A Pilot Study of Peer-Delivered Sun Safety Education: Impact on Elementary Students’ Dermatologic Knowledge and Melanoma Identification Skills

Introduction: Skin cancer is the most common cancer affecting Americans, with sun exposure during childhood playing a major role in skin cancer development. Traditional adult-delivered sun safety programs face engagement limitations, while peer-delivered education may enhance learning through social modeling and relatability. Objectives: To present the results of a pilot study evaluating the preliminary effectiveness of a peer-delivered sun safety education program in improving elementary students’ comprehensive dermatologic knowledge, including skin anatomy, melanoma identification skills, and sun protection knowledge. Methods: In this study, forty-six elementary students (22 third-graders, 24 fifth-graders) completed a comprehensive 9-item knowledge assessment immediately before and after a peer-delivered skin and sun education presentation. Two trained student presenters delivered content covering skin anatomy, ultraviolet radiation, physical versus chemical sunscreens, sun protection strategies, and melanoma ABCs with visual examples. The assessment evaluated anatomical knowledge, sunscreen science, melanoma identification skills, and sun safety knowledge; two additional unscored behavioral questions (sunburn history and intention to protect the skin) were also asked. Results: In this pilot sample, both grades demonstrated statistically significant improvements with very large effect sizes. Third-graders improved from 5.73 to 8.41 out of 9 points (p<0.001, Cohen’s dz=2.29). Fifth-graders improved from 6.42 to 8.75 points (p<0.001, dz=2.08). Overall, 93.5% of students showed improved knowledge. Conclusions: In this pilot study, peer-to-peer education was associated with significant immediate improvements in sun safety knowledge among elementary students. However, given the small sample size (n = 46) and single-site, uncontrolled design, these findings are hypothesis-generating. Further evaluation in larger, multi-site, controlled studies is needed before broader conclusions about the generalizability or superiority of this peer education model can be drawn. This pilot may inform the design of future school-based melanoma prevention research.