spotlight with Rachel J. Mesia, PhD

Newly published study on melanoma awareness and prevention among Latinx and non-Latinx White adults in urban and semi-rural California

Rachel J. Mesia, PhD co-led the WOM-CA team that conducted qualitative research to understand melanoma awareness, beliefs, and behaviors of Latinx and low income non-Latinx White adult populations. Dr. Mesia provides insights on the inception and findings of the study, and how new knowledge gained from this research will contribute to the prevention and early detection of melanoma.

The study was presented by WOM-CA director Susan Swetter, MD at the American Society of Clinical Oncology Annual Meeting in June 2022, and recently published as an open-access medical journal article in Cancer Medicine (DOI: 10.1002/cam4.5457). 

How did the research idea come about – to conduct interviews with Latinx and non-Latinx White adults on the topic of melanoma?

Dr. Swetter and I engaged community health experts in Northern and Southern California to address melanoma prevention using community-based approaches. Wipe out Melanoma-California collaborators are particularly concerned about socioeconomic, cultural, and healthcare access issues that result in worse outcomes for certain populations. According to prior research findings published in health and medical journals, melanoma mortality rates decreased by approximately 18% for non-Latinx White patients. However, improved melanoma survival has not been demonstrated for those of lower socioeconomic status, populations living in rural areas, and for Latinx and Black individuals regardless of socioeconomic status. 

Wipe Out Melanoma-California researchers at Stanford Medicine, Cedars-Sinai Medical Center, and the University of California, Los Angeles formed a collaboration to investigate why health differences occur within these groups. We felt that gaining knowledge directly from community members would be beneficial in helping us identify barriers and facilitators related to melanoma prevention and early detection, and to develop solutions based on our findings. 

Together, we designed and implemented focus group interviews with non-Latinx White and Latinx community members in Northern and Southern California. We were very grateful for the bilingual research team members who recruited or interviewed the study participants and that the focus group work was completed before the pandemic took hold. Our participants were essential informants in helping us develop a trial intervention to improve health outcomes related to melanoma prevention and early detection.

Can you give a summary of the newly published paper in Cancer Medicine?

The paper, “Melanoma awareness and prevention among Latinx and non-Latinx White adults in urban and rural California: A qualitative exploration”, describes our findings from 19 focus group interviews conducted with 176 Latinx and low-income non-Latinx White adult participants. These focus groups were conducted in Northern and Southern California semi-rural and urban cities. Our Latinx participants had the option to be interviewed in English or Spanish.

The main purpose of the study was to gather information about their awareness of melanoma, preventative health behaviors, and the barriers and facilitators associated with the prevention and early detection of melanoma. When we analyzed the data, we used a framework to understand the ways in which various socioecological factors were related to the knowledge, prevention, and early detection of melanoma in these populations.

We learned a lot from the interviews. We found that most participants did not know that melanoma is a form of skin cancer. Nonetheless, they were eager to learn from trusted sources about how this disease can be prevented and detected at its early stages. It was often presumed that individuals who have brown or darker skin tones were not at risk or were at very low risk for skin cancer.

Social and family influences were main factors for how the participants learned and talked about health, as well as engaged in healthy behaviors. For example, some participants felt obligated to use sunscreen if their family members or peers encouraged them to do so. We also discovered problems with access to dermatology care and patients having communication issues with their physicians. More rural participants felt that the lack of transportation and the far distance to a clinic made it difficult to seek to medical specialty care.

Based on the data we collected and analyzed from different communities, we gained more understanding that versatile interventions are critical for engaging communities to take action for their health, and for creating strategies to improve access to health care. With the new knowledge gained from this study, we have better insights of people’s awareness, experiences, feelings, and access to care related to melanoma prevention and early detection.

Why do you think this kind of study is important in the prevention of melanoma and improving melanoma survival?

Our research team wanted to involve community members as a critical source for melanoma research knowledge. Our study is a form of ‘qualitative research’, a type of research that provides descriptive and interpretive context behind melanoma incidence and mortality statistics. If you look at the paper’s table of quotes, you will find that the perceptions, ideas, and experiences shared by the participants allows researchers to explore deeper meanings associated with melanoma prevention, detecting cancer early, and seeking health care. Health interventions should be designed to help communities feel knowledgeable and confident in practicing preventative behaviors, talking with the doctor about their concerns, and seeking care for suspicious skin marks.

How can our readers find this paper?

The article can be downloaded for free from Cancer Medicine, an open-access medical journal published by John Wiley & Sons Ltd. We plan to also provide access to our paper on our Wipe Out Melanoma – California website. The website features information about melanoma prevention and the Melanoma Community Registry of California, which is open to melanoma survivors, family, and friends to join as a way to be part of our efforts.

Article Citation: Mesia RJ, Rodriguez Espinosa P, Hutchison H, Safaeinili N, Finster LJ, Muralidharan V, Glenn BA, Haile RW, Goldman Rosas L, Swetter SM. Melanoma awareness and prevention among Latinx and non‐Latinx white adults in urban and rural California: A qualitative exploration. Cancer Medicine. 2022; doi: 10.1002/cam4.5457