ArticleFrontiers in oncology2025
SUNTEL pilot study: first school-based integration of the ugly duckling sign and a dedicated e-learning platform with peer education for melanoma prevention.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Educational initiatives among young people are pivotal in promoting healthy behaviors, yet only a few studies to date have used peer education in schools to convey health messages for melanoma prevention. Here we report the results of a peer-education-based skin cancer prevention program combined with teledidactics (SUN Education and TELematic Learning - SUNTEL) targeting high school students in Italy. Methods: In 2023-2024, thirty third-year high school students attended training sessions to become peer educators and then conducted interventions across first-year students using a multimedia platform. Students targeted by the peer-education intervention completed pre- and post-intervention questionnaires to assess changes in their knowledge, attitudes and behaviours regarding melanoma prevention. Marginal homogeneity tests were used to compare responses in the pre- vs. post-intervention questionnaires. Results: The study population included 323 students (56.7% boys) mostly aged 14-16 years. Most participants had fair/light dark skin (>97%); 24% had freckles, and over one third developed skin rash often/always after UV exposure. Students' knowledge about melanoma risk factors and prevention, and attitude about UV exposure, changed significantly after the intervention, e.g., students wanting to use a tanning bed/lamp dropped from 9.6% to 3.8% (p-value <0.001), and those aware that using a tanning bed/lamp is as risky as tanning in the sun rose from 75.4% to 90.5% (p-value <0.001). Knowledge of the ABCDE rule rose from 7.5% to 96.6%; for the ugly duckling sign, the change was from 9.1% to 91.2%. Conclusions: e-learning/web-based tools and peer-education proved highly effective in enhancing students' knowledge regarding melanoma prevention and recognition, proving comparably or even more effective compared to teachers-/physicians-led educational approaches. Notably, this is the first school-based program to introduce the "ugly duckling" sign, a simple and reproducible rule for early melanoma detection. Sustained message reinforcement and parental involvement will be key to achieving lasting behavioral change in sun safety.
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