Chapter 09: Creating Project SAFETY [Sun Awareness For Educating Today's Youth]

Title

Chapter 09: Creating Project SAFETY [Sun Awareness For Educating Today's Youth]

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Description

In this chapter, Dr. Ahearn turns to the pro-bono projects he has instigated in cancer prevention, projects inspired by the blistering burns he saw on young people who attended his summer programs. He describes these programs in detail and offers touching anecdotes on their influence. He talks about the dangers of tanning booths for young people. He talks about a state-sponsored action plan to address skin cancer.

Identifier

Ahearn,MJ_02_20110803_S09

Publication Date

8-3-2011

Publisher

The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; The Administrator; The Educator; Philanthropy, Fundraising, Donations, Volunteers; Education; Professional Practice; The Professional at Work; Professional Values, Ethics, Purpose

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey Ann Rosolowski, PhD

OK, now I recall the situation. OK, the acronym didn’t connect for a second. Well, since we’re broaching the subject of preventative questions, I wanted to turn to that, because a good part of your career has been involved, too, in setting up programs to educate people about cancer and cancer prevention, and I wanted to first talk a little bit about the history of that movement at MD Anderson, because then Dr. in -- excuse me -- in 1979 Dr. LeMaistre established the only department of cancer prevention in the world, and I was reading Dr. Olson’s book, Making Cancer History, and he said at this period of time that was a pretty unusual move, because the thinking about cancer prevention was fairly rudimentary. So I’m wondering if you could set the context a little bit and tell me your perspective on in the late ’70s and the ’80s what the thinking on prevention was, and then how you responded to that with your own programs.

Michael Ahearn, PhD

Well, I think you pretty well said... During that period of time I think that we turned some of our direction away from trying to cure cancer into trying to prevent cancer, and in the summer programs it was sort of the natural attrition, because we had these summer students in at the high school level, and I noticed that so many of them arrived with blistering sunburns, and during the time they were here on the weekend they’d come back on Monday morning blistered, and information began to come available that blistering sunburns during adolescent years could trigger (inaudible) development of melanoma, which is the more deadly of the skin cancers, and it was the episodic blisterings that seemed to be the key. And so we saw young people, and we would talk with them, but they had absolutely no idea the kind of risk that they were running, because it’s pretty well established now that you get your lifetime risk for melanoma prior to year 18, so it’s these students that right at the time they were coming in here was a perfect time to approach them. So we started in our summer program, in the enrichment series, and doing a cancer prevention, a skin cancer prevention module for them, but we realized that we were catching them at the very end of the time and that we needed to move back into middle school and elementary school, so we developed a model for the high school teachers to provide education on cancer prevention in their science classrooms, and that was Project SAFETY, or Sun Awareness For Educating Today’s Youth, and --

Tacey Ann Rosolowski, PhD

And that goes from fourth grade to twelfth grade, too, isn’t that correct?

Michael Ahearn, PhD

Yes, yes.

Tacey Ann Rosolowski, PhD

OK, mm-hmm.

Michael Ahearn, PhD

So we had a module that started out as a boxed unit. I think one of them is up there.

Tacey Ann Rosolowski, PhD

Oh yeah, there it is. It’s in a box and it’s got a bright --

Michael Ahearn, PhD

That was the elementary module

Tacey Ann Rosolowski, PhD

For the recorder, I’m just saying it’s got a bright yellow thing on it with a sun! (laughter)

Michael Ahearn, PhD

Yeah. We had three modules at that time: one for elementary, one for middle school, and then one for high school. And it had 35-millimeter slides, a video tape in it that talked with the students that teachers could actually use, and then a lot of visuals that could be used with an overhead projector, and that was the primary -- and then a teacher’s guide, too.

Tacey Ann Rosolowski, PhD

Now when, when did that project actually start? Do you remember when the first boxes went out to the teachers?

Michael Ahearn, PhD

Gosh... It was in the... It was in the mid-’80s, I think.

Tacey Ann Rosolowski, PhD

In the ’80s. OK. And what was the response? I mean...

Michael Ahearn, PhD

Very good. It was and expensive unit to produce. I mean, we had to, you know -- you can look at it and see the component parts.

Tacey Ann Rosolowski, PhD

You were doing multimedia.

