Online Health Promotion for Home Radon Testing

(HHS Trial)

Overseen By Lisa A Purvis, EdD, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Dartmouth-Hitchcock Medical Center

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

172 Participants Needed

Trial Summary

What is the purpose of this trial?

This study is about home air radon testing and has two phases. The goal of the first phase is to learn about renters' and homeowners' views and plans related to radon testing. The main question this phase aims to answer is: 1. Does taking part in a focus group with information about radon testing change people's plans to test for radon? Participants in the first study phase will: * Take a survey about their views on and plans for radon testing. * Take part in a focus group discussion about radon testing, during which they will receive information about radon testing. * Right after the focus group, take a survey about their plans for radon testing. The second phase is a pilot interventional study. The goal is to test interventions about radon testing with renters and homeowners who smoke and do not smoke. The main questions this phase aims to answer are: 1. Does the recruitment strategy result in enough participants enrolling within 3 months? 2. Will at least 80% of participants complete data collection activities? 3. Will more participants who view an online intervention developed by the researchers request free radon test kits, set them up in their homes, and complete radon testing, compared to participants who view a standard public health infographic? And will even more participants who receive reminder messages, in addition to the online intervention, request free radon test kits, set them up in their homes, and complete radon testing? Participants in this second phase will: * Take a survey about their views on and plans for radon testing. * View an intervention about radon testing. * Right after viewing the intervention, take a survey about their views on and plans for radon testing. * 2 months later, take a survey about what, if any, steps they've taken to test their homes for radon. * Provide the researchers permission to collect data from their State Radon Program on: a) whether they requested a free radon test kit and b) whether testing was completed. Some participants will receive reminder messages for 2 months after viewing the intervention. Researchers will compare an online intervention they developed about radon testing to: a) a standard public health infographic and b) their online intervention combined with reminder messages about radon testing. They will compare the interventions by proportion of participants who: a) request a free radon test kit from their State Radon Programs, b) set-up the radon test kit in their homes, and c) complete radon testing.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for Online Health Promotion for Home Radon Testing?

Research shows that using a smartphone app to promote radon testing significantly increased users' knowledge and confidence in testing compared to printed brochures. Additionally, tailored feedback on radon levels and smoking status has been effective in reducing radon exposure and encouraging behavior change. ^{1 2 3 4 5}

Is the Online Health Promotion for Home Radon Testing safe for humans?

The research articles do not provide specific safety data for the Online Health Promotion for Home Radon Testing or related interventions. They focus on the effectiveness of radon testing and mitigation strategies rather than safety concerns. ^{1 3 5 6 7}

How does the online health promotion for home radon testing differ from other treatments for radon exposure?

This treatment is unique because it uses a smartphone app to increase awareness and encourage home radon testing, which is more interactive and accessible compared to traditional methods like printed brochures. The app not only provides information but also allows users to request a free radon test, making it a more engaging and convenient option for promoting radon testing. ^{1 4 5 8 9}

Research Team

Judith R Rees, BM, BCh, PhD

Principal Investigator

Dartmouth-Hitchcock Medical Center

Rian M. Hasson

Principal Investigator

Dartmouth-Hitchcock Medical Center

Eligibility Criteria

The Healthy Homes Study is for adults over 18 living year-round in New Hampshire or Vermont who haven't tested their current homes for radon. It's suitable for both renters and homeowners with a valid mailing address.

Inclusion Criteria

Have a valid mailing address in New Hampshire or Vermont

Have not tested their current homes for radon

Rent or own their home

Exclusion Criteria

N/A

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-4 weeks

Focus Group and Survey

Participants take a survey about their views on radon testing and participate in a focus group discussion with educational overview about radon testing.

1 day

1 visit (in-person or virtual)

Pilot Interventional Study

Participants view an online health promotion intervention about radon testing, tailored by smoking status, and receive reminder messages for 2 months.

2 months

Online intervention and follow-up surveys

Follow-up

Participants are monitored for their actions regarding radon testing, including requesting and setting up radon test kits.

18 months

Treatment Details

Interventions

• Focus group with educational overview (AIM 1)
• Online health promotion intervention tailored by smoking status (AIM 3)
• Online health promotion intervention tailored by smoking status, plus reminder messages (AIM 3)
• Public health infographic (AIM 3)

Trial Overview This study tests the effectiveness of different educational interventions on people's intentions to test their homes for radon. Interventions include online health promotion, focus groups, public infographics, and reminder messages.

Participant Groups

Group I: Online health promotion intervention tailored by smoking status, plus reminder messages (AIM 3) Experimental Treatment 1 Intervention

Participants will view an online health promotion intervention about home air radon testing, with messaging tailored based on whether the participant smokes or does not smoke. Participants will also receive information about requesting a free home air radon test kit from their state radon program, as well as reminder messages about radon testing for about two months after initially viewing the online intervention component.

Group II: Online health promotion intervention tailored by smoking status (AIM 3) Experimental Treatment 1 Intervention

Participants will view an online health promotion intervention about home air radon testing, with messaging tailored based on whether the participant smokes or does not smoke. Participants will also receive information about requesting a free home air radon test kit from their state radon program.

Group III: Focus group with educational overview (AIM 1) Experimental Treatment 1 Intervention

Participants will participate in a focus group discussion about radon testing and will receive a brief educational overview about radon testing.

