The validated sun exposure questionnaire: association of objective and subjective measures of sun exposure in a Danish population‐based sample

Abstract

SummaryBackground Few questionnaires used in monitoring sun-related behaviour have been tested for validity. Objectives We established the criteria validity of a questionnaire developed for monitoring population sun-related behaviour. Methods During May-August 2013, 664 Danes wore a personal electronic ultraviolet radiation (UVR) dosimeter for 1 week that measured their outdoor time and dose of erythemal UVR exposure. In the following week, they answered a questionnaire on their sun-related behaviour in the measurement week. Results Outdoor time measured by dosimetry correlated strongly with both outdoor time and the developed exposure scale measured in the questionnaire. Exposure measured in standard erythema dose (SED) by dosimetry correlated strongly with the exposure scale. In a linear regression model of UVR (SED) received, 41% of the variation was explained by skin type, age, week of participation and exposure scale, with exposure scale as the main contributor. The weekly sunburn fraction correlated strongly with the number of ambient sun hours (r = 0Á73, P < 0Á001). Conclusions This criteria-validated questionnaire provides evidence of the exposure that the questionnaire aimed to measure. The evidence provided showed a strong link between the objectively measured behaviour and the behaviour measured by this survey construct. The questionnaire is the first validated tool to measure the UVR exposure in a national population-based sample.

Validation of Questionnaire and Diary Measures of Time Outdoors Against an Objective Measure of Personal Ultraviolet Radiation Exposure

“…Our findings indicate strong agreement between self‐reported time spent outdoors recorded by a daily sun diary and objectively measured UV exposure using UV dosimeters, and moderate agreement between questionnaire measures of “usual” sun exposure and UV dosimeter SEDs. Other studies have found similar levels of agreement . In Denmark, Koster et al .…”

Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample

“…Finally, we show the protection scale (7 items, sunscreen SPF15+, long sleeves, long trouser/skirt, cap, wide brimmed hat, shade, stay inside between 12pm- 15pm), which was previously described [30]. …”

Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study

“…Given the higher use of sunscreen among MHT users and the higher risk observed for the lentigo maligna subtype, there is potential for confounding by UV exposure and for residual confounding by sun‐sensitivity in our analyses, and the adjustment for residential UV exposure that we used could not sufficiently control this bias. Ideally, future cohort studies investigating this issue should use objectively validated week‐based questionnaires to assess UV exposure at baseline and should evaluate potential effect modification by UV exposure and sun‐sensitivity on the relation between MHT use and melanoma risk. Another limitation is that the education level in our cohort population, which is composed mainly of teachers, is higher on average than in the general population; this limitation is moderate however, since a gradient of socio‐economic status is nevertheless present among E3N women, and self‐reported features were generally highly reliable thanks to the motivation of E3N women to participate in research …”