Michael Ahearn, PhD

Yes, we were doing multimedia. It soon became the idea that it was popular and we couldn’t keep up with the demands, so we took the VCR and changed it into a DVD, and it could be just done, you know, all the visuals, and what -- there was another reason is simply because schools no longer had slide projects. That sort of went out with the computer area. And then the VCR units, they didn’t have those anymore, so we needed to get into a cheaper way of producing them, and that way we could put all the slides and everything that we had had in that big box in just a sleeve inside the teacher’s guide, and it was easier to transport, it was cheaper to mail, so it was a much more feasible unit. The Texas Cancer Council, which was the predecessor for the CPRIT here in Texas, we got a grant from them to supply these units to all the schools in the State of Texas, and once they got out in Texas, neighboring states started seeing them, because teachers were talking at meetings about Project SAFETY. And then it was necessary to try to supply some of those for out of state. We tried to get cost recovery out of it by selling them at the out of state. And then the Institution’s Advance Team, which is a philanthropic area in the hospital in which we have outside individuals that support initiatives at Anderson, and they decided that it would be good, since we know that in the Sunbelt area, which is latitude 46 below, the incidence of skin cancer is one in three, and then in the rest of the United States it’s one in five. They said, “Why don’t we provide you with some funds to see if you can introduce the Project SAFETY unit in all 16 of those Southern states that are in the Sunbelt?” And so we accepted that challenge, and we did distribute about 46,000 units in the 16 Sunbelt states to schools. And we went primarily through the education agencies in those states, or some person that was Superintendent of Education for the state, or a leading figure in the state to endorse the modules to the teachers within his state system. And we just finished up in California, which was the biggest bite because there were over 9,000 schools in California that we had to supply the module for. And Senator Feinstein wrote a letter to the educators within the State of California endorsing the unit. That was just one person, but there were -- in each state we had a covering letter to all the educators in that state from a recognizable figure within the education area.

CLIP:

A: The Educator

B: Institutional Mission and Values

C: Patients

C: Human Stories

“The SAFETY Program for Kids Helps Teachers and Parents, Too”

Tacey Ann Rosolowski, PhD

Now just so I understand, are these various programs offered through the School of Health Professions?

Michael Ahearn, PhD

No.

Tacey Ann Rosolowski, PhD

OK, how does that work?

Michael Ahearn, PhD

Well, this is just a pro bono, an interest of mine in prevention, and it’s been very effective. You know, the letters that we’ve gotten back from teachers and students and family members that have been affected by Project SAFETY, which was primarily a message directed to the young people, one of them was from a high school principal. Seemingly they make observations of their teachers each year, and during the period that he was visiting in one of the classrooms the teacher was presenting the Project SAFETY unit, and in the Project SAFETY unit it talks about the different lesions and the importance of the ABCDs of detecting a lesion that can be melanoma, and he saw the slides that were being projected from the DVD and realized that he had a lesion like that on his back, and so he wrote us and said, “You all saved my life, because if I had not been in that classroom that day, I ignored it, you know, and up until that point I realize.” And then there was another teacher that wrote and said that one of her students’ father had what the student called “fisherman arms,” and the student saw a lesion and went home and told his Daddy, “You’ve got one of those on his arm,” and sure enough it was in April and there was a skin cancer awareness fair going on in his hometown that was offered by the local dermatologist, and he went, and sure enough it was a melanoma. So it was not only the students that got the information, but there was collateral knowledge transferred both to the families and to the administrators in the school that were actually using the unit themselves.

Tacey Ann Rosolowski, PhD

It also puts the school itself in a really interesting position of, you know, being, you know, part of delivering health care information, so part of the whole education, and that new mindset, basically, for primary and secondary schools.

Michael Ahearn, PhD

Yeah, and I think that it has changed a lot of the behavior in schools. A lot of the teachers said, “We never had any sun shade.” And of course, they have to have physical education, and they scheduled it by the hour, and there were always those individuals that their time for physical education outdoors was 11:00, 12:00, 1:00, 2:00, all the hours where we’re telling people to avoid the direct rays of sun. So a lot of the teachers have told us, “We got sun shade areas simply because of the information that you provided to us in Project SAFETY.” So I think that it had a lot of effect in an audience that needed it. When we first introduced the module I had an invitation from some teachers in Midland and Odessa to come out and to give an introduction to a workshop that they were going to get science educators from the whole area, and we could just give an overview of Project SAFETY to them prior to their being able to teach it in their classrooms, so I flew out -- the airport is between Midland and Odessa, and I think in the morning I went to Midland, and in the afternoon to Odessa to one of these workshop areas that had been set up in a school. And when I drove up to the Midland school there was a campus there with a school, and it’s kind of a barren area out there, and on the front of the campus, laying out in front on great big strips of aluminum foil, was all these girls in their bathing suits laying out all over the front of the campus. And so the teacher had told me, she said, “I’ll meet you at the front door of the school.” So as I stood there I said, “What is going on out here?” She said, “Oh.” She said, “Friday night is the junior/senior banquet,” and she said, “it’s been raining here for three weeks and the girls are enhancing their tans for the junior/senior banquet.” So I said, “Well, I am in the right place.” (laughter) So she said the PE teacher had gotten the kitchen to give her these wide strips of aluminum foil, so it was like bacon frying out there on the campus in front of the school in the direct sunlight in midmorning, so...

Tacey Ann Rosolowski, PhD

Do you know if that’s changed? Have they, have they...?

Michael Ahearn, PhD

Oh, well I’m quite sure, because the teacher was very chagrined when we started the workshop and she saw what they were doing, so...

Tacey Ann Rosolowski, PhD

Pretty amazing. That’s... But I remember that from my own college years, you know, going and... I mean, I was educated up north so it was even more, catching those rare rays was even more important.

