“Goodbye Sunshine”: Effects of a television program about melanoma on beliefs, behavior, and melanoma thickness

doi:10.1016/0190-9622(91)70258-4

Journal of the American Academy of Dermatology

Volume 25, Issue 4, October 1991, Pages 717-723

https://doi.org/10.1016/0190-9622(91)70258-4 Get rights and content

Of 333 persons interviewed after a television show about the effects of melanoma, 113 (34%) saw the show and 73% believed that the sun protection/skin examination message applied to them. Fifty-six percent of persons examined their own skin and 36% examined someone else's skin after seeing the program. Fifteen persons (4.5% of the total sample) planned to visit a doctor for an abnormal skin spot as a result of the program, of whom three actually did so within 4 weeks of the show. An increase of 167% was observed in the number of melanomas diagnosed in the 3 months after the show, compared with those diagnosed in the same period the year before. There was a significant shift in the proportion of tumors removed in the thin, easily cured stage. The high rate of diagnosis of new tumors and the high proportion of thin tumors was maintained a year after the program. By extrapolation from these figures, it is estimated that 208,000 Victorians out of a total population of 4.1 million intended to seek a consultation after a single television program. Of these, it is estimated that about 27,000 actually sought attention in the month after the viewing.

References (9)

GG Giles et al.
Trends in skin cancer in Australia—an overview of the available data
Transcripts of Menzies Foundation
(1989)
CM Balch et al.
A comparison of prognostic factors and surgical results in 1786 patients with localised (Stage I) melanoma treated in Alabama, USA, and New South Wales, Australia
Ann Surg
(1982)
S Nichols
Effect of a public campaign about malignant melanoma on general practitioner work-load in South Hamptom
Br Med J
(1988)
VR Doherty et al.
Experience of a public education programme on early detection of cutaneous malignant melanoma
Br Med J
(1988)

There are more references available in the full text version of this article.

Cited by (70)

