Background
Biases inherent in self‐assessment of sun exposure and sun‐safe behavior may lead to inaccurate conclusions about the effectiveness of sun‐safety educational programs.
Objectives
We aimed to compare self‐reports to objective measures of sun exposure, when examining the effectiveness of passive versus active educational interventions.
Methods
From May to June 2018, 73 participants recruited at a dermatology clinic were sequentially assigned to receive sun‐safety education through one of 3 modes: interactive online module, video, or no education. A baseline Sun Exposure and Behavior Inventory (SEBI) questionnaire was administered, and spectrophotometric measurements of sun‐exposed and sun‐protected areas were taken and reported in the CIE L*a*b* color space. Participants were followed 4–8 and 16 weeks after the initial visit where the SEBI was re‐administered, and serial measurements of skin color were taken. The change in SEBI scores and L*a*b values, as calculated by the individual typology angle (ITA°), was analyzed.
Results
There was a significant increase in skin darkening in all the groups at 4–8 and 16 weeks follow‐up. There was no statistically significant difference between the groups in the magnitude of color change. However, subjectively at 4‐8 weeks post‐intervention, participants in the interactive module and video groups had significantly improved self‐reported SEBI scores compared to control (p < .05, Kruskal‐Wallis). By 16 weeks, only the interactive module group showed significant improvement in SEBI scores compared to control (p < .05, ANOVA).
Conclusion
In determining the effectiveness of sun‐safety programs, spectrophotometric evaluation of sun‐induced skin pigmentation can allow for a more complete evaluation of self‐reported sun exposure and sun‐protective behavior.