Knowledge, Attitudes, and Practices (KAP) Regarding Photoprotection Among Medical Students at a Nicaraguan University: A Cross-Sectional Study

BackgroundMedical students represent a critical population for photoprotection education, as future physicians responsible for skin cancer prevention counseling. However, no previous studies have characterized knowledge, attitudes, and practices (KAP) regarding photoprotection among medical students in Central America or the Caribbean. ObjectiveTo assess KAP related to photoprotection and identify associated factors among medical students at a Nicaraguan university. MethodsA cross-sectional study was conducted among 133 medical students at the Universidad Iberoamericana de Ciencias y Tecnologia (UNICIT), Managua, Nicaragua. An ad hoc questionnaire assessed sociodemographic characteristics, knowledge, attitudes, and photoprotective practices. Domain-specific and global KAP scores were calculated. Bivariate analyses examined associations with sex, academic year, skin phototype, and age. ResultsParticipants were predominantly female (73.7%), with a median age of 20 years (IQR: 18-21). Although 97.0% knew what sunscreen is and 88.0% correctly identified adequate sunscreen characteristics, only 33.1% knew the minimum recommended SPF for daily use, and 21.8% understood endogenous photoprotective mechanisms. Regular sunscreen use was reported by 39.1%, while 24.8% reported never using it. Women demonstrated significantly higher scores across all domains, with moderate effect sizes for practice (d = 0.56) and global KAP (d = 0.60). No improvements were observed across academic years (p > 0.05). Age showed weak negative correlations with practice ({rho} = -0.237; p = 0.006) and global KAP ({rho} = -0.204; p = 0.018). The primary barrier to sunscreen use was forgetfulness (49.6%). ConclusionsThis first KAP study among medical students in Nicaragua reveals a substantial gap between photoprotection knowledge and practice. Current medical training appears insufficient to promote sustained protective behaviors. Findings support integrating practical, behavior-oriented photoprotection education into medical curricula and establish a regional baseline for future interventions.