Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida.
The Caridad Center, Boynton Beach, Florida.
JAMA Dermatol. 2016 Dec 1;152(12):1342-1347. doi: 10.1001/jamadermatol.2016.3156.
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.
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.
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, χ2 tests, and Pearson correlations.
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.
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.
随着美国少数族裔人口的增加，皮肤癌的发病率对公共健康有重要影响，部分原因是晚期诊断，导致皮肤癌的预后不良。因此，确定这些社区在皮肤癌预防方面存在的障碍非常重要。
描述美国佛罗里达州南部无保险、少数族裔和移民社区的皮肤癌预防和教育需求。
设计、地点和参与者：在佛罗里达州的一家大型免费医疗诊所，通过便利抽样的方法对 219 名参与者进行了一项包含 23 个问题的调查，这些参与者用英语、西班牙语或海地克里奥尔语回答，内容包括他们对皮肤癌风险的认知、知识、防晒行为和障碍，以及理想的外展方法。所有参与者都没有保险，且生活水平低于联邦贫困线的 200%。参与者为在一般候诊室招募的成年人，他们理解上述 3 种语言之一，且不是预约皮肤科就诊而来。
该调查使用了李克特量表、真/假和是/否问题。使用 IBM SPSS 统计软件（版本 22）进行数据分析，采用单因素方差分析、卡方检验和 Pearson 相关分析。
在受邀的 219 人中，有 206 名参与者（平均[SD]年龄，43[13.2]岁）完成了调查；75%的参与者为女性，通常在室内工作。近四分之一（49[24.5%]）从未听说过皮肤癌或黑色素瘤。将近一半（89[44.3%]）从未进行过自我皮肤检查。五分之一（41[20.7%]）的人认为深色皮肤的人不会得皮肤癌。超过四分之三（156[75.7%]）的参与者被归入“低/不一致”的防晒行为类别。防晒行为的障碍包括“使用防晒措施太热了”（75 名参与者[39.3%]）和“我忘记了”（72 名参与者[37.7%]）。超过 85%（175[87.9%]）的参与者希望更多地了解如何预防皮肤癌。观看视频（37.3%）和短信（30.8%）被认为是最受欢迎的外展方式。
皮肤癌预防的重要障碍是知识缺乏、深色皮肤具有保护作用的信念，以及使用防晒措施会使他们感到过热。在无保险、少数族裔和移民人群中，皮肤癌教育和干预措施可以通过视频和短信来提供。
