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Adolescents’ use of purpose built shade in secondary schools: cluster randomised controlled trial

BMJ 2009; 338 doi: (Published 17 February 2009) Cite this as: BMJ 2009;338:b95
  1. Suzanne J Dobbinson, senior research fellow1,
  2. Vanessa White, research officer2,
  3. Melanie A Wakefield, director1,
  4. Kris M Jamsen, research fellow3,
  5. Victoria White, deputy director1,
  6. Patricia M Livingston, senior research fellow4,
  7. Dallas R English, director3,
  8. Julie A Simpson, senior lecturer3
  1. 1Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Vic 3053, Australia
  2. 2Lincoln Centre for Research on Ageing, Australian Institute for Primary Care, La Trobe University, Bundoora, Vic 3086
  3. 3Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton
  4. 4Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Melbourne, Vic 3215
  1. Correspondence to: S Dobbinson Suzanne.Dobbinson{at}
  • Accepted 30 October 2008


Objective To examine whether students use or avoid newly shaded areas created by shade sails installed at schools.

Design Cluster randomised controlled trial with secondary schools as the unit of randomisation.

Setting 51 secondary schools with limited available shade, in Australia, assessed over two spring and summer terms.

Participants Students outside at lunch times.

Intervention Purpose built shade sails were installed in winter 2005 at full sun study sites to increase available shade for students in the school grounds.

Main outcome measure Mean number of students using the primary study sites during weekly observations at lunch time.

Results Over the study period the mean change in students using the primary study site from pre-test to post-test was 2.63 (95% confidence interval 0.87 to 4.39) students in intervention schools and −0.03 (−1.16 to 1.09) students in control schools. The difference in mean change between groups was 2.67 (0.65 to 4.68) students (P=0.011).

Conclusions Students used rather than avoided newly shaded areas provided by purpose built shade sails at secondary schools in this trial, suggesting a practical means of reducing adolescents’ exposure to ultraviolet radiation.

Trial registration Exempt.


  • We thank the school staff and students who participated in this study. We also thank the shade sail manufacturer and the research assistants without whom this study would not have been possible.

  • Contributors: SJD developed the original study idea, was principal investigator, and, with MAW, Victoria White, PML, and DRE, developed the trial design and protocols and directed the conduct of the study. Vanessa White helped to refine the study protocols, recruited the schools, and coordinated the intervention and collection of outcome measures. KMJ did the statistical analysis with direction from JAS and DRE. SJD, MAW, and Victoria White assisted with interpretation of results. SJD, MAW, and KMJ drafted the manuscript. All authors critically reviewed the article and approved the submitted manuscript. SJD is the guarantor.

  • Funding: The study was funded by a research project grant (ID 265902) from the Australian National Health and Medical Research Council. The building of the shade sails was covered by the research grant, and the manufacturer did not provide any funding to this study.

  • Competing interests: None declared.

  • Ethics approval: The Cancer Council Victoria’s Human Research Ethics Committee approved the research (HREC 0402), as did the education authorities.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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