spotlight with Dawn Siegel, MD

Melanoma awareness and prevention among adolescents

Dr. Dawn Siegel, Professor in Dermatology at Stanford University, is a pediatric dermatologist. She is affiliated with Lucile Packard Children's Hospital at Stanford Medicine Children's Health. Her research interests are in improving health equity for children with skin disease through innovative skin health and science education programs, hemangiomas, and the related multiple congenital anomaly syndrome - PHACE (Posterior fossa anomalies, Hemangiomas, Arterial anomalies, Cardiac defects, and Eye anomalies). 

For this issue, I spoke with Dr. Siegel about her team’s research on their innovative, immersive interactive workshop that uses technologies to educate about melanoma awareness and prevention in teens.

What are the top three intriguing lessons you’ve learned from your melanoma related work in pediatric dermatology, which covers children and adolescents?

My work has mainly been focused on implementing augmented reality applications to teach lessons in melanoma prevention and awareness. The top three lessons we’ve learned are:

• The teens are really excited about learning with technology. 

• The teens love understanding the science behind ultraviolet (UV) radiation damage. They’re really interested in learning about the layers of the skin, and how UV light affects skin integrity and skin cells. I was surprised that this is one of their favorite things about the app.

• In terms of melanoma prevention and sun safety practices, it turns out that the parents are less likely to use sun protection for themselves, but they're excited about knowing their kids need to be protected. As a result, they’re thinking about modeling sun safety behavior by doing their own sun protection. This helps to engage the parents, so it is more of a family effort, which is great for changing adolescents' behavior around this. 

What do you want our readers to know about iTS-CORE, starting with what the acronym stands for? Who helps you implement this program?

iTS-CORE is an acronym we’ve developed that stands for Interactive Technology, for Skin - Community Outreach Research and Education. It is an innovative, immersive interactive workshop that uses technologies to educate about melanoma awareness and prevention. We’re developing these programs through community outreach. The research part is using a co-design process with teens so that the information is relevant to them. The teens give us feedback that we can use to improve the education about melanoma awareness.

We have an exciting model in terms of the Stanford teams with whom we work. This collaborative process allows us to improve the app from a multitude of perspectives. The Stanford teams include School of Medicine dermatologists and medical students; the Graduate School of Education Center to Support Excellence in Teaching, which is especially critical in science standards and educating across different socio-economic groups and cultures; the Department of Communication Virtual Human Interaction Lab; and the Chariot Program, which is part of the Lucille Packard Children’s Hospital.

Outside of Stanford, we’ve been working with community groups and several local area schools in the San Francisco Bay Area, including the San Mateo County Office of Education, and groups in Oakland and Santa Clara. Study participants come from diverse backgrounds and cultures.

Once we have our final product in place, we hope to disseminate it across the state, including through Wipe Out Melanoma – California, as well as nationwide. In terms of extending our program further into California, we’re interested in having more of a collaboration in the Central Valley and Central Coast regions. As part of our first steps in this area, we’ve interviewed primary care providers in the Central Valley about the needs of their population around sun safety/protection and melanoma awareness.

Could you explain the educational games you and your team have developed to improve adolescent skin health and melanoma prevention? 

We’re developing an augmented reality sun safety application. Our first version is on the specialized computer called zSpace, which uses three-dimensional technology to give students an immersive learning experience. They learn about UV radiation and other forms of electromagnetic radiation.

The machine has three cameras that track the students’ eye movements. The beauty of it is that the teens don't need goggles, so they can interact with their peers and the people around them but still be in this immersive experience. Then, they can spray on sunscreen and put on hats and sunglasses. There's a 3D model of the skin that they can dissect and learn about the layers of the skin and the sun damage that may occur. And it lets them take apart the layers of the skin.  

In the future, we’re hoping to develop an app that has augmented reality filters so that it could be used on a phone-based system.

How do you see technologies such as Augmented Reality and Virtual Reality advancing the prevention or early detection of melanoma in adolescents, especially in low-income and racial-ethnic minority populations? 

I think the key thing about using augmented reality (AR) and virtual reality (VR) is that it's just so engaging for the kids. They love it. They think it's so much fun. We've tested it with over 30 kids now from very diverse racial and ethnic backgrounds. Over 90 percent think that using augmented reality could help them learn about skin health, and that they're going to think more about protecting their skin from the sun after using the app. We believe It is so much more engaging and exciting than reading a sun safety and protection workshop handout or instruction sheet.

Right now we’re developing the app and doing the testing in person. Once we have a final product, it will be available through a link in a patient after-visit summary or instructions, and also available in curriculum through schools. The augmented reality lessons won’t require special headsets that are typically seen with AR or VR, so it will be easy for most kids to use.

The goal of this app is similar to a public health message, which we can make widely available, whether or not people have this type of technology.

What final items would you like readers to take away from this interview?

The big message is to stay safe in the sun. And, we are really excited about this new technology. We think it's going to be a game changer for kids. We hope it will move the bar on behavior change, since one of the big challenges with education is translating it into a way of life. We hope this immersive experience will do just that.

ELLEN DINUCCI is a contributing writer of WOM-California Gazette and staff member of the Office of Cancer Health Equity at Stanford Cancer Institute.