Date of this Version

4-9-2021

Document Type

DNP Project

Abstract

Abstract

Background. Skin cancer is the most common cancer diagnosed in the United States. Malignant melanoma is the least common skin cancer type but the deadliest form causing the vast majority of skin cancer deaths. Its incidence has increased dramatically worldwide, being the sixth most commonly diagnosed cancer in the USA in both genders in 2018. Fair-skinned patients have the highest incidence of melanoma and, for this reason, receive more education than other groups. Minority groups are more likely to have melanomas that metastasize and have poorer outcomes than Non-Hispanic Whites. Blacks and Hispanics do not use daily skin cancer protective strategies and are less knowledgeable about skin cancer risks and prevention methods than Non-Hispanic Whites (NHW). A lack of public education efforts tailored toward minorities, socioeconomic status, access to care, and a lack of early diagnosis is thought to contribute to the disparity in survival rates between minorities and NHW.

Method: A Quality Improvement Project with a Quasi-Experimental Design was developed to increase Hispanic patients' knowledge about skin cancer risks and protective behaviors. A convenience sample of 30 Hispanic patients aged 20-65 who attended a Dermatology Clinic to receive medical attention for skin conditions different from skin cancer was recruited between June 19th and September 4th, 2020. Local advertisements posted in the waiting and exam rooms and medical assistants' help were very useful in recruiting the participants. The whole implementation of the QIP was online using a telemedicine platform DermConnect Doxy. me, and Qualtrics. After completing a pre-intervention survey, the participants received an educational intervention that encompassed a PowerPoint Presentation and a practical demonstration of how to perform a self-skin examination and to apply the sun protector effectively. Immediately after the implementation of the educational intervention, the patients completed the post-intervention survey. The data was collected, processed, and analyzed using Qualtrics.

Results: After the Educational Intervention, there was an overall group knowledge average improvement of 58.3%. Although 63.3% of participants were able to identify the association between tanning salon use and skin cancer, and 70% were capable of recognizing melanoma as a type of skin cancer previous to the intervention, some areas of knowledge deficit were identified. These areas were: the association between blistering sunburn occurrence during childhood and adolescence and the increased melanoma incidence in adulthood, the skin cancer types, the alarming melanoma signs, the typical sites where melanoma appears in Hispanics, and the right frequency to perform the self-skin examination and to visit the dermatologist. Most participants did not recognize the use of sunglasses and sun exposure avoidance between 10:00 AM to 4:00 PM as sun-protective methods in the pre-intervention surveys. Melanomas could also appear from the retinal pigment cells, and sunglasses' use is an appropriate strategy to prevent them in this localization.

Conclusions: This cultural-sensitive Educational Intervention effectively raised Hispanic participants' knowledge about skin cancer risks and protective behaviors. Primary prevention through education is decisive to reduce the incidence of the different types of Skin Cancers and specifically melanoma, not only among Hispanics but also in any other ethnic group. It is crucial to start educating Hispanics as earlier as in childhood and adolescence due to the strong association between sunburns occurring during these early years of life and Malignant Melanoma's appearance later in adulthood.

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