Childhood sunburns are a major risk factor for skin cancer in adulthood, and sun habits during childhood can serve as the foundation for later healthy sun behavior. However, current interventions for childhood sun protection tend to produce small effects, and most involve one-time education without the parent. The Evaluating Ultraviolet Radiation (UVR) Exposure in Kids for Adaptive Intervention (EUREKA) mobile health intervention addresses this important gap in skin cancer prevention efforts for children. EUREKA targets daily sun habits; it provides engaging and timely sun protection messages to both parent and child participants, along with an end-of-day action planning module.

In our pilot of the beta version of the EUREKA Smart Phone app, 11 parent-child dyads (children were 8-17 years old, 82% non-Hispanic White, 64% female) reporting infrequent child use of sun protection were enrolled in a 3-week study. Weeks 1 and 3 served as observation periods in which both parent and child participants were asked to complete a weekly survey along with brief self-report items about the child’s sun behavior through the app every 2 hours from 8 AM-6 PM daily. During the intervention week (Week 2), participants received just-in-time messages based on reported child sun behaviors. They also were directed to create an action plan in the app to select the sun protection behaviors they would use during an outdoor activity the next day and the strategies for enacting that plan.

During this pilot, all dyads were retained and all completed the final follow-up survey. Compared to baseline, parent reports of child behavior on a 5-point scale reflected modest improvements in most areas (e.g., for sunscreen, shade, and long-sleeve use, respectively, Ms(baseline)=1.91, 2.64, 4.09 vs. Ms(follow-up)=2.27, 3.09, 4.82). Given the small sample size, statistical tests are not reported. All participants completed exit interviews and provided feedback on potential technical improvements, benefits of the app (e.g., raised their awareness about sun protection), and recommended additional features (e.g., sunscreen reminders, alerts/information based on forecasted UV levels). Our study team is incorporating this input into the next version of the app, which we will test with a larger sample. In sum, our initial results support the feasibility and acceptability of the EUREKA intervention while also providing important input on future improvements.