Non-profit organizations and public education: a compendium of resources for physicians

Skin cancer prevention and detection public education programs were established by dermatologists in 1983.1 Since 1985 the American Academy of Dermatology’s (AAD) national program of Melanoma/Skin Cancer Detection and Prevention has occurred annually in May2 and has produced extensive print, radio, and television coverage about the dangers of sun exposure and benefits of sun protection. This program was developed in response to the rising incidence of invasive melanoma and the nonmelanoma skin cancers, basal cell and squamous cell carcinoma. Statistics have indicated that the incidence of melanoma in 1980 was 1 in 250 (up from 1 in 1500 in 1930)3 and now is projected to reach 1 in 75 by the year 2000.4 In 1994, an estimated 1,000,000 Americans developed a skin cancer of some type.5 The long-term strategic goal of the AAD’s skin cancer control program has been to reduce the incidence and mortality of skin cancer. The interim tactical objectives were to increase the awareness and knowledge of skin cancer with eventual change in the attitudes, beliefs, and behaviors that affect individual skin cancer risk. Initially, the goal was to educate the public about melanoma and nonmelanoma skin cancer and the potentially harmful aspects of ultraviolet light (UVL) exposure. Later the emphasis was placed on societal attitudes about having a tan obtained by the deliberate use of either indoor or outdoor UVL. Media advocacy and consumer interest from this program brought the matter to the attention of the United States Food and Drug Administration, which issued guidelines about tanning facilities in 1986.6 Since then, dermatologists have carried the legislative regulatory and safety programs for tanning facilities to the state level. Although the majority of states have not legislated tanning facility guidelines or policies, several states have adopted various programs to help monitor and assure safety. Since 1985, the annual AAD May program of free skin cancer screening and counseling about sun protection provided a focus for the development of media materials for print, television, and radio, which were covered by the national media each summer from 1985 to 1998.7–9 In 1994, many local television news programs and newspapers began to report the daily “Ultraviolet Index” (UV Index) in conjunction with the United States National Weather Service ozone and ultraviolet radiation monitoring program. Media coverage of the UV Index promoted awareness of the ease of sunburning and provided guidelines for sun avoidance and the use of sun protection.10 Because an estimated 80% of an individual’s lifetime sun exposure occurs by age 18, it is particularly important to protect children from damage by the sun.11 This compelling need for sun safety messages for children and their parents was recognized by other nonprofit organizations, and a great wealth of educational materials and programs were created over the years by many different organizations, including national organizations such as the American Cancer Society and the Skin Cancer Foundation and local community organizations such as hospital or health department-based cancer prevention programs. National education groups began to develop age-appropriate school health materials on sun protection for preschool to grade 12 (this is discussed more fully in the chapter on public education projects). In April 1995, the variety of materials and messages available was discussed at the National Conference to Develop a National Skin Cancer Agenda in Washington, DC, sponsored by the AAD and the Centers for Disease Control and Prevention. Those attending felt that teaching photoprotective habits should reduce the incidence of adverse health effects from both short-term UV exposure (e.g., sunburn) and long-term exposure (e.g., cutaneous photodamage, skin cancer, and cataracts). The basic safe sun recommendations developed for the agenda were as follows.12