{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T23:09:30Z","timestamp":1777072170749,"version":"3.51.4"},"reference-count":46,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T00:00:00Z","timestamp":1636156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/50008\/2020"],"award-info":[{"award-number":["UIDB\/50008\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["SFRH\/BD\/147608\/2019"],"award-info":[{"award-number":["SFRH\/BD\/147608\/2019"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Excessive sun exposure during childhood increases the risk of skin cancer. This study characterized the knowledge and attitudes of caregivers regarding exposure and sun protection of children and adolescents. One hundred and ninety-eight caregivers (38.5 \u00b1 8.0 years) who resorted to the consultations of a Pediatrics Service or a Family Health Unit answered a questionnaire. The age of children\/adolescents was 6.5 \u00b1 5.1 years. On average, caregivers presented a high level of knowledge regarding exposure and sun protection. One hundred and twenty-six caregivers indicated that they obtained more information about sun protection on social communication, and 66% considered the information provided by healthcare professionals to be enough. One-hundred and fifteen caregivers reported that the child\/adolescent was more exposed to the sun after 4 a.m., and 88% reported applying sunscreen on the beach\/pool and outdoor activities. Fifty-seven percent of caregivers renewed sunscreen application on the child\/adolescent every 2 h, and 94% applied a sun protection factor \u2265 50 in the child\/adolescent. There was a significant association (p &lt; 0.001) between education level and caregivers\u2019 self-knowledge about sun protection (the higher the education, the higher the knowledge), and between the knowledge of the hour of sun exposure avoidance and the time when the child\/adolescent was more exposed to the sun. This study shows that caregivers are highly knowledgeable about exposure and sun protection in children\/adolescents, and their attitudes follow the general recommendations.<\/jats:p>","DOI":"10.3390\/children8111019","type":"journal-article","created":{"date-parts":[[2021,11,7]],"date-time":"2021-11-07T20:41:14Z","timestamp":1636317674000},"page":"1019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sun Exposure in Pediatric Age: Perspective of Caregivers"],"prefix":"10.3390","volume":"8","author":[{"given":"Mafalda","family":"Salvado","sequence":"first","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Cidade do Lis, Centro de Sa\u00fade Dr. Gorj\u00e3o Henriques, 2410-272 Leiria, Portugal"}]},{"given":"Ana","family":"Fraga","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Centro Hospitalar de Leiria, 2410-197 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6653-0616","authenticated-orcid":false,"given":"Diogo Lu\u00eds","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences, University of Beira Interior, 6201-001 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3394-6762","authenticated-orcid":false,"given":"Ivan Miguel","family":"Pires","sequence":"additional","affiliation":[{"name":"Instituto de Telecomunica\u00e7\u00f5es, Universidade da Beira Interior, 6200-001 Covilh\u00e3, Portugal"},{"name":"Escola de Ci\u00eancias e Tecnologia, University of Tr\u00e1s-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal"}]},{"given":"Carmo Coelho","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Vitrius, Centro de Sa\u00fade da Marinha Grande, 2430-269 Marinha Grande, Portugal"}]},{"given":"N\u00e1dia Mendes","family":"Silva","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Cidade do Lis, Centro de Sa\u00fade Dr. Gorj\u00e3o Henriques, 2410-272 Leiria, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.24095\/hpcdp.29.S1.04","article-title":"Ultraviolet radiation","volume":"29","author":"Gallagher","year":"2010","journal-title":"Chronic Dis. Can."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Council on Environmental Health and Section on Dermatology (2011). Ultraviolet Radiation: A Hazard to Children and Adolescents. Pediatrics, 127, 588\u2013597.","DOI":"10.1542\/peds.2010-3501"},{"key":"ref_3","unstructured":"World Health Organization (2017). Artificial Tanning Devices: Public Health Interventions to Manage Sunbeds, World Health Organization."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/phpp.12139","article-title":"The relationship between UV exposure and incidence of skin cancer","volume":"31","author":"Moan","year":"2015","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6202","DOI":"10.3390\/molecules19056202","article-title":"Ultraviolet Radiation, Aging and the Skin: Prevention of Damage by Topical cAMP Manipulation","volume":"19","author":"Yan","year":"2014","journal-title":"Molecules"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1093\/her\/17.4.405","article-title":"Behavior of caregivers to protect their infants from exposure to the sun in Queensland, Australia","volume":"17","author":"Lowe","year":"2002","journal-title":"Health Educ. