Margaret Collins

Teaching children about skin cancer: the draw-and-write technique as an evaluation tool.

Abstract: Childhood exposure to sunlight is a risk factor for melanoma. To formulate a meaningful program to educate children about the ill effects of the sun, their extant knowledge base must be determined. We have used the “draw‐and‐write” technique to assess childrens perceptions about the sun, suntans, and skin cancer. A total of 693 school children aged 4 to 13 years were asked to draw pictures and label them in response to a series of carefully worded questions. Awareness of the need to apply sunscreen increased from 44% in children aged 4 to 6 years to 95% in children aged 9 to 10 years. Ten percent of children aged 4 to 6 years already perceived a suntan as attractive. While almost all children were aware of the negative immediate effects of sun exposure, namely sunburn, just 30% of American children aged 11 to 13 were aware that sun exposure is a risk for skin cancer. No differences between boys and girls were seen. The “draw‐and‐write” technique allows assessment of the attitudes and perceptions of children regarding the sun and skin cancer. It also provides valuable information on which to base health education and evaluate its cost‐effectiveness.

Health education about sun and skin cancer: language, ideas and perceptions of young children

Summary Excessive sunlight in early childhood is thought to be a risk factor for skin cancer. We report the use of the ‘draw and write’ technique for determining changing perceptions, attitudes and knowledge of young children (aged 4–12 years) to the sun and skin cancer. Children were asked to draw pictures and label them in response to a series of carefully worded invitations and questions. The captions were then analysed to assess changing views and perceptions about particular issues in relation to behaviour in (he sun. Four hundred and sixty children completed the exercise. An increasing spiral of knowledge with age about effects of the sun and appropriate behaviour was demonstrated. The study revealed a relatively high level of knowledge. Misconceptions and stereotypes were demonstrated. This technique is a simple and effective way of eliciting information from children about health issues. It provides baseline data for producing material for health education for children in relation to sun and skin. It is also a method of assessing the effectiveness in young children of health promotion initiatives.

Researching nursery children’s awareness of the need for sun protection: towards a new methodology

Describes a small study to evaluate the usefulness of a song tape to promote sun protection messages to children in nursery schools and to find a method of researching young children’s views that could be used with small groups of children which would be simple to administer and analyse, and which would provide reliable data. Finds that the song tape was useful in stimulating work about the skin and the sun in nursery schools, although it was not the only cause of increased awareness of sun protection issues among the children as a result of the study. From the several methods considered, “draw and talk”, in which the children drew pictures in response to a suggestion and then talked to the researcher, proved to be the most successful in eliciting children’s levels of awareness of the need for sun protection. Draw and talk is an illuminative approach which provides quantifiable data and which could be used for development of other curriculum materials or for evaluation of existing programmes for the nursery age group.

Making others happy

Describes a draw and write exercise for use with primary school children on the theme of making others happy, and the links that this topic has with curriculum guidance on health education. Lists and categorizes some of the responses made by the children and concludes that few children at this age were able to appreciate concepts such as caring for others, putting others first or understanding their point of view. Summarizes ways to develop the exercise.

Putting road safety in the picture

Argues that teaching of road safety should begin in infant schools, if not before. Describes a draw‐and‐write exercise for five‐year‐olds on safety which can encourage discussion of safe places to play and safe places to cross the road. Outlines ways in which this exercise can be followed up. Describes how seven‐year‐olds who took part in a similar draw‐and‐write exercise were already aware of messages such as not to play near roads, that safety helmets should be worn, and that they should use a seat belt in the car.

Practical projects for all to try

Describes the activities and experiences involved in attending a “Promoting Health in Primary Schools” event and concludes that it was illuminating, stimulating and fun. Describes how health education topics may be translated into meaningful and stimulating activities for children and adults by outlining some of the tasks set during the event and the methods of presentation. Concludes by reporting on the positive reactions of some of the participants and how the event has benefited them.

Keeping safe on firework night

Describes a small investigation into keeping safe around fireworks with Key Stage 1 pupils. The investigation used the draw and write technique to find out what children in years 1 and 2 already knew about safety in relation to fireworks. Finds that many were already aware of the danger from fireworks, particularly the need to keep behind a barrier of some kind, and the importance of not putting fireworks in pockets. Year 2 children were much more aware that fireworks could hurt or even kill them. Describes a series of exercises that can provide a starting point for further work to reinforce the message that care needs to be exercised when watching fireworks. Makes suggestions for follow‐up work.

Cycle safety among infant school children

Describes a small investigation into cycle safety with Key Stage 1 pupils. The investigation used the draw and write technique to find out what children in years 1 and 2 knew about safety in relation to riding bicycles. Finds that many children were aware of the need to wear a cycle helmet, and that some wrote about the need to wear knee pads, arm bands or special clothes. Suggests that a session such as that described could provide a useful way to work about keeping safe outdoors, road safety, protective clothing or safe behaviour, or as a useful one‐off session before a school holiday.

Passports to safety

Describes a visit to a “Safety and Me” event organized in Chichester with a view to helping children become aware of the dangers in the world. Discusses the various displays and exhibits, and explains the system of incentives given to the visiting children. Gives an account of the demonstrations and activities taking place at each display and the lessons to be learnt: not to touch strange objects; to evaluate toys for safety; what to do in the event of a gas leak; to check the credentials of strangers and what not to do near rail lines. Describes other displays concerning electricity, water and fire as well as the possible hazards of everyday objects. Considers the whole day immensely interesting and stimulating and beneficial to adults and children alike.