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Stanifer SR, Rademacher K, Beckett W, Simpson K, Rayens MK, Thaxton-Wiggins A, Hahn EJ. Public library lending programs increase radon testing in rural communities. LIBRARY & INFORMATION SCIENCE RESEARCH 2024; 46:101283. [PMID: 38463029 PMCID: PMC10919551 DOI: 10.1016/j.lisr.2024.101283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Radon exposure is the second leading cause of lung cancer, yet few Americans test their homes for radon, particularly in rural areas. The academic team and community partners engaged the public library systems in four rural counties to offer digital radon detectors for check-out as a means of increasing the public's access to free radon testing. The check-out procedures and instructional materials were created through an iterative process, and library personnel were educated on radon and home radon testing prior to launching the lending program. Library patrons reported high usability, feasibility, and acceptability of the program. Library patron-staff interactions mainly included discussions about the logistics of radon testing. Given that public libraries are invested in making communities thrive and promoting health, providing library lending programs for radon detectors is a novel, feasible, and acceptable way to reduce the risk of lung cancer in the community.
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Affiliation(s)
- Stacy R Stanifer
- College of Nursing, 751 Rose Street, University of Kentucky, Lexington, Kentucky, USA 40536
| | - Kathy Rademacher
- College of Nursing, 751 Rose Street, University of Kentucky, Lexington, Kentucky, USA 40536
| | - Whitney Beckett
- College of Nursing, 751 Rose Street, University of Kentucky, Lexington, Kentucky, USA 40536
| | - King Simpson
- Logan County Public Library, 225 Armory Drive, Russellville, KY, USA 42276
| | - Mary Kay Rayens
- College of Nursing, 751 Rose Street, University of Kentucky, Lexington, Kentucky, USA 40536
- College of Public Health, 111 Washington Ave., University of Kentucky, Lexington, Kentucky, USA 40536
| | - Amanda Thaxton-Wiggins
- College of Nursing, 751 Rose Street, University of Kentucky, Lexington, Kentucky, USA 40536
| | - Ellen J Hahn
- College of Nursing, 751 Rose Street, University of Kentucky, Lexington, Kentucky, USA 40536
- College of Public Health, 111 Washington Ave., University of Kentucky, Lexington, Kentucky, USA 40536
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Hevey D, Perko T, Martell M, Bradley G, Apers S, Rovenská KN. A psycho-social-environmental lens on radon air pollutant: authorities', mitigation contractors', and residents' perceptions of barriers and facilitators to domestic radon mitigation. Front Public Health 2023; 11:1252804. [PMID: 37649784 PMCID: PMC10463182 DOI: 10.3389/fpubh.2023.1252804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Radon is a major indoor air pollutant that poses a significant risk of lung cancer to those exposed in their homes. While mitigation of high radon levels in homes has been shown to be effective, home mitigation rates remain low. This study examines the barriers and facilitators to radon mitigation in homes from the perspectives of authorities responsible for radon risk management, the mitigation industry (contractors), and residents in four European countries (Belgium, Ireland, Slovenia, and the UK) with high radon risks and low mitigation rates. Methods A multi-method approach was used to gather data from various stakeholders, including online surveys, content analysis of legal documents, group interviews, workshops, and focus groups. Results Authorities, contractors, and residents identified various facilitators to radon mitigation, including legal requirements for mitigation, awareness campaigns, low mitigation costs, availability of financial support, accreditation of mitigation contractors, and a perception of radon as a health threat. However, barriers to mitigation were also identified, such as a lack of awareness, fragmented mitigation processes, and inadequate communication between stakeholders. Discussion The study highlights the complexity of the radon mitigation process and suggests that interventions aimed at increasing mitigation rates should target stakeholders beyond just residents, such as constructors, health professionals, and policy makers. An integrated approach to radon mitigation, from policy to provision, is necessary to effectively lower levels of this indoor air pollutant.
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Affiliation(s)
- David Hevey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Tanja Perko
- SCK CEN, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre, Mol, Belgium
- Department of Political Science, University of Antwerp, Antwerp, Belgium
| | | | - Gary Bradley
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Sofie Apers
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
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Stanifer SR, Rayens MK, Wiggins A, Hahn EJ. Social Determinants of Health, Environmental Exposures and Home Radon Testing. West J Nurs Res 2022; 44:636-642. [PMID: 33882759 PMCID: PMC10953677 DOI: 10.1177/01939459211009561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Home radon testing is a primary lung cancer prevention strategy, yet the majority of Americans have not tested their home. This descriptive, ecological study uses 54,683 observed radon values collected in Kentucky homes from 1996 to 2016 to examine the association of county-level social determinants of health and environmental exposures on home radon testing rates. Multivariate linear regression analysis indicates that as median home value, rurality, and radon risk potential increased, counties experienced an increase in annual home radon testing rates. As adult smoking prevalence increased, counties experienced a decrease in annual rates of residential radon testing. These findings indicate that counties with low median home values, high adult smoking prevalence, and high incidence of lung cancer may benefit most from prevention interventions aimed at promoting home radon testing, adopting radon- and smoke-free home policies, and integrating radon risk reduction messaging into tobacco cessation and lung cancer screening programs.