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1136\/adc.2005.086918","article-title":"Sun exposure and risk of melanoma","volume":"91","author":"Oliveria","year":"2005","journal-title":"Arch. Dis. Child."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s10552-011-9762-3","article-title":"Early-life sun exposure and risk of melanoma before age 40 years","volume":"22","author":"Cust","year":"2011","journal-title":"Cancer Causes Control"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1542\/pir.2016-0233","article-title":"Sun Exposure","volume":"38","author":"Long","year":"2017","journal-title":"Pediatr. Rev."},{"key":"ref_10","unstructured":"RON (2018). Registo Oncol\u00f3gico Nacional 2018, Registo Oncol\u00f3gico Nacional."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1067\/mjd.2000.103984","article-title":"Summertime sun protection used by adults for their children","volume":"42","author":"Robinson","year":"2000","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1177\/0009922815591889","article-title":"Pediatric Sunscreen and Sun Safety Guidelines","volume":"54","author":"Julian","year":"2015","journal-title":"Clin. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.jaad.2007.07.003","article-title":"Sun habits in the children of Southern Italy","volume":"57","author":"Balato","year":"2007","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.pbiomolbio.2011.08.010","article-title":"Childhood exposure to ultraviolet radiation and harmful skin effects: Epidemiological evidence","volume":"107","author":"Green","year":"2011","journal-title":"Prog. Biophys. Mol. Biol."},{"key":"ref_15","first-page":"22","article-title":"Conhecimentos e Atitudes dos Cuidadores acerca da Exposi\u00e7\u00e3o Solar em Idade Pedi\u00e1trica","volume":"45","author":"Leite","year":"2014","journal-title":"Acta Pedi\u00e1tr. Port."},{"key":"ref_16","first-page":"31","article-title":"Prote\u00e7\u00e3o solar: Conhecimentos e h\u00e1bitos na popula\u00e7\u00e3o pedi\u00e1trica","volume":"26","author":"Ribeiro","year":"2017","journal-title":"Nascer E Crescer Birth Growth Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"G\u00f6rig, T., S\u00f6del, C., Pfahlberg, A.B., Gefeller, O., Breitbart, E.W., and Diehl, K. (2021). Sun Protection and Sunburn in Children Aged 1\u201310 Years in Germany: Prevalence and Determinants. Children, 8.","DOI":"10.3390\/children8080668"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Thoonen, K., Schneider, F., Candel, M., de Vries, H., and van Osch, L. (2019). Childhood sun safety at different ages: Relations between parental sun protection behavior towards their child and children\u2019s own sun protection behavior. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7382-0"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s40271-015-0141-0","article-title":"Ethics Review of Survey Research: A Mandatory Requirement for Publication?","volume":"8","author":"Whicher","year":"2015","journal-title":"Patient-Patient-Cent. Outcomes Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Alsoghair, M., Almazyad, M., Alburaykan, T., Alsultan, A., Alnughaymishi, A., Almazyad, S., Alharbi, M., Alkassas, W., Almadud, A., and Alsuhaibani, M. (2021). Medical Students and COVID-19: Knowledge, Preventive Behaviors, and Risk Perception. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18020842"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/BF02310555","article-title":"Coefficient alpha and the internal structure of tests","volume":"16","author":"Cronbach","year":"1951","journal-title":"Psychometrika"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Hisham, R., Ng, C.J., Liew, S.M., Lai, P.S.M., Chia, Y.C., Khoo, E.M., Hanafi, N.S., Othman, S., Lee, P.Y., and Abdullah, K.L. (2018). Development and validation of the Evidence Based Medicine Questionnaire (EBMQ) to assess doctors\u2019 knowledge, practice and barriers regarding the implementation of evidence-based medicine in primary care. BMC Fam. Pract., 19.","DOI":"10.1186\/s12875-018-0779-5"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.1111\/pde.12572","article-title":"Good, but Not Perfect: Parental Knowledge About Risk Factors for Skin Cancer and the Necessity of Sun Protection in Southern Germany","volume":"32","author":"Gefeller","year":"2015","journal-title":"Pediatr. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s13187-012-0413-5","article-title":"Improving Sun-Safe Knowledge, Attitude and Behaviour in Parents of Primary School Children: A Pilot Study","volume":"28","author":"Cercato","year":"2013","journal-title":"J. Cancer Educ."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/j.1600-0781.2011.00598.x","article-title":"Parental perspective on sun protection for young children in Bavaria","volume":"27","author":"Li","year":"2011","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gefeller, O., Uter, W., and Pfahlberg, A. (2016). Protection from Ultraviolet Radiation during Childhood: The Parental Perspective in Bavaria. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13101011"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/jdv.12897","article-title":"Comparison of sun protection modalities in parents and children","volume":"29","author":"Mortier","year":"2015","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1067\/mpd.2003.mpd039","article-title":"Sunburn reduction through parental role modeling and sunscreen vigilance","volume":"142","author":"Geller","year":"2003","journal-title":"J. