From knowledge gaps to confidence: a pilot study evaluating a multilingual skin cancer educational intervention in underserved Spanish- and Punjabi-speaking communities.

Abstract

Background: Latine and underserved populations experience worse skin cancer outcomes and limited access to dermatologic care. Linguistically tailored interventions are essential for improving sun protection behaviors and skin self-examinations. Few studies have evaluated community-based interventions and skin cancer beliefs tailored to underserved Spanish- and Punjabi-speaking populations in the United States.

Objective: To evaluate the effectiveness of a community-based skin cancer educational intervention in underserved Latine Spanish-speaking and Asian Punjabi-speaking communities.

Methods: We implemented a 3-part, in-person intervention between April and August 2024 at University of California, Davis-affiliated student-run clinics. Participants completed pre- and postintervention surveys assessing demographics, skin cancer knowledge, beliefs, and self-examination confidence. The intervention used American Academy of Dermatology materials, delivered in English, Spanish, and Punjabi, supported by trained bilingual medical and undergraduate student volunteers.

Results: Thirty-two adults (56% Latine, 44% Asian; 81% women, 84% aged ≥40 years) participated. Significant improvements were observed in skin cancer knowledge, including understanding of the ABCDE rule (6-90%, P < .001), and self-examination confidence (19-63%, P < .001). However, changes in beliefs, particularly regarding biopsies and skin cancer misconceptions, were limited. Key structural barriers identified included high costs, lack of insurance, and referral access, disproportionately affecting Latine participants.

Limitations: This study is limited by variability in educational delivery and a small, older sample population, limiting generalizability.

Conclusion: An in-person, linguistically tailored, community-based education can significantly improve skin cancer awareness and self-examination confidence among underserved Spanish- and Punjabi-speaking populations. Shifting deeper health beliefs may require more sustained and targeted interventions. Future efforts should expand community-driven, language-concordant interventions and explore long-term impacts on behavior and beliefs.