Assessing the Impact of Visual and Audio Media on Sunscreen Use Among People of Color: Pre- and Post-Survey

July 2024 | Volume 23 | Issue 7 | 525 | Copyright © July 2024


Published online June 11, 2024

doi:10.36849/JDD.7821

Symone Fowler-Canty BS, Carolina Puyana MD MSPH, Maria Tsoukas MD PhD

University of Illinois at Chicago, Department of Dermatology, Chicago, IL

Abstract
Background: Poor melanoma outcomes in people of color (POC) are attributed to a variety of factors, including healthcare literacy, socioeconomic status, and healthcare access barriers. 
Methods: We designed a survey to determine if visual and audio media (VAM) would increase POC's understanding of the need for sunscreen and their willingness to use it. Patients recruited at a dermatology clinic were asked to watch a 2.5-minute video on sun protection and complete a pre- and post-survey assessing their knowledge.
Results: Forty-one (41) patients were recruited, 43.9% of whom identified as POC and 31.7% as Hispanic or Latino. In the post-survey, 100% of participants agreed that daily sunscreen use helps prevent sun-related risks, compared to 68% before (P<.0001). 71% of the participants intended to use sunscreen daily after watching the video, compared to 24% who did so before (P<.0001). One-hundred percent (100%) of Black participants in the post-survey agreed that sunscreen wear helps prevent risks associated with sun exposure, compared to 46% in the pre-survey (P=0.0052); no significant difference among White participants (80% vs 100%; P=0.1121).
Limitations: Small sample size, no long-term follow-up.
Conclusions: This study demonstrates the persistence of health disparities and the effectiveness of VAM in enhancing Black patients' healthcare literacy.

J Drugs Dermatol. 2024;23(7):525-528.     doi:10.36849/JDD.7821

INTRODUCTION

It is well understood that people of color (POC) are at lower risk for developing melanoma compared to their white counterparts. However, skin cancer tends to be diagnosed at a more advanced stage leading to a poorer prognosis in POC.1 Poorer melanoma outcomes in POC are attributed to many reasons including differences in healthcare literacy, socioeconomic status (SES), and barriers to healthcare access.2,3 Misinformation among POC regarding the dangers of ultraviolet light exposure and the advantages of sun protection has contributed to the increase in skin cancer mortality and morbidity rates. It is believed that the disproportionate marketing of sunscreen to individuals with lighter skin has perpetuated this misconception.4,5 In order to improve skin cancer outcomes for POC, research indicates that there is a need to improve healthcare literacy regarding skin damage caused by ultraviolet light exposure and the importance of sun protection.1 We designed a study to evaluate the efficacy of using visual and audio media (VAM) to educate POC about skin damage caused by ultraviolet light and the benefits of sunscreen use.

MATERIALS AND METHODS

A Black female medical student recorded a 2.5-minute video on the dangers of ultraviolet light to the skin and sun protection. The video also included diagrams of the different types of sunscreens and an example of the type of sunscreen patients should use. These diagrams and examples served as visual aids for those watching the video. 

Participants were recruited in the waiting room of a university dermatology clinic in a metropolitan area. Patients were required to be between 20 and 80 years old to participate in the study. Each participant watched the video and completed a pre- and post-video survey as seen in Table 1. The pre- and post-surveys assessed their knowledge of sun-induced skin damage, the necessity of sunscreen, their confidence in wearing it correctly, and their current sunscreen practices/motivation. Results were summarized and univariate analyses were performed using Chi-square tests, P values were calculated with an alpha of 0.05. SAS software, version 8.6 was used to perform all data analysis (copyright 2019 SAS Institute Inc, Cary, NC).
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