Pool Cool Diffusion Trial

Funded by the National Cancer Institute (NCI), Pool Cool was a sun-safety education program especially designed for use at swimming pools. Its main objective was to increase awareness, motivation, and sun protection practices among children ages 5-10 who take swimming lessons, their parents, aquatics staff, and other pool users. The Pool Cool program has been evaluated in several studies, and the name Pool Cool has been used for multiple research projects.

Pool Cool website


Efficacy Trial

Glanz K, Geller AC, Shigaki D, Maddoc JE & Isnec MR. A randomized trial of skin cancer prevention in aquatic settings: The Pool Cool program. Health Psychology, 21, 579-587, 2002.

Geller A, Glanz K, Shigaki D, Isnec MR, Sun T & Maddock J. Impact of skin cancer prevention on outdoor aquatics staff: The Pool Cool program in Hawaii and Massachusetts. Preventive Medicine, 33, 155-161, 2001.

Dissemination and Diffusion

Hall D, Escoffery C, Nehl E, Glanz K. Spontaneous diffusion of an effective skin cancer prevention program through web-based access to program materials. Preventing Chronic Disease, 7(6): 2010.

Hall D, McCarty F, Elliott T & Glanz K. Lifeguards' sun protection habits and sunburns: Association with sun-safe environments and skin cancer prevention program participation. Archives of Dermatology, 145(2), 139-144, 2009.

Hall D, Elliott T, Nehl E & Glanz K. Effectiveness of a targeted, peer-driven skin cancer prevention program for lifeguards.International Journal of Aquatic Research and Education, 2, 287 - 297, 2008.

Glanz K, Steffen A, Elliott T & O'Riordan D. Diffusion of an effective skin cancer prevention program: Design, theoretical foundations, and first-year implementation. Health Psychology, 24(5), 477-487, 2005.

Process Evaluation

Rabin BA, Nehl E, Elliott T, Deshpande AD, Brownson RC, Glanz K. Individual and setting level predictors of the implementation of a skin cancer prevention program: a multilevel analysis. Implementation Science, 5:40, 2010.

Elliott T, Glanz K & Nehl E. Characteristics of swimming pools with high rates of objectively measured sunscreen use.Journal of the American Academy of Dermatology, 60, 684-688, 2009.

Escoffery C, Glanz K, Hall D & Elliott T. A multi-method process evaluation for a skin cancer prevention diffusion trial. Evaluation and the Health Professions. Evaluation Health Professional, 32, 184, 2009.

Hall D, Dubruiel N, Elliott T & Glanz K. Linking agents' activities and communication patterns in a study of the dissemination of an effective skin cancer prevention program. Journal of Public Health Management and Practice, 2009.

Escoffery C, Glanz K & Elliott T. Process evaluation of the Pool Cool Diffusion Trial for skin cancer prevention across 2 years. Health Education Research, 23(4), 732-743, 2008.

Glanz K, Isnec MR, Geller A & Spangler K. "Process evaluation of implementation and dissemination of a sun safety program at swimming pools." In Steckler A, Linnan L (Eds.), Process Evaluation in Public Health Interventions (pp. 58-82). San Francisco: Jossey-Bass, 2002.

Methods and Validation

Elliott T, Nehl E & Glanz K. A controlled trial of objective measures of sunscreen and moisturizing lotion. Cancer Epidemiology, Biomarkers & Prevention, 18(5), May 2009.

Gies P, Glanz K, O'Riordan D, Elliott T, Nehl E. Measured occupational solar UVR exposures of lifeguards in pool settings.American Journal of Industrial Medicine, 52, 645-653, 2009.

Glanz K, McCarty F, Nehl E, O'Riordan D, Gies P, Bundy L, Locke A & Hall D. Validity of self-reported sunscreen use by parents, children and lifeguards. American Journal of Preventive Medicine, 36(1), 63-69, 2009.

O'Riordan DL, Nehl E, Gies P, Bundy L, Burgess K, Davis E & Glanz K. Validity of covering-up sun protection habits: Association of observations and self-report. Journal of the American Academy of Dermatology, 2009.

Glanz K, Yaroch AL, Dancel M, Saraiya M, Crane LA, Buller DB, et al. Measures of sun exposure and sun protection practices for behavioral and epidemiologic research. Archives of Dermatology, 144, 217-222, 2008.

O'Riordan DL, Glanz K, Gies P & Elliott T. A pilot study of the validity of self-reported ultraviolet radiation exposure and sun protection practices among lifeguards, parents and children. Photochemistry and Photobiology, 84(3), 774-778, 2008.

Glanz K & Mayer J. Reducing ultraviolet radiation exposure to prevent skin cancer. American Journal of Preventive Medicine, 29(2),131-142, 2005.

O'Riordan DL, Lunde KB, Urschitz J & Glanz K. A noninvasive objective measure of sunscreen use and reapplication.Cancer Epidemiology, Biomarkers & Prevention, 14(3), 722-726, 2005.

Other Related Publications

Kim B, Glanz K, Nehl E. Vitamin D Beliefs and Associations with Sunburns, Sun Exposure, and Sun Protection. In Press,International Journal of Environmental Public Health, 2012.

Glanz K, Buller DB & Saraiya M. Reducing ultraviolet radiation exposure among outdoor workers: State of the evidence and recommendations. Environmental Health, 6(22), 2007.

Glanz K, Halpern AC & Saraiya M. Behavioral and community interventions to prevent skin cancer. Archives of Dermatology, 142, 356-360, 2006.

Glanz K & Saraiya M. Using evidence-based community and behavioral interventions to prevent skin cancer: Opportunities and challenges for public health practice (Editorial). Preventing Chronic Disease: Public Health Research, Practice, and Policy, 2(2), 2005.

Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D, et al. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation - A systematic review. American Journal of Preventive Medicine, 27, 422-466, 2004.


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