise the web site and link it to the 4-H
web page. we need some feedback from adults and young people. That is why we have contacted you

Why we chose sun exposure.
We chose sun exposure because potential health effects of over exposure can be serious. and negative

effects are best prevented when precautions begin in early life. Skin cancer. premature aging of the
skin and increased incidence of cataracts have all been linked with sun exposure. Kids need to be

- aware of sun precautions because the effects of sun exposure accumulate throughout life. and the
majority of one‘s lifetime exposure (50 to 80%) occurs prior to age 18.

Three ways that you can help.
First. as 4-H staff member. we hope that you will visit the sunwise web site and complete the on-line

adult evaluation form. Your feedback will be very helpful to us in revising and enhancing the web
site. This will take approximately 15-25 minutes. Your response will be anonymous. The response
will not be linked to a name or address and will be combined with others we receive. The URL for
the web site is: '
‘ . http:I/nmv.msu.edul~aslocumlsun/sunwisehornepagehtrn :

Second. please encourage any youth in your family (children. nieces/nephews. etc) to look at the web
site and complete the evaluation questionnaire for kids. While we prepared the site with kids ages 10-
:13 in mind. response from kids of all ages is important.

 

Finally. please help us by distributing the enclosed letter and post card to a parent who has a child 9
years of age or older. We would appreciate it if you did this quickly. as we would like to receive most
of the responses by mid April. Feedback from parents. staff. leaders and youth is critical for us to
know how to proceed with the project. '

If you have any questions or concerns about this project please contact one of us. Our addresses and
phone numbers are listed below. Thank you so much for your interest and your help.

Joanne Schultink. M.S. Ann C. Slocum. PhD. Ji-Hyun Kim. B.S.
Extension Specialist Associate Professor Research Assistant

..lS Human Ecology Bldg 2 l4 Human Ecology Building 404 Human Ecology Bldg.
Phone: 51 lass-7704 Phone: 517-355-3779 Phone: 517-355-3779

E-mail: joannes@pilot.msu.edu E-mail: aslocum@pilot.msu.edu E-mail: kimjihyu@rnsu.edu

rm...- MAM/“wow

129

APPENDIX F - V

F OLLOW-UP POSTCARD TO 4-H LEADER / STAFF

Please check one or more statements to describe your situation. Then drop
this pre-stamped post card in the mail for us. Thank you so much again
for your interest and your help!

[:1

[:1

I/we completed and submitted the online web evaluation.
Where? D at home 0 at school/ work D at the library El other

I/we didn’t complete the questionnaire because

[:1 I don’t have access to the lntemet.

C] I tried but could not connect to the web site.

Cl Sorry, I didn’t have time.

Cl Kids are not interested.
The earliest date by which I can distribute letters and cards to parents
18

 

I can distribute additional letters to parents; please send more.

130

- .;

 

 

BIBLIOGRAPHY

131

 

 

 

BIBLIOGRAPHY

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