Melanoma awareness and prevention among latinx and non‐latinx white adults in urban and rural California: A qualitative exploration

• Published in: Cancer medicine (Malden, MA) Vol. 12; no. 6; pp. 7438 - 7449
• Main Authors: Mesia, Rachel J., Espinosa, Patricia Rodriguez, Hutchison, Hayden, Safaeinili, Nadia, Finster, Laurel J., Muralidharan, Vijaytha, Glenn, Beth A., Haile, Robert W., Rosas, Lisa Goldman, Swetter, Susan M.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.03.2023; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Aged; California - epidemiology; Community; Education; Ethnicity; Family income; Focus groups; health behaviors; Health care; health disparities; Hispanic Americans; Humans; Insurance coverage; Latino/a/x; Male; Melanoma; Melanoma - diagnosis; Melanoma - epidemiology; Melanoma - prevention & control; Minority & ethnic groups; Mortality; Navigation behavior; Prevention; Qualitative Research; Race; Rural areas; rural disparities; Skin cancer; Skin Neoplasms; Socioeconomic factors; White; California; Southern California; United States > US; rural disparities; melanoma; health disparities; Latino/a/x; health behaviors
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.5457

Background Melanoma mortality rates in the US are highest among older men, individuals of lower socioeconomic status (SES), and people of color. To better understand these inequities, a qualitative exploratory study was conducted in Northern and Southern California to generate knowledge about barriers and facilitators of awareness, prevention, and early detection of melanoma in lower SES Latinx and non‐Latinx White (NLW) individuals living in urban and semi‐rural areas. Methods Nineteen focus groups were conducted (N = 176 adult participants), stratified by race/ethnicity (Latinx, low‐income NLW), geography (semi‐rural, urban), and language (English and Spanish). Inductive and deductive thematic analysis was conducted, and the findings were organized using the socioecological model framework: individual, interpersonal, community, and health system/policy levels. Results Four socioecological themes describe how key factors affect knowledge, perceived risk, preventive behaviors, and melanoma screening. Individual level findings revealed that many participants were not familiar with melanoma, yet were willing to learn through trusted sources. Having brown or darker skin tone was perceived as being associated with lower risk for skin cancer. Interpersonally, social relationships were important influences for skin cancer prevention practice. However, for several Latinx and semi‐rural participants, conversations about melanoma prevention did not occur with family and peers. At the community level, semi‐rural participants reported distance or lack of transportation to a clinic as challenges for accessing dermatology care. Healthcare systems barriers included burdens of additional healthcare costs for dermatology visits and obtaining referral. Conclusions Varying factors influence the awareness levels, beliefs, and behaviors associated with knowledge, prevention, and early detection of melanoma among low‐income Latinx and NLW individuals and in semi‐rural areas. Results have implications for health education interventions. Navigation strategies that target individuals, families, and health care settings can promote improved prevention and early detection of melanoma in these communities. Disparities in melanoma outcomes appear to be associated with varying factors that influence community knowledge, prevention, and early detection of melanoma. This qualitative study can help inform the design of effective and culturally relevant melanoma prevention and early detection strategies among low‐income Latinx and non‐Latinx White adults across rural and urban regions.