Original article
Skin cancer education and early detection at the beach: A randomized trial of dermatologist examination and biometric feedback

https://doi.org/10.1016/j.jaad.2010.01.040Get rights and content

Background

There are limited data on the effectiveness of skin cancer prevention education and early detection programs at beaches.

Objectives

We evaluate 4 strategies for addressing skin cancer prevention in beach settings.

Methods

This prospective study at 4 beaches included 4 intervention conditions: (1) education only; (2) education plus biometric feedback; (3) education plus dermatologist skin examination; or (4) education plus biometric feedback and dermatologist skin examination. Outcomes included sun protection behaviors, sunburns, and skin self-examinations.

Results

There was a significant increase in hat wearing, sunscreen use, and a reduction in sunburns in the education plus biometric feedback group (odds ratio = 1.97, 1.94, and 1.07, respectively), and greater improvements in knowing what to look for in skin-self examinations (odds ratio = 1.13); there were no differences in frequency of self-examinations. Skin examinations plus biometric feedback led to greater reductions in sunburns. The dermatologist examinations identified atypical moles in 28% of participants.

Limitations

Inclusion of only one beach per condition, use of self-report data, and a limited intervention period are limitations.

Conclusions

Education and biometric feedback may be more effective than education alone for impacting sun protective attitudes and behaviors in beachgoing, high-risk populations.

Section snippets

Methods

Four popular and crowded beaches in low- to middle-income communities in the Boston, MA, area participated in this study, each randomized to receive one of the 4 different education programs delivered on a community education van.

Eligibility criteria included being: (1) aged 18 years and older; (2) able to understand, speak, and read English; and (3) able to give informed consent. Analyses were restricted to Caucasians because of the few African Americans and Hispanics at the beaches and their

Baseline findings

In all, 596 beachgoers were eligible for the study and enrolled (Fig 1); 532 completed the final survey (89% response rate). Participants overall were middle-aged, and were at high risk for skin cancer as reflected by fair complexion and burning history (Table I); of note, almost 60% had received a sunburn in the previous month, and sun protection practices overall were relatively poor. There were significant baseline differences in demographic characteristics by condition including sex,

Discussion

From 2- to 4-fold risks of melanoma have been associated with intermittent sun exposure incurred at beaches.23, 24, 25 In this study of beachgoers, we observed fewer sunburns, more sunscreen use and hat-wearing, and improvement in knowing what to look for when conducting a SSE, in the biometric feedback groups, compared with conditions not including biometric feedback. The Community Preventive Services Task Force26 concluded that there is sufficient evidence for sun protection interventions in

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    Supported by an unrestricted grant from the SHADE Foundation of America.

    Conflicts of interest: None declared.

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