Background: Health districts in southwest Virginia have one of the highest ultraviolet (UV) radiation exposure and sunburn rate. Due to higher levels of UV exposure, rural farm youth are at higher risk for skin cancer than non-farm youth. Few studies have been published that explore best practices for decreasing UV exposure among this population. Purpose: This 5-week study assessed the effectiveness of a health promotion intervention including a UV monitoring device in decreasing UV exposure among youth. Methods: A mixed methods research design (focus groups and a pretest-posttest one-group design) set in rural southwest Virginia, long tied to the agricultural sector, was used. Youth ages 14 to 16 (93.5% white, 87.1% female) participated in the 4-unit (90-minute each) intervention based on the Health Belief Model (n = 31). It also incorporated a user-friendly UV monitoring device. Results: Participants' knowledge of factors related to skin cancer (p < 0.001), skin protection attitude (p < 0.05), and likelihood of engaging in protection practices increased significantly (p < 0.05). Female participants' positive tanning perception was reduced (p < 0.05). Participants were satisfied with the functions of the monitoring device but found the bulky design unattractive. Discussion: This tailored health promotion intervention with a UV monitoring device was effective for rural youth. Translation to Health Education Practice: The health belief model is an effective model for framing a skin cancer prevention/UV exposure intervention for this population.