Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory: Measure description and comparisons to UVR sensor and sun protection survey data

Stump, Tammy K.; Aspinwall, Lisa G.; Gray, Elizabeth; Xu, Shuai; Maganti, Nenita; Leachman, Sancy A.; Alshurafa, Nabil; Robinson, June K.

doi:10.1016/j.pmedr.2018.07.010

Cited by 11 publications

(11 citation statements)

References 30 publications

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“…At the end of each day, an email provided a link to the survey administered via REDCap 17 . The daily Minutes of Unprotected Sun Exposure (MUSE) 18 survey was adapted with self‐report of sunburn of body areas and intensity and types of outdoor physical activities. Each day, participants were asked to report details of all outdoor activities performed between 6 am and 6 pm for more than 15 minutes, which is typical in most studies, since it is difficult to report every time an individual goes outdoors.…”

Section: Methodsmentioning

confidence: 99%

“…The protection‐adjusted UV dose is a measure of personal sun exposure computed by integrating sun protection self‐reports 18 with UV sensor data for a specific outdoor activity. The UV exposure recorded by the sensor was adjusted for sun protection use for face, forearms, lower legs, and body (J/m 2 ) and for each unique activity using the following methodology: For each unique (non‐overlapping) activity k , let τ k = “time spent in hours in activity”.…”

Section: Methodsmentioning

confidence: 99%

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Protection‐adjusted UV dose estimated for body areas: Daily self‐reported sun protection modification of wearable UV sensor dose

Robinson

Durst

Gray

et al. 2020

Photoderm Photoimm Photomed

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Background During the last 20 years, 50% of adults with sun‐sensitive skin have sunburned annually. Reducing the proportion of people who sunburn requires understanding the circumstances and outdoor activities during which at‐risk people sunburn. Methods A 7‐day observational study of melanoma survivors (n = 20) and young adult first‐degree relatives of melanoma survivors (FDRs) (n = 20) captured daily UV exposure, sun protection, and sunburns during spring and summer in the Midwest of the United States (latitude 41.8°N). Participants wore UV and physical activity sensors and completed a daily self‐reported survey of sun protection, sunburn, and physical activities. The estimated protection‐adjusted UV dose was calculated for each body area by integrating self‐reported sun protection with UV sensor dose. Results In 254 days, at least one body area in 9 of 20 (45%) melanoma survivors and 11 of 20 (55%) FDRs was sunburned (erythema at 24 hours). Sunburns were associated with spring and walking for transportation or leisure, especially walking the dog. Melanoma survivors used sunscreen daily on the face; however, forearms and lower legs were not protected during walking. Young adults did not use sun protection on the face, forearms or lower legs during walking for transportation and use was ineffective during sports. Conclusion The sun protection patterns of daily living identified in this study may promote recognition of erythema as sunburn and inform the development of tailored sun protection mobile applications promoting self‐monitoring with wearable UV sensors.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Protection‐adjusted UV dose estimated for body areas: Daily self‐reported sun protection modification of wearable UV sensor dose

Robinson

Durst

Gray

et al. 2020

Photoderm Photoimm Photomed

Self Cite

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“…The study smartphone was only used to upload the data, and participants did not need to carry the device with them all day. They were emailed a link containing the Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory self-report questionnaire to report their outdoor activities and sun protection habits at the end of each day [16]. Participants were sent daily reminders and instructions for performing the data upload and completing the questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Assessing recall of personal sun exposure by integrating UV dosimeter and self-reported data with a network flow framework