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Horv\u00e1th, Z., Evelin, C.A., Ol\u00e1h, P., Gyulai, R., and Lengyel, Z. (2021). Results of a Primary Skin-Cancer-Prevention Campaign in Early Childhood on Sun-Related Knowledge and Attitudes in Southern Hungary. Cancers, 13.","DOI":"10.3390\/cancers13153873"},{"key":"ref_30","first-page":"CD011061","article-title":"Educational programmes for primary prevention of skin cancer","volume":"2018","author":"Langbecker","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4768","DOI":"10.3390\/ijerph110504768","article-title":"The Impact of Parental Knowledge and Tanning Attitudes on Sun Protection Practice for Young Children in Germany","volume":"11","author":"Gefeller","year":"2014","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ypmed.2016.05.016","article-title":"Long-term development of parental knowledge about skin cancer risks in Germany: Has it changed for the better?","volume":"89","author":"Gefeller","year":"2016","journal-title":"Prev. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"K\u00f8ster, B., S\u00f8ndergaard, J., Nielsen, J.B., Christensen, K.B., Allen, M., Olsen, A., and Bentzen, J. (2017). Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178190"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1007\/s00103-017-2570-5","article-title":"Knowledge and sources of knowledge about skin cancer risk factors in parents of 3 to 6 year old children","volume":"60","author":"Uter","year":"2017","journal-title":"Bundesgesundheitsblatt Gesundheitsforsch. Gesundh."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Uter, W., Eversbusch, C., Gefeller, O., and Pfahlberg, A. (2021). Quality of Information for Skin Cancer Prevention: A Quantitative Evaluation of Internet Offerings. Healthcare, 9.","DOI":"10.3390\/healthcare9020229"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1111\/pde.14330","article-title":"Characterizing online searches in pediatric dermatology","volume":"37","author":"Schlarbaum","year":"2020","journal-title":"Pediatr. Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"345","DOI":"10.29021\/spdv.75.4.873","article-title":"Euromelanoma in Portugal 2010\u20132016","volume":"75","author":"Filipa","year":"2018","journal-title":"J. Port. Soc. Dermatol. Venereol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1111\/j.1365-4632.2010.04474.x","article-title":"Review: Ultraviolet radiation and skin cancer","volume":"49","author":"Narayanan","year":"2010","journal-title":"Int. J. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.ijheh.2013.07.013","article-title":"Determinants of inadequate parental sun protection behaviour in their children\u2014Results of a cross-sectional study in Germany","volume":"217","author":"Klostermann","year":"2014","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_40","first-page":"139","article-title":"Sun exposure and sun protection practices of children and their parents","volume":"102","author":"Kiely","year":"2009","journal-title":"Ir. Med. J."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Vashist, P., Tandon, R., Murthy, G.V.S., Barua, C.K., Deka, D., Singh, S., Gupta, V., Gupta, N., Wadhwani, M., and Singh, R. (2020). Association of cataract and sun exposure in geographically diverse populations of India: The CASE study. First Report of the ICMR-EYE SEE Study Group. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227868"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Tang, Y., Ji, Y., Ye, X., Wang, X., Cai, L., Xu, J., and Lu, Y. (2015). The Association of Outdoor Activity and Age-Related Cataract in a Rural Population of Taizhou Eye Study: Phase 1 Report. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0135870"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1002\/pon.3888","article-title":"Keeping kids sun safe: Exploring parents\u2019 beliefs about their young child\u2019s sun-protective behaviours","volume":"25","author":"Hamilton","year":"2016","journal-title":"Psycho-Oncology"},{"key":"ref_44","first-page":"e123","article-title":"Time required for a standard sunscreen to become effective following application: A UV photography study","volume":"32","author":"Aguilera","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/1203475419856611","article-title":"Sunscreen Application, Safety, and Sun Protection: The Evidence","volume":"23","author":"Li","year":"2019","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_46","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade (2013). Programa Nacional de Sa\u00fade Infantil e Juvenil 2013."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/11\/1019\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:26:43Z","timestamp":1760167603000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/11\/1019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,6]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["children8111019"],"URL":"https:\/\/doi.org\/10.3390\/children8111019","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,6]]}}}