Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Michelle Kabakibi, DNP, FNP-C, AGNP-C


Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to prospectively evaluate the ability to alter the behavior of young adults by providing sunscreen education and thereby reduce their risk of skin cancer from sun exposure. Twenty-three collegiate athletes ages 18 to 21 years old who were on the university softball team were enrolled. These student athletes were then educated about the impact of daily sun protection and risk factors. The goal was to observe an increase in sunscreen use and increase sun exposure awareness.

Background: Skin cancer is the most frequently diagnosed cancer in the United States. In ages 20-29 melanoma of the skin is the third most common cancer. One of the most effective ways to prevent skin cancer in young adults is UV skin protection. Outdoor sport athletes specifically have higher rates of sun exposure, thereby leading to additional risk of melanoma. Based on primary and secondary research, many college athletes lack a basic understanding of skin cancer.

Methods: UV exposure risk and sun protective behaviors were determined by using The Sun Exposure and Protection Index (SEPI). This questionnaire was administered to female softball players before and after the intervention period. Athletes were instructed to apply SPF 50 to any unexposed skin once daily for 14 days before sun exposure. One 15-minute educational session was completed where materials about melanoma were distributed, and sun protection was discussed. This education session was conducted prior to the intervention period.

Results: Twenty-three students participated in the evidence-based practice project and results were primarily evaluated on SEPI Part 2. SEPI Part 2 consists of five questions ranked zero to four with the total score ranging from 0 to 20. The average score of the SEPI Part 2 was 9.65 before the intervention. After the intervention, the average score decreased to 8.81 which reflects an increase in sun protection habits. While these results are not statistically significant, these small behavior changes will likely have a positive impact over the long term.

Evaluation: Sunscreen application and UV risk screening are successful in targeting behaviors correlated with melanoma risk. If properly incorporated, appropriate sun exposure behaviors decrease lifetime skin cancer risk for college athletes. While this evidence is encouraging, additional efforts are needed to expand educational programs, further reinforce sunscreen application, and modify young adults’ behaviors towards sunscreen use.