Promoting sun safety among US Postal Service letter carriers: impact of a 2-year intervention

Am J Public Health. 2007 Mar;97(3):559-65. doi: 10.2105/AJPH.2005.083907. Epub 2007 Jan 31.


Objectives: We examined whether US Postal Service letter carriers who received a sun safety intervention would wear wide-brim hats and sunscreen significantly more often than those who did not receive the intervention.

Methods: We used a 2-group randomized design with 2662 evaluation cohort participants from 70 US postal stations. Evaluations were conducted at baseline, 3 months, 1 year, and 2 years. Questionnaire items assessed occupational use of sun-screen and wide-brim hats. The 2-year sun safety intervention included the provision of wide-brim hats, accessible sunscreen, reminders, and 6 educational sessions.

Results: At the 3-month follow-up evaluations, the odds ratio (OR) for regular sun-screen use was 2.8 times higher among the intervention group than among the control group (95% confidence interval [CI]=2.2, 3.5); at the 2-year follow-up evaluations, the rate was still significantly higher (OR=2.0; 95% CI=1.6, 2.6). Intervention group participants also had significantly higher rates of hat use, with the differences remaining consistent across all follow-ups (OR=2.9; 95% CI=2.3, 3.6).

Conclusions: The intervention should be disseminated to postal stations nationwide and possibly to other occupational groups that work outdoors.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • California
  • Female
  • Health Behavior*
  • Health Education
  • Health Knowledge, Attitudes, Practice
  • Health Promotion*
  • Humans
  • Male
  • Middle Aged
  • Occupational Health Services*
  • Postal Service*
  • Primary Prevention
  • Protective Clothing / statistics & numerical data*
  • Reminder Systems
  • Self Efficacy
  • Skin Neoplasms / etiology
  • Skin Neoplasms / prevention & control*
  • Sunlight / adverse effects*
  • Sunscreening Agents / therapeutic use*
  • Workforce


  • Sunscreening Agents