David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria.
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ObjectivesTo test whether shade sails will increase the use of passive recreation areas (PRAs).MethodsWe conducted a stratified randomized pretest-posttest controlled design study in Melbourne, Australia, and Denver, Colorado, in 2010 to 2014. We randomized a sample of 144 public parks with 2 PRAs in full sun in a 1:3 ratio to treatment or control. Shade sails were built at 1 PRA per treatment park. The outcome was any use of the study PRA (n = 576 pretest and n = 576 posttest observations; 100% follow-up).ResultsCompared with control PRAs (adjusted probability of use: pretest = 0.14, posttest = 0.17), use of treatment PRAs (pretest = 0.10, posttest = 0.32) was higher at posttest (odds ratio [OR] = 3.91; 95% confidence interval [CI] = 1.71, 8.94). Shade increased use of PRAs in Denver (control: pretest = 0.18, posttest = 0.19; treatment: pretest = 0.16, posttest = 0.47) more than Melbourne (control: pretest = 0.11, posttest = 0.14; shaded: pretest = 0.06, posttest = 0.19; OR = 2.98; 95% CI = 1.09, 8.14).ConclusionsPublic investment in shade is warranted for skin cancer prevention and may be especially useful in the United States.Trial RegistrationClinicaltrials.gov identifier NCT02971709.