Group IV: Public health infographic (AIM 3) Active Control 1 Intervention

Participants will view a standard public health infographic about home air radon testing and will receive information about requesting a free home air radon test kit from their state radon program.

Who Is Running the Clinical Trial?

Dartmouth-Hitchcock Medical Center

Lead Sponsor

Trials

548

Recruited

2,545,000+

Findings from Research

The smartphone app significantly improved radon knowledge and self-efficacy among users compared to printed brochures, with app users requesting radon tests three times more often (41.4% vs. 13.2%).

Despite the app's effectiveness in increasing awareness and test requests, the actual rate of test usage remained low at around 3%, indicating a need for strategies to encourage more people to follow through with testing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interventions to promote home radon testing: A randomized clinical trial of a smartphone app vs. printed brochures. Kim, S., Chiu, T., Klug, MG., et al.[2023]

Only 24.7% of 692 surveyed patients had tested their homes for radon, highlighting a significant gap in awareness and action regarding this lung cancer risk factor.

An intervention aimed at encouraging radon testing, which included information and a discount coupon, resulted in only 14.4% of participants testing their homes, suggesting that stronger and more frequent interventions may be needed to increase testing rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Radon testing and mitigation: an intervention in a primary care setting. Nissen, MJ., Leach, JW., Nissen, JA., et al.[2021]

A tailored report back process significantly improved participants' awareness and action regarding high radon and air nicotine levels, with positive changes in behavior observed from baseline to 15 months.

Participants who received the tailored feedback showed a notable decrease in radon levels, with a reduction of 15% by 15 months, indicating the effectiveness of the intervention in promoting health behavior change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of Theory-Driven Report Back to Promote Lung Cancer Risk Reduction. Huntington-Moskos, L., Rayens, MK., Wiggins, AT., et al.[2023]

A survey of 1,209 New York State residents revealed that while 82% had heard of radon, only 21% had a knowledgeable understanding of it, indicating a significant gap in awareness.

Only 15% of those aware of radon had tested their homes for it, highlighting the need for renewed public health efforts to educate residents about radon risks and promote testing and remediation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Radon awareness, testing, and remediation survey among New York State residents. Wang, Y., Ju, C., Stark, AD., et al.[2019]

A survey of 300 homeowners in a radon-prone area revealed that while 64% were concerned about radon, only 7% had tested their homes, indicating a gap between concern and action.

The study found that greater knowledge about radon and proactive information-seeking behaviors were linked to higher rates of home testing, suggesting that targeted education, especially relating radon risks to environmental issues, could improve testing rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The relationship between radon knowledge, concern and behavior, and health values, health locus of control and preventive health behaviors. Kennedy, CJ., Probart, CK., Dorman, SM.[2019]

Homeowners in radon-prone areas tend to be more informed and concerned about radon exposure, while those in non-prone areas often resist testing, highlighting the need for targeted risk communication strategies.

Health Canada recommends testing all homes for radon, as some homes outside designated radon-prone areas may still have levels exceeding safety guidelines, emphasizing the importance of widespread awareness and education on radon risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Radon Risk Communication Strategies: A Regional Story. Cheng, W.[2016]

A study involving 60 homeowners in rural Kentucky showed that training them to test for radon significantly increased their environmental health literacy and self-efficacy regarding radon testing and mitigation over time.

Despite increased confidence in contacting radon mitigation professionals, participants did not change their beliefs about the effectiveness of radon mitigation or their ability to hire professionals, indicating a need for further research on citizen science's impact on radon exposure reduction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Citizen Science Approach to Home Radon Testing, Environmental Health Literacy and Efficacy. Stanifer, S., Hoover, AG., Rademacher, K., et al.[2023]

In Iowa, a collaborative effort to raise awareness about radon gas has led to a 20% increase in home radon tests from 2009 to 2014, highlighting the effectiveness of community engagement in public health initiatives.

The number of radon mitigations completed by certified professionals more than doubled (108% increase) during the same period, indicating successful implementation of radon control measures in homes at risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Successes and Challenges in Implementation of Radon Control Activities in Iowa, 2010-2015. Bain, AA., Abbott, AL., Miller, LL.[2018]

Indoor radon exposure is a significant cause of lung cancer, yet the availability of radon information online is often limited, with only three dedicated pages found in highly radon-prone areas across eight European countries.

Improving radon websites with consistent information, engaging content, and interactive features could enhance public awareness and encourage protective actions, ultimately helping to reduce lung cancer rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is internet a missed opportunity? Evaluating radon websites from a stakeholder engagement perspective. Perko, T., Turcanu, C.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Interventions to promote home radon testing: A randomized clinical trial of a smartphone app vs. printed brochures. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Radon testing and mitigation: an intervention in a primary care setting. [2021]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Use of Theory-Driven Report Back to Promote Lung Cancer Risk Reduction. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Radon awareness, testing, and remediation survey among New York State residents. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

The relationship between radon knowledge, concern and behavior, and health values, health locus of control and preventive health behaviors. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Radon Risk Communication Strategies: A Regional Story. [2016]

7. England pubmed.ncbi.nlm.nih.gov

Citizen Science Approach to Home Radon Testing, Environmental Health Literacy and Efficacy. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Successes and Challenges in Implementation of Radon Control Activities in Iowa, 2010-2015. [2018]

9. England pubmed.ncbi.nlm.nih.gov

Is internet a missed opportunity? Evaluating radon websites from a stakeholder engagement perspective. [2020]