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Affiliation(s)
| | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Amanda Wiggins
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J. Hahn
- College of Nursing, University of Kentucky, Lexington, KY, USA
- College of Public Health, University of Kentucky, Lexington, KY, USA
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Kim S, Chiu T, Klug MG, Schmitz D, Schwartz GG. Interventions to promote home radon testing: A randomized clinical trial of a smartphone app vs. printed brochures. Cancer Med 2022; 12:2027-2032. [PMID: 35762397 PMCID: PMC9883538 DOI: 10.1002/cam4.4988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/09/2022] [Accepted: 06/19/2022] [Indexed: 02/02/2023] Open
Abstract
Radon is a preventable cause of lung cancer, but the percentage of homes tested for radon is low. We previously developed a smartphone app that informs users about radon and allows them to request a free radon test. Here we conducted a randomized, controlled trial comparing the radon app versus printed brochures on radon knowledge, attitudes, and behaviors, including the proportion of participants requesting radon tests. Participants (N = 138) were undergraduates at a midwestern university. Data were analyzed by t-tests, general linear models, and logistic regression. App users showed significantly greater increases in radon knowledge (p = 0.010) and self-efficacy (p < 0.001) and requested tests three times more often than brochure recipients (41.4% vs. 13.2%, p < 0.001). However, the rate of test usage in each condition was low, ~3%. In conclusion, the radon app markedly outperformed brochures in increasing knowledge and requests for radon tests. Future work should focus on methods to increase test usage.
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Affiliation(s)
- Soojung Kim
- Department of CommunicationCollege of Arts and Sciences, University of North DakotaGrand ForksNorth DakotaUSA
| | - Tiffany Chiu
- Department of Education, Health & Behavior StudiesCollege of Education & Human Development, University of North DakotaGrand ForksNorth DakotaUSA
| | - Marilyn G. Klug
- Department of Population HealthSchool of Medicine and Health Sciences, University of North DakotaGrand ForksNorth DakotaUSA
| | - David Schmitz
- Department of Family and Community MedicineSchool of Medicine and Health Sciences, University of North DakotaGrand ForksNorth DakotaUSA
| | - Gary G. Schwartz
- Department of Population HealthSchool of Medicine and Health Sciences, University of North DakotaGrand ForksNorth DakotaUSA
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Stanifer S, Hoover AG, Rademacher K, Rayens MK, Haneberg W, Hahn EJ. Citizen Science Approach to Home Radon Testing, Environmental Health Literacy and Efficacy. CITIZEN SCIENCE : THEORY AND PRACTICE 2022; 7:26. [PMID: 36845873 PMCID: PMC9949773 DOI: 10.5334/cstp.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Exposure to radon is a leading cause of lung cancer worldwide. However, few test their homes for radon. There is a need to increase access to radon testing and decrease radon exposure. This longitudinal, mixed-methods study using a citizen science approach recruited and trained a convenience sample of 60 non-scientist homeowners from four rural Kentucky counties to test their homes for radon using a low-cost continuous radon detector, report back findings, and participate in a focus group to assess their testing experience. The aim was to evaluate changes in environmental health literacy (EHL) and efficacy over time. Participants completed online surveys at baseline, post-testing, and 4-5 months later to evaluate EHL, response efficacy, health information efficacy, and self-efficacy related to radon testing and mitigation. Mixed modeling for repeated measures evaluated changes over time. Citizen scientists reported a significant increase in EHL, health information efficacy, and radon testing self-efficacy over time. While there was a significant increase in citizen scientists' confidence in their perceived ability to contact a radon mitigation professional, there was no change over time in citizen scientists' beliefs that radon mitigation would reduce the threat of radon exposure, nor was there a change in their capacity to hire a radon mitigation professional. Further research is needed to understand the role of citizen science in home radon mitigation.
