title: Dermatologic health literacy in underserved communities: a case report of south Los Angeles middle schools.
abstract: BACKGROUND
  The incidence of melanoma and other skin cancers has risen drastically in the United States.  As with most types of cancer, the prognosis and survival rates are significantly improved with early diagnosis, but dismal for patients who present with advanced disease.  It remains a fact that although melanoma is most common in Caucasian populations, ethnic minorities have a worse prognosis. Our hypothesis in this dermatologic health literacy study was that before necessary education, the required fund of knowledge with respect to skin cancer risk is lacking in several ethnic communities, but that intended compliance occurs when educational intervention occurs.
  
  
  METHODS
  Three middle schools in South Los Angeles with predominantly Latino and African American youth were surveyed. Permission was obtained from the principals of the middle schools for the multi-day educational initiative. A total of 150 students were ultimately recruited and a pre-intervention survey administered. After preliminary review of the pre-intervention dermatologic health literacy results, a set of "core" learning concepts about sun safety were summarized and solidified for incorporation into the adolescent-appropriate sun safety protection pamphlet that was designed by designers at UCLA/Johnson &amp; Johnson Health Care Institute. A full day of education on skin disease and the importance of sun protection from an early age was executed, followed three months later by a post-intervention visit that assessed compliance with the sun protection products and intended future use.
  
  
  RESULTS
  Results from the pre- and post-intervention surveys/questionnaires were analyzed and interpreted. Of 150 pre-intervention surveys that were distributed, 54 identified as African American and 96 of whom identified as Latino. Of these, 75% of Latino students reported having a sunburn in the last year, whereas only 38.9% of African American students reported a sunburn.  A total of 80% of the students reported as least some use of sunscreen in the 3 months prior to the post-intervention survey.  Only 8% of African American students reported "everyday" use, whereas 24% of Latino students reported "everyday" use (P &lt; 0.05).  A total of 94% of the students intend to wear sunscreen in the future (89% of African American students and 97% of Latino students, with a P &lt; 0.05 calculated using a two-sample t test).  However, it should be noted that more than half (54%) of the total students reported that although they planned to apply the sunscreen daily, they deemed it too expensive, which might prevent consistent future use.
  
  
  CONCLUSIONS
  Our hypothesis in this dermatologic health literacy study was that before necessary education, the required fund of knowledge with respect to skin cancer risk is lacking in several ethnic communities, but that intended compliance occurs when educational intervention occurs.  The data, both quantitative and qualitative, demonstrate that our hypothesis is substantiated.
authors.affiliation: UC Irvine Medical Center; David Geffen School of Medicine at UCLA. LaChapman@mednet.ucla.edu.
authors.forename: Lance W
authors.initials: LW
authors.lastname: Chapman
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ochoa
authors.forename: Francesca
authors.initials: F
authors.lastname: Tenconi
authors.forename: Ariella
authors.initials: A
authors.lastname: Herman
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008507:Medically Underserved Area; D008545:Melanoma / Q000208:ethnology / Q000517:prevention & control*; D010174:Pamphlets; D012574:Schools; D012878:Skin Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D013471:Sunburn / Q000208:ethnology / Q000517:prevention & control; D013473:Sunscreening Agents / Q000627:therapeutic use
chemical_list: D013473:Sunscreening Agents