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