With the recent dramatic rise in the incidence of skin cancer in the U.S., mortality from the disease is also increasing.  Unfortunately, while most Americans are aware of the link between skin cancer and sun exposure, most are not taking the necessary steps to protect their skin – especially adolescents and young adults ages 14-25.  Choose Your Cover, a national, multi-year mass media campaign featuring TV and radio PSAs, a web site, and targeted partnership development, broke through the clutter of health communications in 2000 to communicate the danger of sun exposure and sunburn and present skills-building messages to enable young people to make smart choices.  The campaign, which featured cutting-edge television production technology, reached more Americans than any other PSA campaign during the summer months of 2000 – the prime time for unprotected sun exposure.   


The primary challenges we faced on this project were twofold.  The first was the continuing scientific debate over the role that sunscreens play in skin cancer prevention and the need, therefore, to promote additional behaviors to protect one’s skin.  Not surprisingly, our research revealed that sunscreen is by far the most acceptable option for adolescents and young adults, while other options – such as covering up with clothing and staying in the shade – are rejected almost entirely.  Therefore, we faced the challenge of balancing the public health perspective with messages and images that research indicated would appeal to and motivate our target audience.  

Our second major challenge was to persuade the target population -- traditionally resistant to public health messages and behavior change – that skin cancer is relevant to them and that protecting one’s skin is important in the long-term prevention of skin cancer.  To accomplish this, we relied on our extensive focus group research, which revealed that preventing the immediate pain and embarrassment of sunburn is a powerful motivator for protecting one’s skin.  Through careful planning and execution, we were able to overcome these challenges and develop a science-based yet entertaining public service campaign that communicates both the immediate and long-term consequences of unprotected sun exposure. 


In late May 2000, Ogilvy Public Relations Worldwide/Washington and the Centers for Disease Control and Prevention (CDC) launched a new phase of a national skin cancer prevention initiative – Choose Your Cover.  This phase is the third year of what is expected to be a five-year initiative.  Communications objectives are to:

  • Raise awareness of sun protective options;  
  • Raise awareness of the link between sunburns and skin cancer; and  
  • Motivate Americans to increase sun protective behaviors. 

Our short-term measure of success was to generate at least 300 million audience impressions through a national public service campaign.  CDC is using long-term surveillance mechanisms to measure behavioral changes.  


Choose Your Cover was developed with extensive research and materials testing, including:

  • A comprehensive review of skin cancer-related epidemiology and behavioral science literature.  
  • Research about media consumption habits of adolescents and young adults.  
  • Eight focus groups with adolescents in two cities to explore issues related to sun exposure/skin protection, and identify and explore benefits, barriers and motivators to protecting one’s skin from UV rays.  
  • Twelve focus groups with adolescents in three cities to assess knowledge, attitudes and behaviors regarding sunscreen use and test reactions to existing skin cancer prevention messages and materials.   
  • Four focus groups with parents ages 25-44 in two cities to evaluate existing materials for broader audience appeal.  
  • Ten focus groups with adolescents and young adults in two cities to evaluate existing materials and test new concepts, messages and approaches for TV and radio PSAs.  
  • Ten focus groups with adolescents and young adults in two cities to test potential executions for PSAs.  
  • Intercept interviews with parents ages 25-44 to test concepts for sunscreen-specific materials.

Messages were drawn from this focus group research, which revealed that: (1) young people are most motivated by short-term consequences, especially sunburns’ pain and embarrassment; (2) the knowledge (often unknown) that even a few serious sunburns increase one’s risk for skin cancer motivates skin protection; (3) young people lead busy lives and skin protection is often not thought of; and (4) young people do not want to be “preached to.”


Our strategy comprised two tracks of activity: a national mass media campaign (TV and radio PSAs, web site) to communicate our messages to a broad audience; and strategic partnerships with both public and private sector organizations to extend the reach and impact of our messages.  Research suggested that adolescents and young adults are not likely to be motivated by emotional or fear-inducing messages, or by messages that are “preachy.”  Rather, clever, humorous, straightforward approaches that offer an immediate benefit of behavior change were deemed more likely to catch their attention and earn their respect.  Thus, we linked the immediate negative consequences of sunburn (e.g., pain, embarrassment) with the long-term health consequence – increased risk of getting skin cancer.  To avoid a “preachy” tone, we developed and emphasized the campaign theme, Choose Your Cover, which offers our audience options for skin protection.


With roughly eight months to research, plan, produce and launch the campaign, we developed several planning documents to guide the process.  These included plans for: research; creative materials development, production, and distribution; collaboration with third-party partners; web site redesign; and media outreach.  We also developed a clearance package for CDC and HHS review and a comprehensive campaign timeline.  

PSA and Web Site Development, Production, Distribution and Marketing:  We developed and produced a series of six TV and five radio PSAs (samples enclosed) and re-designed a campaign web site .  This involved developing and testing initial concepts; choosing talent; coordinating recording and filming; creating packaging that appeals to public service directors; coordinating distribution; and redesigning and promoting the web site to adolescent- and young adult-oriented Internet sites.

The TV PSAs – ranging in length from :60 to :15 to provide maximum flexibility for airplay – were distributed to 1,000 local, cable and network stations.  Our research confirmed that most individuals think to protect their skin around water but not at other times; therefore, we depicted a variety of activities to remind young people that their skin is vulnerable whenever they are outside. 

The 30-second radio PSAs were produced and distributed to 3,000 target stations on CD to appeal to various segments within the adolescent and young adult population.  These ranged from a coach urging her teenage female players to use sunscreen to a science-fiction spot featuring an evil villain, “UV Ray.”

Partnerships: Partnerships included: 

State Departments of Health.  We coordinated with health departments in states with high incidences of skin cancer to localize national materials and provide technical assistance for state skin cancer prevention initiatives.  This included:  localized tags on the TV PSAs for 14 states; customized PSA distribution lists; campaign logo and graphics on zip disks; media outreach tips; and counsel on getting local PSA airtime.

U.S. Synchronized Swimming.  Through a partnership with the U.S. Synchronized Swimming Olympic Team, the Olympic athletes adopted skin cancer as their “cause” and participated in media initiatives surrounding the Olympics, including a press conference with DHHS Secretary Donna Shalala in Sydney, Australia.  In addition, we created a poster, “Sun Protection. Think in Synch,” which was unveiled during a press event at the National Synchronized Swimming Championships in April 2000 and is being distributed at synchronized swimming events nationwide throughout the year.  (Sample enclosed.)

Seventeen Magazine.  As an additional means to reach our adolescent target audience and engage them in the issue, we partnered with Seventeen Magazine to promote a poster design contest through both the Beauty section of the June 2000 magazine and the Seventeen web site