Susan Boiko, MD, is a dermatologist at Rady Children's Hospital San Diego and a clinical associate professor of dermatology and pediatrics at the University of California in San Diego, CA. She specializes in pediatric skin cancer prevention and overall sun safety. She was cochair of the National Council on Skin Cancer Prevention and has authored journal articles regarding skin cancer prevention and detection around the world. She is known for speaking at national pediatrics meetings about pediatric dermatology, particularly focusing on the effects of ultraviolet radiation. Dr Boiko met with The Dermatologist to discuss her session at the 2021 AAD Summer Meeting titled, “You Can Do Community Outreach to Underserved Children and Teens with the AAD's ‘Good Skin Knowledge’ Program.”

Can you elaborate on the importance of utilizing outreach skills with children and teen patients?
When you're in an office and you're having a visit with the doctor, you're there because you have some problem. Any kind of education you get or that your family members get when they're with you as a child is colored by the fact that you still are worried about your agenda item.

In a more relaxed setting where people are there to have fun and learn, it's a lot easier to instill ideas about good health habits in a group of peers. It's a wonderful and rewarding experience because, as my daughter's kindergarten teacher said to me when I asked her, "Why do you teach kindergarten?" she said, "Because the children think you're God."

You have a captive audience who is dying to hear from you. Also, they're full of questions about what is it like to be a doctor? What do you have to do to become a doctor? Many of them, if they're seeing somebody who is female, who is Black, who is Latin American, or who is speaking with an accent like they have, that makes them think for the first time, "Here's somebody like me. I could be a doctor."

That setting is a wonderful setting to talk to children and teens. It’s an opportunity to answer some questions that they might be intimidated to ask in their own doctor's office.

How can clinicians go about developing these outreach skills for underserved children and teens?
People may not realize how many youths are in situations where they're in foster care, where they're in a school where everybody gets free lunch, where they're in an after-school program, or a community program. A wonderful place to start if you don't know how to reach out to a community is the public library.

The public library is happy to host you as a volunteer to come read some storybooks to children and talk to them. You can even bring your own equipment and show them what you do. The public library reaches across a wide variety of our society. Even if you don't specifically know a charity or an organization, that's a good place to start.

Other places to start are after-school programs, Boys & Girls Clubs, Girl Scouts, Boy Scouts, and community centers. There are many community centers now that have both senior programs and youth programs. Both the seniors and the kids really enjoy learning. Those are all places to start if you're not sure.

Of course, one of the best places to start is in your own home, or your own neighborhood, with either your children or someone you borrow. Just practice the presentation informally with them. That way, you'll find out what gets a good laugh, what gets a lot of interest, and what just causes a ho-hum even before you present it to a larger group.

Our next question for you is, how does the “Good Skin Knowledge” go about teaching the structure and function of skin?
Vanessa Ramos and Kate O’Connell, two medical students at Eastern Virginia College of Medicine, took a skin schematic that was meant for the 11- to 13-year-olds, and we had Girl Scouts building models of this. They used soft cotton balls and little pom-poms for the nerves and blood vessels. It's painted like Neapolitan ice cream for the three different layers of the skin.

On our lesson plan website, you will see medical students giving testimonials about how they did this. This is the best way to learn. It's not just somebody blathering at you, but taking cotton balls, gluing them on, and all that stuff to get a literal hands-on experience.

There’s another interactive way to do it, especially for distance learning. Outreach things that you could do like this or even sending a kit in the mail. Actually, you don't even have to have a kit. You could just look around your house, find stuff, and make something like this. That's going to be a great way to reach people.

The problem with underserved youth that the library fulfills is many of them don't have computers or good internet access at home. At least, they'll be in school. Maybe, there would be an after-school program where could interact with them in person even if you can't do so at a distance.

Why is it important for children and teens to be inspired or develop an interest in a health career, especially in dermatology?
Unfortunately, dermatology, like many other specialties in medicine, was not diverse. The selection was not equitable, and people were not included. If you go to the dermatology website now and you type in diversity, equity, or inclusion, there's a huge movement to get more people of color. Also, more people who are differently gendered and have different gender expression.

There was an unfair selection of people raised with wealth and privilege over people who had more diverse life experiences but didn't have those advantages.

All it takes is one little spark to kindle that interest in a child. I would say the great majority of children—even most parents—have no idea what a dermatologist actually does or how do you get that training. Some of them even think that I could also work at a cosmetic counter and do facials. We need to get a better understanding of, "I'm a medical doctor. I had to go through college, a medical school."

It just tells a child or a teenager who is interested, "You could do this all your life, and it would be very rewarding."

Is there anything else you’d like to share with your colleagues regarding “Good Skin Knowledge” or community outreach to underserved children and teens?
One exciting thing about “Good Skin Knowledge” is that it's going to be completely revamped in 2022 with a bigger eye towards diversity, equity, inclusion, and more attention on skin of color. Every skin has color. We should even call it skin of colors. If you look all over your body, there are all different colors.

Besides the fact that the program is going to be revamped, the material is there for you. You can consider it as a starting point. Nobody will tell you that you can't. Just like these wonderful medical students I worked with who had children building skin models based on that paper image of the skin model, take it to a new level. Practice it over and over. See what works, see what doesn't. Get honest feedback from your audience. This will be a tremendously fulfilling experience for you. I highly recommend it.