Sun protection in outdoor workers – Development and validation of standardized questionnaires for behavior and knowledge

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Background and objectives: Outdoor workers are at increased risk of developing non-melanoma skin cancer. We aimed to address the lack of validated German-language measurement instruments for outdoor workers’ sun safety behavior and knowledge by compiling and validating two questionnaires. Participants and methods: By expert consensus, items for the assessment of protective behavior (OccuSun) were compiled based on existing instruments. For knowledge, a translation of the Skin Cancer and Sun Knowledge (SCSK) scale was selected. After a pre-test, a validation study including 68 outdoor workers (62% female) was conducted in 2020. Results: The retest reliability was r = 0.93 (95% confidence interval: 0.86–0.96) for the protection score and rs = 0.78 (0.67–0.86) for the knowledge score. Protective behaviors were correlated with respective diary data (0.38 ≤ rs ≤ 0.74, p < 0.001) and skin pigmentation changes (–0.23 ≥ rs ≥ –0.42, 0.007 ≤ p ≤ 0.165) but not with self-reported sunburn frequency (0.21 ≥ rs ≥ –0.04). Conclusions: Among German outdoor workers, two questionnaires for the assessment of sun protection behavior (OccuSun) and knowledge (SCSK) demonstrated good reliability. The OccuSun had generally good validity. Both instruments are fit for subsequent validation to determine their sensitivity to change.


Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalJDDG - Journal of the German Society of Dermatology
Issue number5
Early online date25 Mar 2024
Publication statusPublished - 25 Mar 2024

External IDs

PubMed 38528320
ORCID /0000-0001-8649-9196/work/158766448
ORCID /0000-0001-9905-1999/work/158767144
ORCID /0000-0002-4411-3088/work/158767152


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