Table 1.
Content-related aspects of counselling with regard to UV protection for skin cancer prevention according to [8]: Absolute and relative frequencies of occurrences as well as, in the last two lines, the distribution of the content completeness score and the global quality score, respectively, for the four search queries A, B, C, and D (for the definition of A to D, see Methods). Q1, first quartile; Q3, third quartile.
| Criterion | A: n (%) | B: n (%) | C: n (%) | D: n (%) |
|---|---|---|---|---|
| Number of relevant web pages | 103 | 120 | 81 | 128 |
| 1 Addressing UV-related hazard | ||||
| 1.1 Association with skin cancer | 101 (98.1) | 79 (65.8) | 46 (56.8) | 83 (64.8) |
| 1.2 Leisure time exposure | 27 (26.2) | 16 (13.3) | 7 (8.6) | 2 (1.6) |
| 1.3 Exposure in some occupations | 16 (15.5) | 15 (12.5) | 2 (2.5) | 3 (2.3) |
| 1.4 Dependency on season and time of day | 16 (15.5) | 20 (16.7) | 9 (11.1) | 17 (13.3) |
| 1.5 Dependency on weather (clouds) | 18 (17.5) | 6 (5) | 7 (8.6) | 7 (5.5) |
| 1.6 Altitude (sea level, mountains) | 25 (24.3) | 25 (20.8) | 5 (6.2) | 17 (13.3) |
| 1.7 Reflection by the ground (soil, sand, snow, water) | 32 (31.1) | 44 (36.7) | 18 (22.2) | 48 (37.5) |
| 1.8 Exposure in the shade | 26 (25.2) | 30 (25) | 24 (29.6) | 40 (31.2) |
| 1.9 Exposure also with overcast sky | 34 (33) | 31 (25.8) | 21 (25.9) | 29 (22.7) |
| 1.10. What is UV (UV-A/-B/-C) | 34 (33) | 27 (22.5) | 8 (9.9) | 11 (8.6) |
| 2 Motivation to change behavior: Avoid UV radiation | 74 (71.8) | 92 (76.7) | 75 (92.6) | 105 (82) |
| 3 Avoid strong sun exposure | ||||
| 3.1 Schedule outdoor activities to morning or evening | 15 (14.6) | 14 (11.7) | 8 (9.9) | 9 (7) |
| 3.2 “Shadow rule”: Shadow shorter than object casting it = strong UV exposure | 2 (1.9) | 2 (1.7) | 3 (3.7) | 0 (0) |
| 4 Avoid midday sun | ||||
| 4.1 Mentioning of “Need to avoid” | 63 (61.2) | 67 (55.8) | 50 (61.7) | 90 (70.3) |
| 4.2 Definition of the critical period (mostly 11:00–15:00) | 46 (44.7) | 48 (40) | 42 (51.9) | 55 (43) |
| 5 Mentioning “Stay in the sun as brief as possible” | 7 (6.8) | 2 (1.7) | 1 (1.2) | 0 (0) |
| 6 Seek shade | ||||
| 6.1 Mentioning of “Seek shade” | 31 (30.1) | 37 (30.8) | 36 (44.4) | 36 (28.1) |
| 6.2 Mentioning of diffused radiation e.g., on the beach or beneath umbrella | 8 (7.8) | 6 (5) | 2 (2.5) | 1 (0.8) |
| 7. Avoid sunburn | ||||
| 7.1 Mentioning of “Avoid sunburn” | 23 (22.3) | 18 (15) | 15 (18.5) | 48 (37.5) |
| 7.2 Skin cancer risk is strongly increased by sunburns | 48 (46.6) | 45 (37.5) | 35 (43.2) | 78 (60.9) |
| 8 UV-Index (UVI) | ||||
| 8.1 Explanation of the UVI | 19 (18.4) | 17 (14.2) | 9 (11.1) | 10 (7.8) |
| 8.2 Sun protection related to UVI recommended | 11 (10.7) | 10 (8.3) | 3 (3.7) | 10 (7.8) |
| 8.3 Explanation where UVI information is published | 23 (22.3) | 16 (13.3) | 8 (9.9) | 11 (8.6) |
| 9 Mentioning of “Slow adaptation of the skin to sun exposure” | 14 (13.6) | 23 (19.2) | 5 (6.2) | 24 (18.8) |
| 10 Wearing of sun-protective clothing | ||||
| 11.1 Sun protection factor mentioned | 45 (43.7) | 72 (60) | 44 (54.3) | 34 (26.6) |
| 11.2 Long-sleeved clothing | 27 (26.2) | 23 (19.2) | 17 (21) | 22 (17.2) |
| 11.3 Special beach/swimming garments | 10 (9.7) | 12 (10) | 16 (19.8) | 3 (2.3) |
| 12 Sunscreens | ||||
| 12.1 Correct mentioning as “Last/subsidiary measure” | 25 (24.3) | 17 (14.2) | 11 (13.6) | 0 (0) |
| 12.2 Mentioning of adequate sun protection factor | 70 (68) | 81 (67.5) | 52 (64.2) | 96 (75) |
| 12.3 Application of a sufficient quantity (2 mg/cm2) | 46 (44.7) | 44 (36.7) | 21 (25.9) | 27 (21.1) |
| 12.4 Application before sun exposure | 38 (36.9) | 41 (34.2) | 32 (39.5) | 55 (43) |
| 12.5 Repeat application e.g., after swimming (not providing longer protection) | 53 (51.5) | 55 (45.8) | 52 (64.2) | 61 (47.7) |
| 12.6 Waterproof sunscreens recommended | 19 (18.4) | 27 (22.5) | 22 (27.2) | 24 (18.8) |
| 13 Sensitivity against sunlight | ||||
| 13.1 Mentioning of Fitzpatrick skin types or “Celtic type” | 36 (35) | 42 (35) | 16 (19.8) | 60 (46.9) |
| 13.2 Counselling depending on skin type of patient | 24 (23.3) | 12 (10) | 1 (1.2) | 15 (11.7) |
| 14 Presentation of Fitzpatrick skin type or “Celtic type” | 28 (27.2) | 23 (19.2) | 9 (11.1) | 26 (20.3) |
| 15 Reference to drug information on possible adverse reactions to sun | 13 (12.6) | 17 (14.2) | 6 (7.4) | 24 (18.8) |
| 16 Children | ||||
| 16.1 Children should not sustain sunburn | 17 (16.5) | 18 (15) | 15 (18.5) | 9 (7) |
| 16.2 Infants should not be exposed to direct sunlight | 30 (29.1) | 34 (28.3) | 44 (54.3) | 33 (25.8) |
| 17 Avoid sunbeds: Any justification/detail | 45 (43.7) | 21 (17.5) | 4 (4.9) | 18 (14.1) |
| 18. Sunglasses | ||||
| 18.1 Reference to sufficiently UV-protective quality | 32 (31.1) | 48 (40) | 30 (37) | 25 (19.5) |
| 18.2 European norm EN 1836 mentioned | 1 (1) | 3 (2.5) | 0 (0) | 0 (0) |
| 18.3 Glare categories mentioned | 3 (2.9) | 10 (8.3) | 2 (2.5) | 0 (0) |
| Content completeness score (Median; Q1–Q3) | 11 (8–15) | 10 (5–16) | 9 (5–13) | 9 (6–13) |
| Global quality score (Median; Q1–Q3) | 3 (2–5) | 3 (1–4) | 3 (2–4) | 3 (2–3) |