Optimising Knowledge, Attitudes and Behaviours Regarding Sun Exposure in Australian Public Hospital Dermatology Patients: The Sunshine Study

ABSTRACT Background Referral guidelines and anecdotal evidence from public dermatology services indicate that patients referred to these services are often at high risk of developing future skin cancers or having poor skin cancer outcomes due to immunosuppression, a high skin cancer burden, or lesions that are difficult to manage. The Sunshine study aimed to capture knowledge, attitudes and behaviours related to sun exposure, sun protection and vitamin D among public hospital dermatology outpatients. Methods Adult patients attending the dermatology outpatient service at the University Hospital from August to December 2023 completed a survey assessing sun exposure knowledge, attitudes and behaviours. We reported these overall and within three patient groups: immunosuppressed; history of skin cancer; presenting with an inflammatory dermatology condition. Results We analysed data from 311 participants (immunosuppressed = 81; skin cancer = 122; inflammatory conditions = 108). Over 60% of patients were unaware of the UV index threshold for sun protection and over‐estimated the time outdoors required to maintain adequate vitamin D status. Most patients did not routinely apply sunscreen, including those in the immunosuppressed and skin cancer groups, and this was particularly poor on body sites other than the face. There was also inadequate use of sun protection during outdoors exposure across all groups. Conclusions Knowledge and use of sun protection were poor in this high‐risk population. Dermatologists are ideally placed to identify and address patients' barriers to sun protection, and this should be a priority in this high‐risk setting where prevention is paramount.