Melanoma Awareness Action through Education: Spot a Spot, Save a Life

1
Melanoma Awareness Action through
EducationSpot a Spot, Save a Life!!!

• Jeanette M Waller, William Rietkerk, Jason M
  Phillips, Ken Lam, Jerry McCullough PhD, Kathryn
  Osann PhD, Christopher Zachary FRCP, Kenneth
  Linden MD, PhD
• Joel Myres Melanoma Awareness Project
• University of California, Irvine School of
  Medicine

2
Background Joel Myres Melanoma Awareness Project

• UCI medical students taught gt 5,000 local teens
  in 2004-2005
• Discuss skin and skin cancer, emphasizing
  melanoma prevention self-screening for earlier
  detection
• Spot a Spot,
• Save a Life!!!

3
Curriculum Sample Slides
4
Study Objectives

• To evaluate knowledge, attitudes, and habits of
  Orange County, CA teens regarding sun safety/
  skin cancer
• 2) To assess immediate and lasting impacts of a
  50-minute classroom curriculum addressing these
  topics

5
Methods

• Protocol, all materials approved by UCI IRB
• 1,250 students from 5 Orange County, CA middle
  and high schools (grades 6-12) participated in
  study

• Students completed surveys in their classrooms
• -immediately before education (42 questions)
• -immediately after education (27 questions)
• -three months following education (45 questions)

6
Methods Data Analysis

• Specific indices (Summary Scores) pooled
  responses to related questions and included
• -Risk Factors
• (6 questions regarding skin type, complexion,
  prior sunburn history, etc.)
• -Attitudes
• (4 questions regarding ideas of cosmetic
  effects of sun, level of concern regarding sun
  exposure)
• -Knowledge
• (11 true/false questions about skin cancer, the
  suns effects, and proper sunscreen usage)
• -General Sun-Safety Habits (8 questions
  pertaining to more general habits, i.e. seeking
  shade,
• wearing sunglasses, checking moles,
  etc.)
• -Sunscreen Usage
• (7 questions pertaining specifically to
  sunscreen usage habits)

7
Results Attitudes
(plt0.0005)

• (Not shown)
• Is a suntan beautiful?
• Attitudes regarding aesthetics consistently
  improve immediately after education, but almost
  uniformly return to baseline by 3 months.

(plt0.0005)
8
Results Attitudes Summary Scores
Attitudes may be engrained culturally and cannot
be influenced easily through simple education.
Interestingly, we also found no significant
gender-related differences in our
attitude-related questions.
9
Results Knowledge Summary Scores

• Skin cancer can rarely be cured True/False?
• People can die from skin cancer True/False?
• Water-proof sunscreen only needs to be applied
  once a day, even if you are swimming/ playing in
  the sun all day. True/False?
• The sun is not a danger on cloudy days
  True/False?

(plt0.0005)
Dramatic increase in overall knowledge
immediately after education at Survey 2, with
some drop-off by Survey 3 however, the
improvement remains statistically significant
(plt0.0005).
10
Results General Habits
(plt0.0005)
(plt0.0005)

• Between Surveys 1 and 3, the percentage of
  students who stated they tend to seek shade
  also increased significantly, by approximately
  10 (plt0.0005).

11
Results Sunscreen Usage

• When do you usually apply your sunscreen?
• Do you usually wear sunscreen while playing
  sports?
• -( answering yes changed from 22 -38),
  plt0.0005.
• How often do you usually reapply your sunscreen
  when outdoors?
• - ( responding every 2-4 hours increased from
  38 to 51) plt0.0005.

(plt0.0005)
12
Results Habits Summary Scores

• (Below) Significant increase in proper
  sunscreen use across surveys!!! (plt0.0005)

(plt0.0005)

• (Above) EXCITING and significant improvements
  in practice of safe sun habits/ behaviors persist
  after 3 months!!!