Impact of melanoma diagnosis on sun protection
2010, Actas Dermo-Sifiliograficas
El conocimiento sobre los peligros de la exposición solar no siempre se traduce en cambios en el comportamiento. Esto es particularmente alarmante en pacientes de alto riesgo.
a) Evaluar el impacto del diagnóstico de melanoma en los conocimientos, actitudes y hábitos sobre fotoprotección, y b) analizar qué factores pueden influir en el cambio de hábitos de fotoprotección.
Usando un cuestionario anónimo y codificado que recogía datos clinicodemográficos, 195 pacientes con reciente diagnóstico de melanoma fueron interrogados sobre los conocimientos, hábitos y actitudes sobre fotoprotección antes y después del diagnóstico y sobre los sentimientos de angustia y culpabilidad tras el mismo.
El 66% de los pacientes optimizó su conducta tras el diagnóstico. Un 15% mantuvo conductas deficientes, a pesar de que el 98% de los sujetos refería haber recibido consejos de fotoprotección tras el diagnóstico. Las mujeres optimizaron su conducta 4 veces más que los hombres. El subgrupo de pacientes que mejoró presentaba conductas más deficientes que el subgrupo que no mejoró. Aquellos que experimentaron sentimientos de angustia y culpa tras el diagnóstico presentaron mayor probabilidad de optimizar su conducta. La edad, la localización tumoral, la agresividad terapéutica y la creencia de que el bronceado es saludable no tuvieron influencia significativa en la modificación de la conducta.
El diagnóstico de melanoma lleva consigo un aumento en los conocimientos y un cambio favorable en los hábitos de fotoprotección. A pesar de ello, las medidas de fotoprotección no son lo suficientemente adecuadas. La evaluación de las barreras hacia la fotoprotección óptima puede ser la clave para diseñar programas educacionales específicos.
Knowledge of the dangers of sun exposure does not always lead to changes in behavior. Failure to make behavioral adjustments is of particular concern in high-risk patients.
a) To assess the impact of melanoma diagnosis on knowledge, attitudes, and behaviors relating to sun protection, and b) to identify factors that could influence sun protection behaviors.
A coded, anonymous questionnaire was given to 195 patients with a recent diagnosis of melanoma. Data were collected on clinical and demographic variables and on knowledge, attitudes, and behaviors relating to sun protection before and after diagnosis. The questionnaire also addressed patients’ sense of distress and guilt following diagnosis.
Sun protection behaviors improved following diagnosis in 66% of patients. Although 98% of patients reported having received advice on sun protection following diagnosis, 15% continued to take inadequate sun protection measures. The probability of behavioral improvement following diagnosis was 4 times greater in women than in men. The subgroup of patients whose behavior improved had worse behaviors prior to diagnosis than did those who showed no improvement. Patients who expressed distress and feelings of guilt following diagnosis were more likely to improve their sun protection behavior. Age, tumor site, intensiveness of treatment, and belief that a suntan is healthy had no significant influence on behavioral change.
Melanoma diagnosis is associated with increased knowledge of sun protection measures and improvement in behaviors. Nevertheless, patients continue to use inadequate sun protection measures. Identification of barriers to optimal sun protection behavior may be instrumental in designing targeted educational campaigns.
Evaluation of a school intervention program to modify sun exposure behaviour
2007, Actas Dermo-Sifiliograficas
El cáncer de piel melanoma y no-melanoma es el tumor más prevalente y más frecuente en el mundo, la exposición solar es el factor de riesgo más importante. La infancia y la adolescencia es el periodo de la vida en el cual la exposición solar es mayor. La intervención para modificar hábitos ante el sol es fundamental para la prevención del cáncer cutáneo.
Realizamos un estudio cuasiexperimental sobre una población escolar de Granada capital de 11 y 12 años con un test previo a casos y controles, intervención con programa educativo a grupo de casos y test posterior a ambos grupos. Muestreo aleatorio por conglomerados. Cuestionario autocumplimentado. Muestra de 628 adolescentes de colegios e institutos de Granada. Estadístico utilizado: Test de Mc Nemar y Wilcoxon.
Tras la intervención, el grupo de casos mejoraba ampliamente los resultados tanto en conocimientos sobre sol y piel (OR = 2,89), sol y medio ambiente (OR = 2,23) y sol y salud (OR = 1,4) como en actitudes y conductas sanas con respecto al sol, (OR = 4,2), siendo esta diferencia estadísticamente significativa, frente al grupo control.
Antes de planificar una campaña de prevención primaria de cáncer de piel es necesario saber los conocimientos y comportamientos de la población a la que se dirige. En segundo lugar se debe insistir en el riesgo de la exposición solar intermitente aguda y en el uso de los diferentes medios de fotoprotección. Por último hay que señalar que en el grupo de nuestro estudio ha disminuido la frecuencia de quemadura solar.
Nonmelanoma skin cancer is the most prevalent and incident tumor in the world, being sun exposure the most important risk factor. Childhood and adolescence are the periods where sun exposure is greatest. An intervention to modify sun-related behaviours is essential for skin cancer prophylaxis.
We carried out a quasi-experimental study on a school population of Granada with ages ranging from 11-12 years. The control and study groups completed a questionnaire prior to the intervention with educational program and thereafter. We performed a random conglomerate sampling of 628 teenagers. Statistical analysis was carried out using the Mc Nemar and Wilcoxon tests.
After the intervention, the study group showed marked improvement in the results concerning knowledge about sun exposure and skin (OR = 2.89), sun exposure and environment (OR = 2.23), and sun exposure and health (OR = 1.4) as well as in attitudes and healthy behaviour regarding sun exposure (OR = 4.2). This difference was statistically significant compared to the control group.
