Defining the need for skin cancer prevention education in uninsured, minority, and immigrant communities

Audrey A. Jacobsen, Ana Galvan, Claudina Canaan Lachapelle, Cheryl B. Wohl, Robert Kirsner, John Strasswimmer

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

IMPORTANCE As the minority population increases in the United States, the incidence of skin cancer has important public health consequences, including poor skin cancer outcomes, in part because of late-stage diagnosis. Therefore, it is important to identify obstacles in skin cancer prevention in these communities. OBJECTIVE To characterize skin cancer prevention and education needs in uninsured, minority, and immigrant communities in South Florida. DESIGN, SETTING, AND PARTICIPANTS At a large free medical clinic in Florida, a convenience sample of people completed a 23-question survey in English, Spanish, or Haitian Creole assessing their skin cancer risk perception, knowledge, sun protective behaviors and barriers, and desirable outreach methods. All participants were uninsured and living at least 200% below the federal poverty level. Participants were adults recruited from the general waiting room who understood 1 of the 3 languages and were not present for a scheduled dermatology visit. MAIN OUTCOMES AND MEASURES The survey used Likert-type scales, true or false, and yes or no questions. Data were analyzed with SPSS IBM statistical software (version 22) using 1-way analysis of variance, 2 tests, and Pearson correlations. RESULTS Among the 219 people invited, 206 participants (mean [SD] age, 43 [13.2] years) completed the survey; 75% of respondents were women who usually worked indoors. Almost a quarter (49 [24.5%) had never heard of skin cancer or melanoma. Nearly half (89 [44.3%]) had never conducted a self-skin examination. One in 5 (41 [20.7%]) believed that people with dark skin cannot get skin cancer. Three quarters (156 [75.7%]) of respondents fell into the "low/inconsistent" sun protective behavior category. Barriers to sun-protective behaviors were "using sun protection is too hot" (75 participants [39.3%]) and "I forget." (72 [37.7%]). More than 85% (175 [87.9%]) wanted to learn more about how to prevent skin cancer. Watching a video (37.3%) and text messaging (30.8%) were identified as the most popular outreach methods. CONCLUSIONS AND RELEVANCE Important barriers to skin cancer prevention were lack of knowledge, the belief that dark skin was protective, and using sun protection made them feel too hot. Skin cancer education and intervention efforts in uninsured, minority, immigrant populations may be provided by videos and text messaging.

Original languageEnglish (US)
Pages (from-to)1342-1347
Number of pages6
JournalJAMA Dermatology
Volume152
Issue number12
DOIs
StatePublished - Dec 1 2016

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Skin Neoplasms
Education
Solar System
Text Messaging
Skin
Delayed Diagnosis
Poverty
Dermatology
Population
Melanoma
Analysis of Variance
Language
Software
Public Health
Surveys and Questionnaires
Incidence

ASJC Scopus subject areas

  • Dermatology

Cite this

Defining the need for skin cancer prevention education in uninsured, minority, and immigrant communities. / Jacobsen, Audrey A.; Galvan, Ana; Lachapelle, Claudina Canaan; Wohl, Cheryl B.; Kirsner, Robert; Strasswimmer, John.

In: JAMA Dermatology, Vol. 152, No. 12, 01.12.2016, p. 1342-1347.

Research output: Contribution to journalArticle

Jacobsen, Audrey A. ; Galvan, Ana ; Lachapelle, Claudina Canaan ; Wohl, Cheryl B. ; Kirsner, Robert ; Strasswimmer, John. / Defining the need for skin cancer prevention education in uninsured, minority, and immigrant communities. In: JAMA Dermatology. 2016 ; Vol. 152, No. 12. pp. 1342-1347.
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N2 - IMPORTANCE As the minority population increases in the United States, the incidence of skin cancer has important public health consequences, including poor skin cancer outcomes, in part because of late-stage diagnosis. Therefore, it is important to identify obstacles in skin cancer prevention in these communities. OBJECTIVE To characterize skin cancer prevention and education needs in uninsured, minority, and immigrant communities in South Florida. DESIGN, SETTING, AND PARTICIPANTS At a large free medical clinic in Florida, a convenience sample of people completed a 23-question survey in English, Spanish, or Haitian Creole assessing their skin cancer risk perception, knowledge, sun protective behaviors and barriers, and desirable outreach methods. All participants were uninsured and living at least 200% below the federal poverty level. Participants were adults recruited from the general waiting room who understood 1 of the 3 languages and were not present for a scheduled dermatology visit. MAIN OUTCOMES AND MEASURES The survey used Likert-type scales, true or false, and yes or no questions. Data were analyzed with SPSS IBM statistical software (version 22) using 1-way analysis of variance, 2 tests, and Pearson correlations. RESULTS Among the 219 people invited, 206 participants (mean [SD] age, 43 [13.2] years) completed the survey; 75% of respondents were women who usually worked indoors. Almost a quarter (49 [24.5%) had never heard of skin cancer or melanoma. Nearly half (89 [44.3%]) had never conducted a self-skin examination. One in 5 (41 [20.7%]) believed that people with dark skin cannot get skin cancer. Three quarters (156 [75.7%]) of respondents fell into the "low/inconsistent" sun protective behavior category. Barriers to sun-protective behaviors were "using sun protection is too hot" (75 participants [39.3%]) and "I forget." (72 [37.7%]). More than 85% (175 [87.9%]) wanted to learn more about how to prevent skin cancer. Watching a video (37.3%) and text messaging (30.8%) were identified as the most popular outreach methods. CONCLUSIONS AND RELEVANCE Important barriers to skin cancer prevention were lack of knowledge, the belief that dark skin was protective, and using sun protection made them feel too hot. Skin cancer education and intervention efforts in uninsured, minority, immigrant populations may be provided by videos and text messaging.

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