Multi-Institutional Study Evaluating the Efficacy of SPOTS (Sun Protection Outreach Teaching by Students), a Skin Cancer Prevention Educational Program for Adolescents

BACKGROUND The Sun Protection Outreach Teaching by Students (SPOTS) program previously demonstrated benefits to adolescents and medical students in the Midwest. Six years later, there have been significant program enhancements and geographic outreach has expanded.OBJECTIVEThis multi-institutional program evaluation study sought to quantify the efficacy of the enhanced SPOTS program in improving skin cancer knowledge, sun-safe attitudes, and sun protection behaviors in adolescents living in multiple geographic regions of the United States.MATERIALS AND METHODSSurveys assessing students' knowledge, attitudes, and behaviors concerning skin cancer and sun protection were administered before and 1 month after SPOTS teaching.RESULTSAnalysis of 1,508 pre-program and 969 post-program surveys revealed statistically significant improvements in adolescents' knowledge, attitudes, and behaviors regarding sun protection. Notably, there was a 34.3%, 107.5%, and 27.1% relative improvement in the percentage of students' sunscreen protection factor knowledge, belief that a tan is unhealthy, and intention to wear sunscreen, respectively (p <.001). In addition, 57.6% of students reported having tried to increase sunscreen usage after SPOTS. Subgroup analyses demonstrated similar improvements across Fitzpatrick skin-types and across different geographic regions.CONCLUSIONThe enhanced SPOTS program demonstrated significant improvements in adolescents' knowledge, attitudes, and behaviors toward sun protection.