1. Before planning a campaign for primary prophylaxis of skin cancer it is necessary to know the information and knowledge of the target population. 2. The risk of acute, intermittent sun exposure and the use of different means of photoprotection should be stressed. 3. In our study group the rate of sun burn has decreased.
Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: A systematic review
2004, American Journal of Preventive Medicine
Citation Excerpt :
Details of the qualifying studies can be found at www.thecommunityguide.org/cancer. The interventions included a three-segment television program that emphasized early detection and the dangers of sun exposure and sunburn193; the use of a CD-ROM–based information kiosk housed at sites accessible to the public192; media reporting of skin cancer advisories in the form of a UV index189; and a rating of sunlight intensity coupled with recommendations for appropriate sun-protective measures. The team did not review interventions that did not allow for evaluation of the effect of mass media alone on behavior change.
The relationship between skin cancer and ultraviolet radiation is well established. Behaviors such as seeking shade, avoiding sun exposure during peak hours of radiation, wearing protective clothing, or some combination of these behaviors can provide protection. Sunscreen use alone is not considered an adequate protection against ultraviolet radiation. This report presents the results of systematic reviews of effectiveness, applicability, other harms or benefits, economic evaluations, and barriers to use of selected interventions to prevent skin cancer by reducing exposure to ultraviolet radiation. The Task Force on Community Preventive Services found that education and policy approaches to increasing sun-protective behaviors were effective when implemented in primary schools and in recreational or tourism settings, but found insufficient evidence to determine effectiveness when implemented in other settings, such as child care centers, secondary schools and colleges, and occupational settings. They also found insufficient evidence to determine the effectiveness of interventions oriented to healthcare settings and providers, media campaigns alone, interventions oriented to parents or caregivers of children, and community-wide multicomponent interventions. The report also provides suggestions for areas for future research.
Seasonal variations in the diagnosis of cutaneous melanoma
2004, Journal of the American Academy of Dermatology
Seasonal patterns in diagnosis were examined in 7836 patients with cutaneous melanoma (clinical stage I and II) documented at the Department of Dermatology and Allergology at Ludwig-Maximilian-University in Munich, Germany, between 1977 and 2000. Of these patients, 2362 were first given a diagnosis in the summer months (June-August) and 1757 were first given a diagnosis in the winter months (December-February). A summer-to-winter ratio was determined for sex, age, anatomic tumor site, histopathologic subtype, and tumor thickness. The summer-to-winter ratio was 1.34 (95% confidence interval: 1.27-1.43) for all patients, with a ratio of 1.22 (95% confidence interval: 1.12-1.33) for men and 1.47 (95% confidence interval: 1.35-1.60) for women. The frequency of diagnosis of cutaneous melanoma was seasonal for all age classes, for all anatomic tumor sites, for all histopathologic subtypes except acrolentiginous melanomas, and for melanomas with a tumor thickness <3.0 mm. Comparing supgroups of the above-mentioned clinical and histopathologic parameters, significant differences could be observed for sex and anatomic tumor site. On the basis of this data, possible explanations for the diagnostic summer peak may be a greater awareness as a result of clothing habits in summertime or because of incurred sunburns in patients with skin type I and II, and the influence of public-health campaigns usually performed at the beginning of summer.
Detection of artificial changes in mole size by skin self-examination
2000, Journal of the American Academy of Dermatology
Background: The efficacy of the skin self-examination (SSE) to detect artificial changes in the size of nevi has not been evaluated in a controlled setting. Objective: Our purpose was to determine the sensitivity and specificity of the SSE in detecting artificial changes in mole size in patients at high risk for melanoma. Methods: In a single-center, single-blinded cross-over study, patients who had been performing the SSE confidently for at least 1 year examined their backs after the diameter of an existing mole was increased artificially in random order by 0, 2, or 4 mm. Results: The specificity of the SSE was 62% (95% confidence interval [CI], 53%-72%) (N = 103). The sensitivity of the 2 mm change was 58% (95% CI, 49%-68%) and that of the 4 mm change was 75% (95% CI, 66%-83%). SSE performance was not related to perceived risk, number of moles, gender, age, or frequency of self-examination. Conclusion: Even in our highly motivated and selected group of high-risk patients, 25% could not detect an obvious increase in the diameter of an existing nevus, whereas 38% incorrectly identified a change when none was made. The SSE is only a moderately effective tool for the detection of acute, large, changes in mole size. The usefulness of the SSE in detection of new lesions or changes in existing lesions is likely due to a combination of factors or due to factors other than size, such as color, border irregularity, and texture, among others. (J Am Acad Dermatol 2000;42:754-9.)
Evaluation of chronic disease prevention and control public service advertisement on the awareness and attitude change among urban population in Chongqing, China: A cross-sectional study
2017, International Journal of Environmental Research and Public Health

View all citing articles on Scopus

View full text

“Goodbye Sunshine”: Effects of a television program about melanoma on beliefs, behavior, and melanoma thickness

Trends in skin cancer in Australia—an overview of the available data

Transcripts of Menzies Foundation

A comparison of prognostic factors and surgical results in 1786 patients with localised (Stage I) melanoma treated in Alabama, USA, and New South Wales, Australia

Ann Surg

Effect of a public campaign about malignant melanoma on general practitioner work-load in South Hamptom

Br Med J

Experience of a public education programme on early detection of cutaneous malignant melanoma

Br Med J