Original article
Effectiveness of a knowledge-based intervention for melanoma among those with ethnic skin

https://doi.org/10.1016/j.jaad.2009.08.047Get rights and content

Background

Among patients with melanoma, ethnic minorities are 1.96 to 3.01 times as likely to die from melanoma as Caucasians of the same age and sex.

Objective

We sought to assess the effectiveness of a melanoma early detection educational intervention among those with ethnic skin.

Methods

A consecutive convenience sample of patients received instruction on the ABCDEs of melanoma and skin self-examination. Self-report questionnaires assessing knowledge, attitudes, and behaviors were completed before, and immediately and 3 months after, the intervention.

Results

Among the 71 participants, 21% reported a skin phenotype with at least sometimes burning. Knowledge that melanoma is a skin cancer and of the warning signs of melanoma significantly increased after the intervention and was retained at 3 months. The perception of being at risk to develop a melanoma significantly increased after the intervention and was retained at 3 months (P < .001). Monthly checking of the skin, especially acral sites (palms, soles, periungual), increased significantly immediately after the intervention.

Limitations

A limitation is accrual from dermatology patients, who may be more inclined to perform skin self-examination compared with the general minority population.

Conclusions

People of color benefit from specific physician recommendations explaining their risk to develop melanoma and which anatomic sites to check. Acral lentiginous melanoma among ethnic minorities tends to present in non-sun-exposed but visible areas, particularly volar and subungual sites; therefore, skin self-examination educational materials for minority populations should incorporate these anatomic sites.

Section snippets

Participants

In the summer of 2007, consecutive patients seeking care for skin disorders at the Northwestern Center for Ethnic Skin in Chicago, IL, were recruited by the research associate (RA) before their visit with the dermatologist. For the purposes of the study, we defined ethnic skin and skin of color as encompassing subjects with the following self-reported ethnic groups: African American, Asian/Pacific Islander, Hispanic, or mixed ethnicity. Other entry criteria included being older than age 18

Results

The population was predominantly female and African American (Table II). Attrition reduced the population responding to the 3-month telephone interview from 93 participants to 71. The characteristics of those entering the study and completing the 3 month telephone survey are similar (no significant differences between completers and noncompleters of 3-month survey).

Among these people of color, 21% reported a skin phenotype with at least sometimes burning and 32% reported having at least one

Discussion

Our educational intervention was effective in improving knowledge that melanoma is a skin cancer, the warning signs of melanoma, the perception of being personally at risk to develop melanoma, and the behaviors of monthly skin checking of acral sites immediately and with persistence 3 months after the intervention. The educational intervention may have enhanced the perception of personal risk because participants had a history of sunburns, which they recognized as a risk for developing

References (16)

There are more references available in the full text version of this article.

Cited by (0)

Funding sources: None.

Conflicts of interest: None declared.

Denotes co-first authors

View full text