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Abstract
PURPOSE This study compared differences in sociodemographic characteristics, personal risk perception of lung cancer, lung cancer worry, and synergistic risk perception among rural Appalachia residents who completed home radon testing with those who did not, after receiving a free long-term test kit at a rural primary care clinic. The study also examined the association between the Teachable Moment Model constructs and home radon testing. METHODS The study was an exploratory correlational design with a convenience sample of (N = 58) adult participants recruited from 2 rural primary care clinics in Appalachia Kentucky. Participants completed a brief survey and were given a free long-term home radon test kit. Multiple logistic regression was used to determine characteristics associated with home radon testing. FINDINGS Twenty-eight participants (48%) completed home radon testing. There were no differences in personal risk perception of lung cancer, lung cancer worry, or synergistic risk perception between those who completed home radon testing and those who did not. Age was the only significant factor associated with completion of radon testing (B = 0.077, P = .005). For every 5-year increase in age, participants were 47% more likely to test their home for radon. CONCLUSION Providing free home radon test kits in the primary care setting shows promise in prompting radon testing in rural Appalachia. As radon-induced lung cancer risk increases with exposure over time, health care providers in rural Appalachia need to encourage patients of all ages to test their home for radon, especially those who smoke or report smoking in the home.
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Affiliation(s)
- Stacy R. Stanifer
- College of Nursing, University of Kentucky, Lexington, Kentucky
- University of Kentucky Center for Appalachian Research in Environmental Sciences (UK-CARES), Lexington, KY
| | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, Kentucky
- College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Amanda Wiggins
- College of Nursing, University of Kentucky, Lexington, Kentucky
| | - David Gross
- Northeast Kentucky Area Health Education Center, St. Claire Healthcare, Morehead, Kentucky
| | - Ellen J. Hahn
- College of Nursing, University of Kentucky, Lexington, Kentucky
- University of Kentucky Center for Appalachian Research in Environmental Sciences (UK-CARES), Lexington, KY
- College of Public Health, University of Kentucky, Lexington, Kentucky
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Noh J, Jang H, Cho J, Kang DR, Kim TH, Shin DC, Kim C. Estimating the disease burden of lung cancer attributable to residential radon exposure in Korea during 2006-2015: A socio-economic approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:141573. [PMID: 32841859 DOI: 10.1016/j.scitotenv.2020.141573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
Estimating the lung cancer disease burden can provide evidence for public health practitioners, researchers, and policymakers. This study uses claim data from lung cancer patients for 2006-2015 from the Korean National Health Insurance Service to estimate the lung cancer burdens attributable to residential radon in Korea using disability-adjusted life years (DALY) and patients' annual economic burden with societal perspectives using the cost-of-illness (COI) method. The number of patients increased during our study period (from 35,866 to 59,168). The disease burden and that attributable to residential radon, respectively, increased from 517.57 to 695.74 and 64.62 (95%; CIs 61.33-67.69) to 86.99 (95%; CIs 82.7-91.1) DALYs per 100,000 patients. The percentage of years lost due to disability among the DALY doubled from 8% to 17%. The cost for all the patients was US$2.33 billion, with US$292 (95%; CIs 278-306) million attributable to residential radon. During the last decade, the lung cancer disease burden increased by 1.34 times, with a doubled percentage of non-fatal burden and average annual growth rate of 9.5% of the total cost. Hence, the burden and cost of lung cancer in Korean provinces have been steadily increasing. The findings could be used as input data for future cost-effectiveness analysis of policies regarding radon reduction.
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Affiliation(s)
- Juhwan Noh
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea.
| | - Heeseon Jang
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
| | - Jaelim Cho
- Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea; School of Medicine, University of Auckland, Auckland, New Zealand; Institute for Environmental Research, Yonsei University, College of Medicine, Seoul, Republic of Korea.
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
| | - Tae Hyun Kim
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
| | - Dong Chun Shin
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Institute for Environmental Research, Yonsei University, College of Medicine, Seoul, Republic of Korea.
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Seoul, Republic of Korea; Institute for Environmental Research, Yonsei University, College of Medicine, Seoul, Republic of Korea.