et al. 2019

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BackgroundMelanoma survivors often do not engage in adequate sun protection, leading to sunburn and increasing their risk of future melanomas. Melanoma survivors do not accurately recall the extent of sun exposure they have received, thus, they may be unaware of their personal UV exposure, and this lack of awareness may contribute towards failure to change behavior. As a means of determining behavioral accuracy of recall of sun exposure, this study compared subjective self-reports of time outdoors to an objective wearable sensor. Analysis of the meaningful discrepancies between the self-report and sensor measures of time outdoors was made possible by using a network flow algorithm to align sun exposure events recorded by both measures. Aligning the two measures provides the opportunity to more accurately evaluate false positive and false negative self-reports of behavior and understand participant tendencies to over- and under-report behavior.Methods39 melanoma survivors wore an ultraviolet light (UV) sensor on their chest while outdoors for 10 consecutive summer days and provided an end-of-day subjective self-report of their behavior while outdoors. A Network Flow Alignment framework was used to align self-report and objective UV sensor data to correct misalignment. The frequency and time of day of under- and over-reporting were identified.FindingsFor the 269 days assessed, the proposed framework showed a significant increase in the Jaccard coefficient (i.e. a measure of similarity between self-report and UV sensor data) by 63.64% (p < .001), and significant reduction in false negative minutes by 34.43% (p < .001). Following alignment of the measures, under-reporting of sun exposure time occurred on 51% of the days analyzed and more participants tended to under-report than to over-report sun exposure time. Rates of under-reporting of sun exposure were highest for events that began from 12-1pm, and second-highest from 5-6pm.ConclusionThese discrepancies may reflect lack of accurate recall of sun exposure during times of peak sun intensity (10am–2pm) that could ultimately increase the risk of developing melanoma. This research provides technical contributions to the field of wearable computing, activity recognition, and identifies actionable times to improve participants’ perception of their sun exposure.

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“…We will provide a commercially available UVR-sensor-enabled wrist wearable device to all participants, Shade, 2nd generation, which was developed in collaboration with the National Health Institutes (National Cancer Institute). Shade reported significantly more accurate UVR measurements than similar devices [ 18 ], and melanoma survivors have previously reported that the first version of the device was easy to use [ 19 ]. In addition to accurately measuring UVR exposure in a manner that does not rely on self-report and memory, Shade includes a mobile app that helps users set daily limits that take into account UVR intensity, time of exposure, and sunscreen application.…”

Section: Interventionsmentioning

confidence: 99%

UVR-sensor wearable device intervention to improve sun behaviors and reduce sunburns in melanoma survivors: study protocol of a parallel-group randomized controlled trial

Nagler

Ahmed

Brown

et al. 2020

Trials

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Background Individuals who have been diagnosed with melanoma have more than a 9-fold increased risk of developing another melanoma. Ultraviolet radiation (UVR) exposure following a melanoma diagnosis can be modified to reduce risk of a new melanoma diagnosis. Yet research shows that many melanoma survivors do not report optimal sun protection practices. The objective of this study is to evaluate the effectiveness of a UVR-sensor wearable device to improve sun protection behaviors and reduce sunburns in a randomized controlled trial (RCT) in melanoma survivors. Methods We will conduct an RCT among 368 melanoma survivors in two waves (Summer 2020, Summer 2021). This approach allows for adequate recruitment of the required sample and potential improvements to recruitment, compliance, and retention strategies between waves. The intervention includes an informational brochure about sun protection behaviors and a commercially available UVR-sensor wearable device (Shade), which accurately measures UVR. The device, along with its associated mobile application, measures and stores UVR exposure. As UVR exposure accumulates, the device provides notifications to increase sun protection action. Survivors in the control group receive the device and a separate mobile application that does not provide notifications or summary UVR exposure data. Participants will be asked to wear the device for 12 weeks. They will complete surveys about their sun behaviors at study entry, every 4 weeks during the intervention, and 1 year later. At the end of the intervention period, intervention and control groups will be compared for differences in a summary measure of sun protection habits and experience of a sunburn. We will also measure self-reported physical activity, depression, and anxiety to examine potential unintended negative consequences of the intervention. Discussion The study intervention will be completed Fall 2021, with anticipated results available in 2022. If this intervention improves sun protection behaviors in melanoma survivors, these findings would support expanding the use of this technology with other populations at high risk for melanoma. Trial registration ClinicalTrials.gov NCT03927742. Registered on April 15, 2019.

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Daily Minutes of Unprotected Sun Exposure (MUSE) Inventory: Measure description and comparisons to UVR sensor and sun protection survey data

Cited by 11 publications

References 30 publications

Protection‐adjusted UV dose estimated for body areas: Daily self‐reported sun protection modification of wearable UV sensor dose

Protection‐adjusted UV dose estimated for body areas: Daily self‐reported sun protection modification of wearable UV sensor dose

Assessing recall of personal sun exposure by integrating UV dosimeter and self-reported data with a network flow framework

UVR-sensor wearable device intervention to improve sun behaviors and reduce sunburns in melanoma survivors: study protocol of a parallel-group randomized controlled trial

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