Enhancing Sunscreen Adherence among Persons with Albinism: A Quasi-Experimental Study with Policy Implications from Nigeria

Abstract

Background: Persons with albinism (PWAs) are at heightened risk for ultraviolet-induced skin malignancies. Despite the protective efficacy of sunscreen, its utilization among Nigerian PWAs remains suboptimal. Objectives: To evaluate the effect of structured health-education intervention on sunscreen awareness, adoption, and adherence barriers among PWAs in southwestern Nigeria. Methods: A quasi-experimental pre-post study was conducted among PWAs attending a community outreach program in Ile-Ife, Nigeria. Participants received targeted health education on photoprotection and sunscreen use. Data were collected using interviewer-administered semi-structured questionnaires. Changes in awareness, use, and adherence were analyzed using McNemar’s test and logistic regression. Significance was set at p < 0.05. Results: Among 43 participants (mean age: 35.3 ± 10.8 years; 60.5% female), pre-intervention sunscreen awareness was 58.1%, with only 4.7% reporting consistent use. Post-intervention, awareness increased significantly (p < 0.001), and occasional use rose from 23.3% to 37.2% (p = 0.032). However, consistent use remained low (14.0%), hindered by cost (55.8%), limited availability (39.5%), and reapplication challenges (32.6%). Older age and indoor occupations predicted lower adherence (p < 0.05). Conclusion: Health education significantly improved sunscreen awareness but had a limited impact on adherence. Addressing structural and behavioural barriers through subsidized access and context-specific interventions is critical to improving photoprotection among PWAs in Nigeria