13
How many others have you taught since the lecture?

• Averages 1.63 people taught per student,
  with total of 1110 extra people
  taught by this
  group of 680 teens!

14
Summary of Findings

• Attitudes were relatively unchanged 3 months
  after education. This may reflect the cultural
  matrix in which our attitudes are formed.
• Knowledge improved significantly between surveys
  1 and 3, despite some drop after survey 2.
• Sun-safe habits and proper sunscreen usage showed
  significant and sustained improvements.
• Further analyses pending re impacts of age and
  risk level on knowledge, attitudes, and habits.
• This study provides exciting evidence that this
  50-minute curriculum was effective in teaching
  Orange County teens about skin cancer and
  prevention with lasting impact.

15
Next steps National Expansion

• Interested/ Participating Medical Schools
  Include

• East Carolina University
• Duke University
• University of Virginia
• Mercer University (GA)
• University of Arizona
• University of Colorado
• University of New Mexico
• Loma Linda University
• University of Texas, Southwestern
• Oregon Health Science University
• Medical College of Wisconsin

• Mayo Clinic
• SUNY Downstate
• University of Oregon
• UC San Diego
• University of Oklahoma
• Univeristy of Southern California
• Medical Univeristy of South Carolina
• University of California, Los Angeles

Students learning about melanoma through the
JMMAP in Houston, TX
16
www.spotaspot.org Spot a Spot, Save a Life!!!
17
Acknowledgements

• Many thanks to each of my co-authors for their
  hard work and dedication to the project, and
  tremendous appreciation for the family/ friends
  that have supported us.
• Special thanks to teachers at La Paz Middle
  School, Orange High School, Trabuco Hills High
  School, Laguna Hills High School, and El Toro
  High School for their participation.
• To each of our wonderful medical student
  volunteer teachers- youre making a big
  difference out there! Thank you!
• UC Irvine Genetics and Epidemiology departments
  for their accommodation, and special thanks to
  Pamela Flodman and Greg Meyers for their
  assistance with data processing.
• Thanks to Gabrielle Phillips for designing our
  website!
• Thanks to Dr. Prislin and Dr. Manetta for their
  support of our efforts.
• Sincere gratitude to Barbara and Jerry Myres and
  to Natalie, for sharing Joels memory with us,
  for their ongoing support of our efforts, and for
  their dear friendship.
• (This project was funded by the 2005 Alpha Omega
  Alpha
• Medical Student Service Project Award.)

18
Joels Story

• Joel Myres was born and raised in San Diego,
  CA.
• He loved camping, hiking, backpacking, fishing,
  and
• reading.
• When Joel was just 16, his mother
• noticed a mole on his neck that had
• changed. It was melanoma. It was
• removed without too much trouble and
• Joel went on with his life.
• After high school, Joel went to Spain for 2
  years, and
• then attended BYU for college. He did research in
  
• genetics and archaeology including
• adventurous expeditions to places
• like Peru and Egypt. He analyzed
• DNA from ancient skeletons in a lab
• at BYU and published his work.

19
Joels Story
In 1997, Joel married Natalie, his love from
college. They came to Irvine, where Joel started
medical school at UC Irvine. He continued to do
well academically, making many friends along the
way. Just after hed finished his second year
of medical school, Joel noticed a lump in his
abdomen. It was melanoma that had spread through
his body from so many years before.
Joel battled the cancer courageously and
received the best treatments. Even during
the toughest times, he continued to learn
and study, pursuing his genealogy research
between treatments,
with his wife and familys support.
20
Joels Story

• On March 7, 2001, at age 31, Joel passed away
  from melanoma, less than one year after being
  diagnosed with metastatic melanoma.
• During his lifetime, Joels intelligence,
  goodness, integrity, and remarkable
  accomplishments inspired the lives and earned the
  admiration of all who knew him.
• Joels memory will continue to live on, not only
  in the hearts of all those touched by him, but
  also through this project, as his memory teaches
  young teens the importance of melanoma prevention
  and early detection.