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Validity of the Fitzpatrick Skin Phototype Classification in Ecuador
Martha Fors1, Paloma González, Carmen Viada
1At the Universidad de Las Américas, in Quito, Pichincha, Ecuador, Martha Maria Fors Lopez, PhD, MD, MSc, is Researcher and Professor, and Paloma de las Mercedes González Fors, BS, is Librarian. Carmen Elena Viada González, MSc, is Statistician, Center of Molecular Immunology, Havana, Cuba. Kirsten Falcon, MSN, RN, is Professor of Nursing, Universidad de Las Américas. Santiago Palacios-Alvarez, MD, is Professor, Pontifical Catholic University of Ecuador, Quito. Acknowledgment: The authors thank the study participants, the Centro de la Piel for its valuable contribution, and the Universidad de Las Américas for funding travel and study materials and equipment (grant no. MED.MF.17.08). The authors have disclosed no other financial relationships related to this article. Submitted April 3, 2020; accepted in revised form May 6, 2020.
Background:
The Fitzpatrick Skin Phototype Classification (FSPC) is the most common tool used to assess skin phototype in White populations according to the amount of pigment the skin has and its reaction to sun exposure. Scientific evidence about the use of this scale for persons with darker skin is limited.
Objective:
To assess the internal consistency, reliability, and construct validity of the FSPC for Ecuadorians.
Methods:
This observational cross-sectional study recruited participants of both sexes between 40 and 90 years of age living in a rural area of Quito, Ecuador. Cronbach α values were used to assess the internal consistency of the scale. Construct validity was assessed with confirmatory factor analysis.
Results:
The internal consistency coefficients indicated that the reliability of the responses to the scale was fair. Total α value was .515, whereas the α values of the two factors were .42 and .67. Most item-to-factor correlations had a low to moderate magnitude, ranging from r = 0.30 to 0.37. Confirmatory factor analysis supported a two-factor solution and achieved good overall fit as indicated by root mean square error of approximation = 0.08, and nonnormed fit index = 0.88 was mediocre. Goodness-of-fit χ = 177.10, P < .001. The factor loads were greater than 0.30, ranging from 0.30 to 0.99.
Conclusions:
The FSPC showed an acceptable construct validity and a fair internal consistency. The five-item scale could potentially be used as an effective instrument for assessing skin phototype in non-White people.
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