Increase in melanoma knowledge in Latino patients after a targeted digital educational program

testing, and implementing the survey

To the Editor: Latinos are the largest US ethnic group and are projected to become one-third of the US population by 2060. 1 As the US Preventive Services Task Force does not have sufficient evidence to support melanoma screening for the general population, targeted education may serve as a better focus for mitigating skin cancer risk in the Latino population. 2 The Mayo Clinic Institutional Review Board approved this study.Recruitment included emailing a 4% random sample (4151 patients) of Mayo patients who identified as Latino; additional recruitment included Facebook and Instagram advertisements and posts on the Mayo Clinic's website and social media channels.The baseline, postintervention, and 3-month follow-up survey questions were adopted from the War on Melanoma, the National Institutes of Health 2015 questionnaire, and Eilers et al. 3 The material included acral melanomas and Latino patient images and was translated into Spanish.The Melanoma Knowledge Score (MKS) encompassed questions on identifying phenotypes and behaviors associated with melanoma risk, warning signs for melanoma, and how to prevent and detect melanoma early.It was calculated as the sum of correctly answered true items (13) minus incorrectly answered false items (10).A P value of \.05 was considered statistically significant.
Patient demographics, baseline sun-protective behaviors, and baseline MKS are presented in Table I for 394 patients who completed the baseline survey.Sunscreen use was reported by 75.3%, with 31.3% reporting daily application.Based on comparison of Fitzpatrick I/II/III (n ¼ 175) with Fitzpatrick IV/V/VI (n ¼ 206), sunscreen was used by 81.7% and 69.4% of patients, respectively (P ¼ .006).In total, 44.6% of patients reported undergoing a skin examination by a dermatologist or other kind of doctor, 19.3% reported being taught to perform a self-skin examination, 11.6% reported performing a head-to-toe self-skin examination in the last 3 months, and 8.5% reported helping a family member or friend with a self-skin examination in the last 3 months.
Patient demographics and comparisons between baseline, postintervention, and 3-month follow-up sun-protective behaviors and MKS are presented in Table II.Participants reported an average of 22% increase in their MKS (P \ .001)and maintained an 11% increase at the 3-month follow-up (P \.001).
Our study demonstrates that developing melanoma educational materials that are culturally relevant and focused on Latino populations can provide persistent improvements in melanoma knowledge, sun-protective behaviors, self-skin examinations, and helping friends or family members perform self-skin examinations.However, MKS and sunprotective behaviors decreased at 3 months, suggesting that repeated education or reminders are needed to retain long-term, durable responses.To our knowledge, this is the first Latino melanoma educational program leveraging social media.Latinos at higher risk of sun-induced melanoma will likely benefit from self-full-body self-skin examination and daily sunscreen use; however, Latinos at low risk of sun-induced melanoma may derive the most benefit from a focused acral and mucosal selfexamination. 4,5The decrease in retention rates between baseline and postintervention questionnaires was a limitation.
Our study demonstrates that developing melanoma educational materials that are culturally relevant and focused on Latino populations can provide persistent improvements in melanoma knowledge.Patient consent: The authors obtained signed written consent from identifiable patients for their photographs and medical information to be published in print and online with the understanding that this information may be publicly available.Patient consent forms were not provided to the journal but were retained by the authors.No identifiable information was collected from patients recruited by social media, and our IRB deemed these individuals exempt from signing a written consent.These patients had to agree to a written informed consent before participation.

Table I .
Entire cohort demographics and baseline sun-protective behaviors (n ¼ 394) ª 2023 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Table II .
Three-month follow-up cohort demographics and melanoma knowledge (n ¼ 57)

Table I .
Cont'd testing, and implementing the survey.Lastly, we thank our translation team, Patricia Contag and Ruth Dahlstrom.This publication was supported by the Mayo Clinic Cancer Center and Grant Number P30 CA015083 from the National Cancer Institute.Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the National Institutes of Health.