Ultraviolet radiation exposure in children: a review of measurement strategies.

Rates of skin cancer in the U.S. are high and have been increasing rapidly. Recommendations for primary prevention focus on the reduction of ultraviolet radiation (UVR) exposure, especially in childhood. Valid, reliable strategies are needed to measure UVR exposure in children, to document baseline levels, and to assess intervention impact. This article reviews strategies reported in observational and intervention studies and considers their potential usefulness for application with children. The strategies include verbal report (by self or parent), direct observation, visual inspection, ultraviolet (UV) sensitive film, the Erythema Meter, the spectrophotometer, and the colorimeter. Each strategy is described along several dimensions, including ease of use, cost, and whether it is suitable for measuring acute and cumulative exposure. The review describes the existing validity and reliability data and points out a need for further research assessing the reliability and validity of most of these measures. Additionally, suggestions for matching strategies with measurement and intervention objectives are presented.