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“My skin”: A public health program for secondary school students in Spain

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A. Navarro-Bielsaa,
Autor para correspondencia
albanavarrobielsa@hotmail.com

Corresponding author.
, T. Gracia-Cazañaa, S. Marrón-Moyaa, L. Tomás-Aragonésb, E. Ferrer-Garcíac, Y. Gilabertea
a Dermatology, Hospital Universitario Miguel Servet, Universidad de Zaragoza, IIS Aragón, Zaragoza, Spain
b Psychology, Universidad de Zaragoza, Zaragoza, Spain
c Department of Public Health, Government of Aragón, Zaragoza, Spain
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Table 1. Detailed breakdown of survey responses and percentages.
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Table 2. Topic coverage by school year and response percentages.
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To the Editor,

For decades, the Directorate General of Public Health of the Government of Aragón, Spain, has collaborated with dermatologists to offer the “SolSano” program in primary education schools.1 The aim of the program is to raise students’ awareness of the effects of sun exposure and to promote photoprotection measures.2

On this occasion, the project entitled “My Skin” (https://www.aragon.es/-/mi-piel) was aimed at secondary school students and focused on topics relevant to them, such as body image, acne, tattoos and piercings, sexually transmitted infections (STIs), and photoprotection.

The program included a teaching guide with resources, activities, and guidance designed to spark interest, encourage classroom debate, and encourage students to adopt healthy habits, with the support of teachers, families, and dermatology experts. The program was implemented in classrooms during the 2023–2024 school year, and a survey was conducted among teachers (Table 1) to collect their opinions.

Table 1.

Detailed breakdown of survey responses and percentages.

Question  Responses  N  Frequency (%) 
Topics addressed: Body imageYes  20  66.7% 
No  10  33.3% 
Topics addressed: AcneYes  11  36.7% 
No  19  63.3% 
Topics addressed: Tattoos and piercingsYes  14  46.7% 
No  16  53.3% 
Topics addressed: Sexually transmitted infections (STIs)Yes  15  50.0% 
No  15  50.0% 
Topics addressed: PhotoprotectionYes  13  43.3% 
No  17  56.7% 
Was the material useful for health education objectives?Yes  28  93.3% 
No  6.7% 
Student interest and acceptanceAcceptable  26.7% 
Good  19  63.3% 
Very good  6.7% 
None  3.3% 
Teacher satisfactionAcceptable  10.0% 
Good  20  66.7% 
Very good  20.0% 
None  3.3% 
Use of the eps.aragon.es platformYes  16  53.3% 
No  14  46.7% 

N, number of respondents.

The program was distributed to 77 teachers, 30 of whom responded to the questionnaire, which focused mainly on students aged 12–16 years. Body image and aesthetics showed the highest participation, with 66.7% engagement, followed by STIs (50%) and tattoos and piercings (46.7%). Photoprotection and acne were addressed less frequently (43.3% and 36.7%, respectively).

When the results were analyzed by school year, body image was the most frequently addressed topic, especially in the 4th year, where 100% of respondents worked on it. By contrast, acne was the least frequently addressed topic, especially in the 4th year, where no teacher addressed it. Tattoos, piercings, and STIs showed moderate participation, with slightly higher percentages in the 2nd and 3rd years. Photoprotection showed variable participation, with higher participation in the 4th year (66.7%) and lower participation in the 1st year (40%) (Table 2).

Table 2.

Topic coverage by school year and response percentages.

Topic  School year*  Yes (%)  No (%) 
Body image1st  60.0%  40.0% 
2nd  62.5%  37.5% 
3rd  71.4%  28.6% 
4th  100.0%  0.0% 
Acne1st  20.0%  80.0% 
2nd  50.0%  50.0% 
3rd  28.6%  71.4% 
4th  0.0%  100.0% 
Tattoos and piercings1st  40.0%  60.0% 
2nd  50.0%  50.0% 
3rd  57.1%  42.9% 
4th  33.3%  66.7% 
STIs (sexually transmitted infections)1st  40.0%  60.0% 
2nd  50.0%  50.0% 
3rd  71.4%  28.6% 
4th  33.3%  66.7% 
Photoprotection1st  40.0%  60.0% 
2nd  50.0%  50.0% 
3rd  42.9%  57.1% 
4th  66.7%  33.3% 

STIs: sexually transmitted infections.

*

School year 1: 12–13 years; school year 2: 13–14 years; school year 3: 14–15 years; school year 4: 15–16 years.

Regarding the usefulness of the material, 93.3% of teachers considered it useful for achieving health education objectives. Some comments highlighted that the content was sometimes too theoretical and not dynamic enough for students in higher grades, although overall it was considered well structured and relevant.

Regarding student interest, most showed moderate interest: approximately 90% rated the content as “acceptable or good,” and 6.7% as “very good.” Some teachers pointed out the need to expand the information, particularly in relation to STIs and body image.

Overall, teachers were satisfied with the program, with 86.7% rating their experience as “good” or “very good.” Comments indicated that the material facilitated classroom discussions and was easy to apply.

Finally, it was suggested that more interactive and audiovisual content be incorporated, that sessions taught by experts be included, and that online resources, such as videos and tutorials, be added to encourage greater student engagement. The importance of making health education more interactive and adapted to the students’ level was highlighted in order to improve participation and learning outcomes.

In conclusion, the public health program “My Skin,” designed for adolescents, was well received by both teachers and students, together with the materials provided. The project has been reintroduced and institutionalized. It is important to consider incorporating new resources, especially audiovisual and interactive resources, to address the survey suggestions and enrich the experience of teachers, students, and dermatologists.

Funding

Research group recognized by the Government of Aragón B59_23D Dermatology and Photobiology.

Conflicts of interest

None declared.

Data availability

The data supporting the results of this study are available from the corresponding author upon reasonable request.

Acknowledgments

To all the teachers and students who participated in this project and to the Government of Aragón.

References
[1]
M.P. Sirera Rus, J.R. Ipiens Serrate, E. Ferrer Gracia, P. Teruel Melero, J. Gállego Diéguez, Y. Gilaberte.
Effectiveness of SolSano Program on sun protection habits, knowledge, and attitudes among university students.
Actas Dermosifiliogr (Engl Ed), 111 (2020), pp. 381-389
[2]
Y. Gilaberte, J.P. Alonso, M.P. Teruel, C. Granizo, J. Gállego.
Evaluation of a health promotion intervention for skin cancer prevention in Spain: the SolSano program.
Health Promot Int, 23 (2008), pp. 209-219
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