A day at the beach

Key Points

Boston - To get the message out about skin cancer awareness to people in underserved areas, why not take the message to the beach?

That's what Harvard University students, and Dana Farber Cancer Institute nurses and affiliated dermatologists, have done for two summers.

The success of the Boston Skin Cancer Screening Initiative for the underserved has become a model for a nationwide outreach effort, says volunteer participant Stephanie Hu, a second-year medical student, Harvard Medical School, Boston.

In the trenches

During the summers of 2005 and 2006, Ms. Hu and a few medical interns, along with Dana Farber-affiliated social workers, a nurse and volunteer dermatologists, went to Boston area beaches.

Ms. Hu says these beaches are frequented by people in lower income brackets and from medically underserved neighborhoods. The first week of beach visits, during which volunteers park the van and set up tables with materials and giveaways, is devoted to education. Ms. Hu and others on the outreach team make themselves available to passers-by who want more information.

"We tell people who visit us the first week that they can come back on the same day, same time and same place the following week and have a dermatologist check any areas of concern or provide a free full-body skin exam," Ms. Hu tells Dermatology Times.

Mission: Intervention

The first part of the outreach intervention involves educating passers-by about skin cancer risks, prevention and symptoms.

Those who stop by the van sign a waiver and are eligible to receive not only educational brochures, but also free sunscreens and more.

The second outreach intervention involves having participants put their heads into a Dermascan, so that they can see lighted areas of sun damage.

"We talk them through it and tell them what they are seeing," Ms. Hu says. "Participants usually are pretty scared when they see this, because it looks horrible when the UV light reflects on their skin."

As a third intervention, volunteers take regular Polaroid photos showing "before" representations of participants' skin, as well as Polaroid photos with a UV camera, showing "after" images, to remind them of their sun-damaged areas and how the sun is affecting their skin.

The final intervention involves giving people the choice to come back for a dermatological skin screening.

"While they are waiting, we have them fill out a questionnaire, which is like a quiz. The front asks them about how much time they spend in the sun and other questions, to get an idea of their exposure. The back is a quiz, asking questions such as 'When is it the best time to be out in the sun?' and 'Is it true that if you are in the water, you are protected from the sun?' This is to get a sense of their baseline knowledge," Ms. Hu says.

Many find that having the exam done on the way to the beach is convenient, because they are already in their bathing suits, according to Ms. Hu.

She says the program has worked to detect cancer and, she believes, to promote skin cancer prevention and awareness.

Spreading the word

In 2005, the volunteers gave skin cancer screenings to more than 120 people, and "We educated many more," she says.

Of those examined, dermatologists referred 19 people for follow-up; nine of those needed biopsies and two were diagnosed with skin cancer.