Skin Cancer Awareness, Beliefs, Behaviors, and Access to Care Among the Homeless and Underinsured Patients Using a Free Clinic in Nebraska

Introduction: To understand the attitudes, beliefs, knowledge, and access to care surrounding sun safety for a primarily homeless or underinsured patient population at a student-run health clinic.

Methods: All adult attendees at the health clinic were invited to complete an anonymous 16-item questionnaire that assessed their sun safety history, practices, knowledge, and beliefs.

Results: Fifty participants completed our questionnaire, with 35 individuals (70%) reporting that they were without permanent residence, and 21 individuals indicating that they were uninsured or using Medicaid (42%). The typical reported daily sun exposure was high (median=4 hours), while sunscreen use was uncommon (mean=1.83, falling between a "Never" or "Rarely" rating). Only 10 participants (20%) reported having ever seen a dermatologist though commonly assumed barriers such as transportation, cost, or wait time were not endorsed at high rates. Conclusion: Our findings highlight areas for targeted education surrounding sun safety and identify sun protection methods accessible for this patient population.