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Neri A, McNaughton C, Momin B, Puckett M, Gallaway MS. Measuring public knowledge, attitudes, and behaviors related to radon to inform cancer control activities and practices. INDOOR AIR 2018; 28:604-610. [PMID: 29704395 PMCID: PMC6047348 DOI: 10.1111/ina.12468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/21/2018] [Indexed: 06/08/2023]
Abstract
Radon exposure is the second leading risk factor for lung cancer among smokers and the leading risk factor among non-smokers. Radon concentrated in lower levels of homes/buildings can be reduced if found, thus lowering lung cancer risk. The objective of this study was to measure radon knowledge in diverse populations, with varying radon-related laws, to inform radon-related cancer control practices and activities. A survey was mailed to 3000 homebuyers who purchased single-family homes; 995 responses (33%) were received. Overall, 86% of respondents heard of radon-related health issues. Real estate agents (69%) or home inspectors (65%) were the most common sources of information. Respondents were more likely to test their home for radon if they reported previously hearing of radon-related health issues or understanding of how radon-related health issues affect the home-buying process. Respondents in states with notification policies were twice as likely as those without policies to have heard about radon-related health issues (OR 2.01, 95% CI: 1.27-3.17). This study provides useful information for cancer control activities including that education is positively associated with home testing for radon. It also suggests partnering with real estate agents to further radon education and testing efforts to reduce radon exposure and lung cancer risk.
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Affiliation(s)
- A Neri
- Division of Scientific Education and Professional Development, Population Health Workforce Branch, Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology, and Laboratory Services, Preventive Medicine Residency and Fellowship, Atlanta, GA, USA
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Comprehensive Cancer Control Branch, Atlanta, GA, USA
| | | | - B Momin
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Comprehensive Cancer Control Branch, Atlanta, GA, USA
| | - M Puckett
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Comprehensive Cancer Control Branch, Atlanta, GA, USA
| | - M S Gallaway
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Comprehensive Cancer Control Branch, Atlanta, GA, USA
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Ou JY, Fowler B, Ding Q, Kirchhoff AC, Pappas L, Boucher K, Akerley W, Wu Y, Kaphingst K, Harding G, Kepka D. A statewide investigation of geographic lung cancer incidence patterns and radon exposure in a low-smoking population. BMC Cancer 2018; 18:115. [PMID: 29385999 PMCID: PMC5793382 DOI: 10.1186/s12885-018-4002-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer-related mortality in Utah despite having the nation's lowest smoking rate. Radon exposure and differences in lung cancer incidence between nonmetropolitan and metropolitan areas may explain this phenomenon. We compared smoking-adjusted lung cancer incidence rates between nonmetropolitan and metropolitan counties by predicted indoor radon level, sex, and cancer stage. We also compared lung cancer incidence by county classification between Utah and all SEER sites. METHODS SEER*Stat provided annual age-adjusted rates per 100,000 from 1991 to 2010 for each Utah county and all other SEER sites. County classification, stage, and sex were obtained from SEER*Stat. Smoking was obtained from Environmental Public Health Tracking estimates by Ortega et al. EPA provided low (< 2 pCi/L), moderate (2-4 pCi/L), and high (> 4 pCi/L) indoor radon levels for each county. Poisson models calculated overall, cancer stage, and sex-specific rates and p-values for smoking-adjusted and unadjusted models. LOESS smoothed trend lines compared incidence rates between Utah and all SEER sites by county classification. RESULTS All metropolitan counties had moderate radon levels; 12 (63%) of the 19 nonmetropolitan counties had moderate predicted radon levels and 7 (37%) had high predicted radon levels. Lung cancer incidence rates were higher in nonmetropolitan counties than metropolitan counties (34.8 vs 29.7 per 100,000, respectively). Incidence of distant stage cancers was significantly higher in nonmetropolitan counties after controlling for smoking (16.7 vs 15.4, p = 0.02*). Incidence rates in metropolitan, moderate radon and nonmetropolitan, moderate radon counties were similar. Nonmetropolitan, high radon counties had a significantly higher incidence of lung cancer compared to nonmetropolitan, moderate radon counties after adjustment for smoking (41.7 vs 29.2, p < 0.0001*). Lung cancer incidence patterns in Utah were opposite of metropolitan/nonmetropolitan trends in other SEER sites. CONCLUSION Lung cancer incidence and distant stage incidence rates were consistently higher in nonmetropolitan Utah counties than metropolitan counties, suggesting that limited access to preventative screenings may play a role in this disparity. Smoking-adjusted incidence rates in nonmetropolitan, high radon counties were significantly higher than moderate radon counties, suggesting that radon was also major contributor to lung cancer in these regions. National studies should account for geographic and environmental factors when examining nonmetropolitan/metropolitan differences in lung cancer.
