EUREKA: Evaluating Ultraviolet Radiation Exposure in Kids for Adaptive Intervention

Melanoma is the 6th most common form of cancer in the United States and its incidence has been increasing for the past three decades. While individuals diagnosed with melanoma have a generally optimistic prognosis (overall 5-year survival rates of 91%), once melanoma has metastasized to distant organs, the survival rate drops to only 17%. As a result, prevention and early detection of melanoma when it is more easily treated are of prime importance. Ultraviolet radiation (UVR) exposure is the primary modifiable risk factor for melanoma. Adoption of sun protective behaviors, such as sunscreen use, are essential for decreasing acute (sunburn) and long-term (DNA damage) effects of UVR exposure. Minimizing excess UVR exposure is especially important during childhood since childhood sunburns are a risk factor for melanoma.

Existing interventions for skin cancer prevention in childhood have not been able to provide children and families with real-time feedback and associated prompts related to the child's UVR exposure. Previous research has shown that families struggle with knowing how much UVR exposure their children obtain throughout the course of the day. JITAIs offer a unique opportunity to provide children and their parents with real-time feedback on the child's UVR exposure, as well as reminders for the child to use recommended sun protection strategies. Previous JITAIs have been observed to be effective at reducing sedentary activities, preventing relapse related to alcoholism, and helping with smoking cessation. However, JITAIs have been used more seldom among pediatric populations and have not yet been used to facilitate melanoma preventive strategies among children.

The overall goal of the proposed project is to pilot a JITAI approach to providing feedback on child UVR exposure to children and their parents, with the ultimate goal of improving child use of sun protection strategies (e.g., use of sunscreen, protective clothing) and decreasing UVR exposure and sunburn occurrence.

This study will utilize a SmartPhone app. Participants who provide informed consent and/or assent to participate in the study will be asked to complete activities on the app for 21 days. If children do not have a smartphone, they will be provided with one to use the app.

Inclusion criteria

Parents:

• are at least 18 years old
• have at least one child between the ages of 8-17 who is living in the same household
• are the primary caregiver for the child participating in the study (defined as the individual who is responsible for daily implementation of health-related tasks for the child)
• have and are able to use a smartphone
• are willing to download and use a free smartphone app that will share their participating child's ultraviolet radiation exposure data with the research team.

Children:

• are 8 to 17 years old
• with a primary caretaker in Utah
• have no previous diagnosis of skin cancer
• have had a sunburn in the past year
• have used sunscreen and one other sun protection behavior never/rarely/sometimes in the past month (protective clothing items, shade when outdoors)
• are willing to wear a sensor (on their wrist or attached to their clothing) that collects data on ultraviolet radiation (UV) exposure

Exclusion criteria

Parents and Children:

• Do not speak, read/write English
• Have a pacemaker