Table 1 Program planning components and their application in the Clever in Sun and Shade Program (CSSP)

1. Participatory input

To include persons that are most affected by a program in the planning

Young athletes, coaches, parents, and teachers have been included in the PPP process to develop CSSP.

2. Stakeholder check-in

To include stakeholders with influence necessary for program implementation

School administrators have been included in the PPP process to develop CSSP.

3. Definition of need and program purpose

To define the need or challenge to be addressed by the program and its purpose

The need for a sun protection program for sports schools arises due to high dosages of ultraviolet (UV) radiation in young athletes, UV radiation being a major risk factor for skin cancer, and an overall low rate of sun protection behavior in this target group.

On the organisational level, the purpose of the Clever in Sun and Shade Program is to support sports schools in establishing UV protection strategies. On the individual level, CSSP wants to enforce positive attitudes, intentions, and behavior toward UV protection (UVP).

4. Resource and asset mapping

To determine what resources and assets are available for the program from participants and community

Participants of the future CSSP are young athletes, coaches, parents, teachers, and school administration. Each target group not only presents needs concerning sun protection but also brings along assets and resources that can be of great value to the program. For example, athletes and coaches show a high rate of commitment as well as a high regard for health. Parents contribute to the wish for their child’s well-being whereas teachers and school administration can add the framework and expertise to impart knowledge about sun protection behavior.

5. Ecological environment assessment

To determine the purpose of the program within the context of program participants lives

Schools as an ecological environment can be used to teach students health behavior [14]. Referring to CSSP, the relationships between individuals, for example young athletes among each other, but also in relation to their coaches, teachers, and parents, respectively, are considered on the micro level. The connections between young athletes, coaches, and schools as well as sports leagues and associations are regarded on the meso level.

6. Program design or replication

To determine what type of program might be most appropriate to plan

To achieve positive attitudes and intentions toward sun protection, a method mix as well as a targeted approach was chosen to be used in the development of CSSP. In CSSP, the messages of sun protection are to be communicated using various methods and materials: On one hand, target groups are to be addressed personally via multipliers in school (teachers and trainers via school management, students via teachers, and trainers). On the other hand, posters and videos should reach different target groups through the targeting approach. Targeted messages are based on characteristics of population subgroups to make them relevant to individuals [15].

7. Program theory

To define the explicit components of the program and the assumptions underlying its success

The theory underlying CSSP on the individual level is the health action process approach (HAPA [17];). HAPA is based on the assumption that the adoption, initiation, and maintenance of health behaviors can be described as a process that consists of a motivation phase and a volition phase. Specific cognitions such as perceived self-efficacy, risk perceptions, and outcome expectancies are considered to be important along the process of changing attitudes and should be included in program planning [18, 19]. Regarding risk perception, high UV exposure as a main risk factor for skin cancer is introduced. Outcome expectancies are addressed by account of possible consequences of a high UV exposure, i.e., aging skin and poorer physical performance. The presentation of UVP measures as “easy to implement” target at promoting self-efficacy. Volitional processes are particularly supported by the manual and teaching materials, e.g., addressing the handling of barriers. The behavior self-check poster and integration of UVP into the school year plan promote sustainability of UVP behavior.

Based on social learning theory [20, 21], for all students a former canoe world champion as well as student athletes of grade 9 to 11 were chosen as role models for the videos. For adults, the ambassador for skin cancer prevention of German Cancer Aid, a coach, a teacher and one parent were chosen.

On the organizational level, CSSP uses the setting approach. Understanding school as a setting [22], CSSP is not only designed to influence individual determinants of behavior among specific target groups (e.g., students, teachers) but also school processes and structures. CSSP introduces a manual holding wording for UVP policy and further materials available to implement UVP into school structures.

8. Program goals

To create agreed upon program goals and objectives that define the purpose of the program

On the organizational level, CSSP aims at supporting sports schools in establishing UV-protection strategies:

100% of schools that are awarded to be a CSSP school should establish a sun protection strategy including informing all target groups and supporting UVP-measurements.

On the individual level, CSSP wants to enforce positive attitudes and intentions toward UV protection:

70% of students/young athletes, coaches and teachers of schools that are awarded to be a CSSP school should know about UVP.

70% of parents of students in schools that are awarded to be a CSSP should know about UVP.

70% of students/young athletes, coaches, teachers, and parents of schools that are awarded to be a CSSP school should rate adherence to UVP in training and competition as being important.

70% of students/young athletes of schools that are awarded to be a CSSP school should apply UVP as much as possible in regard to the respective sport disciplines.

9. Policy considerations

To identify the larger macro structures such as funding and outside support

Policies that are regarded in developing CSSP concern students’ health, occupational safety, guidelines of the national cancer initiative, and “healthy school” (Gesunde Schule). For example, the resolution of the German Conference of Ministers of Culture on “Health Promotion and Prevention in Schools” recommends using the setting approach for school interventions. Interventions should also be circumstance and behavior oriented and designed to be participatory [23].

10. Evaluation plan

To develop a plan for an on-going participatory evaluation of the program as well as a time line for external, outcome evaluations

In developing CSSP an evaluation approach has been considered early: Data collection on program acceptance and feasibility has been included into the PPP process. Summative evaluation will follow in a subsequent study.