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Affiliation(s)
- Judy Y. Ou
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84112 USA
| | - Brynn Fowler
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
| | - Qian Ding
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84112 USA
| | - Anne C. Kirchhoff
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84112 USA
| | - Lisa Pappas
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84112 USA
| | - Kenneth Boucher
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84112 USA
| | - Wallace Akerley
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
| | - Yelena Wu
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84112 USA
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT 84112 USA
| | - Kimberly Kaphingst
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
- Department of Communication, University of Utah, 255 S Central Campus Dr., Rm 2400, Salt Lake City, UT 84112 USA
| | - Garrett Harding
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
| | - Deanna Kepka
- Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112 USA
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Larsson LS. The Montana Radon Study: social marketing via digital signage technology for reaching families in the waiting room. Am J Public Health 2014; 105:779-85. [PMID: 25121816 DOI: 10.2105/ajph.2014.302060] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES I tested a social marketing intervention delivered in health department waiting rooms via digital signage technology for increasing radon program participation among priority groups. METHODS I conducted a tri-county, community-based study over a 3-year period (2010-2013) in a high-radon state by using a quasi-experimental design. We collected survey data for eligible participants at the time of radon test kit purchase. RESULTS Radon program participation increased at the intervention site (t38 = 3.74; P = .001; 95% confidence interval [CI] = 4.8, 16.0) with an increase in renters (χ(2)1,228 = 4.3; P = .039), Special Supplementary Nutrition Program for Women, Infants, and Children families (χ(2)1,166 = 3.13; P = .077) and first-time testers (χ(2)1,228 = 10.93; P = .001). Approximately one third (30.3%; n = 30) attributed participation in the radon program to viewing the intervention message. The intervention crossover was also successful with increased monthly kit sales (t37 = 2.69; P = .01; 95% CI = 1.20, 8.47) and increased households participating (t23 = 4.76; P < .001; 95% CI = 3.10, 7.88). CONCLUSIONS A social marketing message was an effective population-based intervention for increasing radon program participation. The results prompted policy changes for Montana radon programming and adoption of digital signage technology by 2 health departments.
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Affiliation(s)
- Laura S Larsson
- Laura S. Larsson is with the College of Nursing at Montana State University, Bozeman, MT
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Larsson LS. Risk-reduction strategies to expand radon care planning with vulnerable groups. Public Health Nurs 2014; 31:526-36. [PMID: 24547763 DOI: 10.1111/phn.12111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Radon is the second leading cause of lung cancer in the United States and the leading cause of lung cancer among nonsmokers. Residential radon is the cause of approximately 21,000 U.S. lung cancer deaths each year. Dangerous levels of radon are just as likely to be found in low-rise apartments and townhomes as single-family homes in the same area. The preferred radon mitigation strategy can be expensive and requires structural modifications to the home. The public health nurse (PHN) needs a collection of low-cost alternatives when working with low-income families or families who rent their homes. METHOD A review of the literature was performed to identify evidence-based methods to reduce radon risk with vulnerable populations. RESULTS Fourteen recommendations for radon risk reduction were categorized into four strategies. Nine additional activities for raising awareness and increasing testing were also included. DISCUSSION The results pair the PHN with practical interventions and the underlying rationale to develop radon careplans with vulnerable families across housing types. The PHN has both the competence and the access to help families reduce their exposure to this potent carcinogen.
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Lung cancer risk from radon in Ontario, Canada: how many lung cancers can we prevent? Cancer Causes Control 2013; 24:2013-20. [PMID: 23982909 PMCID: PMC3824583 DOI: 10.1007/s10552-013-0278-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/14/2013] [Indexed: 11/23/2022]
Abstract
Purpose To calculate the burden of lung cancer illness due to radon for all thirty-six health units in Ontario and determine the number of radon-attributable lung cancer deaths that could be prevented.
Methods We calculated the population attributable risk percent, excess life-time risk ratio, life-years lost, the number of lung cancer deaths due to radon, and the number of deaths that could be prevented if all homes above various cut-points were effectively reduced to background levels. Results It is estimated that 13.6 % (95 % CI 11.0, 16.7) of lung cancer deaths in Ontario are attributable to radon, corresponding to 847 (95 % CI 686, 1,039) lung cancer deaths each year, approximately 84 % of these in ever-smokers. If all homes above 200 Bq/m3, the current Canadian guideline, were remediated to background levels, it is estimated that 91 lung cancer deaths could be prevented each year, 233 if remediation was performed at 100 Bq/m3. There was important variation across health units. Conclusions Radon is an important contributor to lung cancer deaths in Ontario. A large portion of radon-attributable lung cancer deaths are from exposures below the current Canadian guideline, suggesting interventions that install effective radon-preventive measures into buildings at build may be a good alternative population prevention strategy to testing and remediation. For some health units, testing and remediation may also prevent a portion of radon-related lung cancer deaths. Regional attributable risk estimates can help with local public health resource allocation and decision making.
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