Michael Ahearn, PhD

Well, and we put iodine with baby oil on to enhance the effect of the sun, but too, you know, with the advent of these tanning booths, which they say are absolutely safe because they’re using UVA radiation rather than a UVB, unfortunately this is not correct information, and young people believe the ad, so to speak, but in reality it’s penetrating -- these rays are penetrating deeper into the dermis than the sunlight would normally do and destroying collagen and doing much more genetic damage than even the UVB radiation. They don’t -- UVA doesn’t burn you, but the effects of the radiation is really more intense insofar as causing genetic damage. And now, of course, the Environmental Protection Agency has listed UVA as a carcinogen. But still, there are no regulations on these suntan (inaudible), and you see them popping up everywhere.

Tacey Ann Rosolowski, PhD

Is there any way in which the tanning booths are integrated into your educational materials?

Michael Ahearn, PhD

Yes, yes. It’s very much addressed, because the young people are the ones that primarily use these [areas?]

.

Tacey Ann Rosolowski, PhD

Sure, sure. I know I’ve seen even on online, you know, you can get coupons from them popping up in your e-mail, and there’s a real encouragement for people to use it. Are there any...? I’ve noticed that you authored an Action Plan On Skin Cancer for the State of Texas. Can you -- how is that related to these other projects, and can you tell me a bit about that?

Michael Ahearn, PhD

Well, I had approached the Texas Cancer Council to get the grants for the Project SAFETY, and --

Tacey Ann Rosolowski, PhD

So this also was in the early ’80s probably, mid to early ’80s?

Michael Ahearn, PhD

Yes, I think that the Action Plan was closer to -- it was in the ’90s.

Tacey Ann Rosolowski, PhD

Oh, OK, OK.

Michael Ahearn, PhD

The Texas Cancer Council asked, after they had seen the work that we had done, if we, if I would chair a committee to do an action plan on skin cancer to direct them and other areas approaching the need for skin cancer prevention of Texas, and so we convened a group that was not only Anderson faculty in the areas of prevention, dermatology, but also people across the state that were interested, and formed a committee and developed collectively an Action Plan For Skin Cancer from the State of Texas.

Tacey Ann Rosolowski, PhD

Who were some people that you worked with, specific individuals that you worked with to put that together? Was there anyone else from MD Anderson, or...?

Michael Ahearn, PhD

Oh yes, Dr. Duvic was here. Dr. Jim Bowen was on the committee. There were -- it was a committee of about 24 people. I can’t remember all of them, but there... Dr. Margaret Spitz, I think, in epidemiology, and it was a large group of individuals. I could get the listing for you, but I can’t recall all of them (inaudible).

Tacey Ann Rosolowski, PhD

So MD Anderson was strongly represented.

Michael Ahearn, PhD

MD Anderson was very strongly represented.

Tacey Ann Rosolowski, PhD

Is there anything else that you’d like to say about these various prevention programs? Anything you’d like to add?

Michael Ahearn, PhD

Well, we’re coming out with a revised module, updated with more statistics that are recent, and it will be distributed within Texas this fall. Some 8,700 modules will be sent out to Texas teachers. These things sometimes have limited life in school. Teachers move and they take the unit with them, and so the school no longer has a unit, and so we’ve gotten a lot of requests for replaceable units, and so we decided that we would once again do a Texas distribution (inaudible).

Tacey Ann Rosolowski, PhD

Have you done any formal follow-up to see if the information is sinking in and really changing behavior in a long term way?

Michael Ahearn, PhD

For utilization of the module -- of course, it’s very different, though, because students are in a classroom only one year, and it’s usually taught in the spring right before spring break. The educators tell us that that’s the most effective time to do it, because students are going to be out, and that’s the time that they head to the beach or other places that they’re outside the classroom. And so the students are not in the same classroom the next year, so it’s hard to do a follow up. What we have done is utilization of the module, and teachers reply back that they are using the module, and it’s 100%. I mean, the teachers -- everyone that gets one uses it. Sometimes because of curricular demands, things that they have to teach -- it’s designed to be presented in three one-hour lectures, but many of the teachers tell us that they have to compress that because they really only have one day where they can present it and not three class period days. Others do it in three class period days, but everybody is using it.

Tacey Ann Rosolowski, PhD

Well, it sounds like it’s a well designed program and that it has that flexibility to fit into different kind of curricular settings, which is great.

Michael Ahearn, PhD

And we have a map of the United States showing the number of modules that are distributed. As I say, we purposefully distributed it in the 16 states, but it’s amazing to see how many of the eastern states are using the module, too, and several hundred in New Jersey, New York, you know, all of the eastern states, the number of modules. These are modules that they paid for (inaudible).

Tacey Ann Rosolowski, PhD

So you are recovering some of the investment.

Michael Ahearn, PhD

We are. For out of state sales, particularly when it was funded by the State of Texas, it was for Texans, and so therefore if someone outside the state -- we just did cost recovery; we’re not making a profit on it, but we did cost recovery on it.

Chapter 09: Creating Project SAFETY [Sun Awareness For Educating Today's Youth]

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