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New Mexico
State Uses Youth Curricula to Meet Cancer Control Plan Objective Relating to Skin Cancer
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Public Health Problem
Although skin cancer is one of the most preventable types of cancer, it
remains an important public health problem in New Mexico. Nourished by social
norms that promote tanning, and veiled by effects that usually do not appear
until well into adulthood, skin cancer presents challenges for primary
prevention efforts. The incidence of melanoma is rising in New Mexico and posted
the second-highest rate of increase (4.9% annually) among all cancers in the
state from 1997 through 2001. Melanoma occurs at the rate of 17.5 cases per
100,000 persons per year, and accounts for approximately 5% of skin cancers in
the state. Basal cell carcinoma, the most common skin cancer among non-Hispanic
whites in New Mexico, occurred at the rate of 930.3 cases per 100,000 males and
485.5 cases per 100,000 females during 1998�1999.
New Mexico's sunny climate and high-altitude regions present substantial
risks for harmful doses of ultraviolet radiation (UV). Approximately 70% of the
days each year are sunny. In the state's most heavily populated areas, during
about 56% of the days each year, UV intensity is rated between "high" and
"extreme" on the UV index scale developed by the U.S. Environmental Protection
Agency (EPA) and the National Weather Service. According to EPA, UV increases 2%
for every 1,000-foot rise in elevation; nearly 40% of the state's 33 county
seats are at elevations higher than 6,000 feet.
Despite these hazards, many New Mexicans are not practicing behaviors that
could reduce their risk of developing skin cancer. Data from the federal
Behavioral Risk Factor Surveillance System survey completed in 2003 indicate
that 36% of adult New Mexicans seldom or never use sunscreen or sunblock when
they are outside on a sunny day for more than an hour, and that 34% seldom or
never wear a hat that shades their face, ears, and neck. Seventy-one percent
reported two or more sunburns within the past year. To protect the youngest
child in households with children under 13 years of age, 74% of adults reported
using sunscreen, sunblock, hats, or other protective clothing.
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Program Example
In the New Mexico Cancer Plan 2002�2006, one of the objectives
specific to skin cancer is as follows: "By 2006, increase the number of
educational efforts to encourage sun safe behaviors among all New Mexicans, with
special emphasis on children and their parents." The New Mexico Department of
Health's (NMDOH) Comprehensive Cancer Program (NMCCP) implemented the RAYS
(Raising Awareness among Youth about Sun safety) Project in 2003 to address this
objective. By targeting elementary-school students in grades 1 through 5, this
ongoing project aims to implant lifelong habits of sun-safe behavior and to
prevent children from accumulating potentially dangerous levels of UV exposure
during childhood.
The RAYS Project primarily uses two skin cancer
prevention curricula. These courses, which are considered to be research-tested
intervention programs by the National Cancer Institute and the federal Substance
Abuse and Mental Health Services Administration, are
Sunny Days Healthy Ways (developed by Klein Buendel, Inc.) and
SunSafe (developed by the Norris Cotton Cancer Center with funding from the
National Cancer Institute). EPA's SunWise curriculum is also approved
for the RAYS Project.
NMCCP health educators worked with staff from
the NMDOH Office of School Health and the state Public Education Department to
develop the RAYS Project. They designed a standardized application process for
schools and organizations interested in competing for funds with which to
purchase and implement a RAYS curriculum. The application package sent to
interested parties includes an application form, a list of RAYS-related
resources available from NMCCP, information on the approved RAYS curricula,
student pretests and posttests, a teacher evaluation form, and information on
the importance of practicing sun-safe behaviors.
Successful applicants receive funding
assistance for 2 or 3 years to reimburse expenses incurred for obtaining and
delivering the curriculum and for evaluating and reporting on the educational
impact achieved. NMCCP has sought to direct funding to regions with relatively
high or rapidly increasing melanoma incidence, to underserved regions and
populations, and to rural areas that cannot afford to provide such supplemental
instruction without outside support. Large school systems, which are able to
deliver the curricula to greater numbers of students and thereby achieve lower
per pupil costs, have participated in the project. Other funded entities have
included a small school district in a frontier county, a nonprofit organization
providing a range of educational and social services, individual schools within
large school districts, and mid-sized school districts in rural counties.
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Implication and Impact
During the first 2 years of the RAYS Project, sun-safety curricula were delivered in 15 communities
across the state, to more than 20,000 elementary-school students. Pretest and posttest
data returned to NMCCP from these sites have shown that students' general knowledge and awareness of sun safety has increased by 40% to 80%.
NMCCP has allowed some flexibility in how the curricula are implemented and evaluated to accommodate local preferences, resources, goals, and constraints. Because of these variations,
however, not all evaluation data have been comparable or able to be aggregated. In the coming year, NMCCP will work with the University of New Mexico's Center for Health Promotion and Disease Prevention to design a common set of evaluation data that can be collected
from all RAYS sites.
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Contact Information
Comprehensive Cancer Program*
New Mexico Department of Health
5301 Central Avenue NE, Suite 800
Albuquerque,
NM 87108-1531
(505) 222-8613
Fax: (505) 222-8608
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service to our users. These links do not constitute an endorsement of these organizations or their
programs by CDC or the federal government, and none should be inferred. The CDC is not responsible
for the content of the individual organization's Web pages found at these links.
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