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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how different methods of sharing information about radon testing influence decisions to test homes for radon, a harmful indoor gas. In the first phase, the trial investigates the impact of joining a focus group with an educational overview on participants' plans to test their homes. The second phase evaluates whether an online health promotion intervention, tailored by smoking status and with or without reminder messages, encourages more people to request and complete radon testing compared to a standard public health infographic. Homeowners or renters in New Hampshire or Vermont who haven't tested their homes for radon and live there year-round may be suitable for this trial. As an unphased trial, this study offers participants the opportunity to contribute to significant public health research that could shape future radon testing strategies.

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 prior data suggests that these interventions for radon testing are safe?

Past studies have used focus groups to gather information and educate people about radon testing. These sessions are generally easy to manage, and participants have not reported any negative effects. The focus groups involve talking and sharing information, which are safe activities.

Research on online health programs, like the one tested in this study, shows they are safe. For example, one study found that using a smartphone app to learn about radon testing increased knowledge without any safety issues. Adding reminder messages also did not cause any problems.

Overall, these programs focus on sharing information and encouraging action. They don't involve taking medications or other physical treatments, so they are usually very safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to encourage home radon testing, which is crucial for preventing lung cancer. Traditional methods often rely on generic public health messages. In contrast, this trial investigates tailored online interventions that adapt based on smoking status, potentially making them more engaging and relevant. Additionally, some interventions include follow-up reminder messages, which aim to increase the likelihood of participants completing the radon testing. These personalized and proactive approaches could significantly enhance public health strategies by increasing awareness and action regarding radon exposure.

What evidence suggests that this trial's interventions could be effective for promoting radon testing?

Research shows that educational sessions can significantly increase the number of people who test for radon. One study found that 74% of people who received this information tested for radon, compared to only 22% who did not. In this trial, participants in the focus group with an educational overview will receive similar information.

For online health programs designed for smokers, evidence suggests that users of a radon app gained more knowledge about radon and were three times more likely to request a test. This trial includes an online health promotion intervention tailored by smoking status, with some participants also receiving reminder messages. Adding reminder messages to these online programs further boosts participation, as reminders prompt people to test for radon, leading to more tests being completed. Overall, these methods effectively encourage more people to test for radon in their homes. ^{1 3 6 7 8}

Who Is on the Research Team?

Judith R Rees, BM, BCh, PhD

Principal Investigator

Dartmouth-Hitchcock Medical Center

Rian M. Hasson

Principal Investigator

Dartmouth-Hitchcock Medical Center

Are You a Good Fit for This Trial?

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

Rent or own their home

Live at their home year-round

Have a valid mailing address in New Hampshire or Vermont

Exclusion Criteria

N/A

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9949773/

Citizen Science Approach to Home Radon Testing ... Three-quarters (74%) of the treatment group completed home radon testing compared to 22% in the control group (Butler et al. 2018). The fact ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S0265931X25002292

Radon literacy assessment and testing in an African ... Over 40 % lacked knowledge about radon, and 88.1 % were unaware of remediation thresholds. Radon literacy was positively associated with higher educational ...

3. ajpmfocus.org ajpmfocus.org/article/S2773-0654(25)00060-4/fulltext

Increasing Residential Radon Testing Through Outreach to ... For parents who participate, the Newborn Radon Testing Project is effective at detecting residential radon exposure above the EPA's action level ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6311142/

A Qualitative Study of Realtor Knowledge, Attitudes, and ... This qualitative study sought to determine radon-related knowledge, attitudes, and practices among Realtors to inform cancer control activities ...

5. mdpi.com mdpi.com/1660-4601/17/24/9178

High School Students as Citizen Scientists to Decrease ... The radon toolkit included radon information, and how to test, interpret, and report back findings. We educated youth as citizen scientists and ...

6. theoryandpractice.citizenscienceassociation.org theoryandpractice.citizenscienceassociation.org/articles/10.5334/cstp.472

Citizen Science Approach to Home Radon Testing ... We trained 60 non-scientist community residents as citizen scientists to test their homes for radon and report back the findings. We engaged ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S1687850723001991

Knowledge, risk perception and awareness of radon risks This study aims to investigate the level of knowledge and awareness of the risks associated with radon exposure among the general public.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11354316/

Radon Testing Status in Schools by Radon Zone and ... Assessing indoor radon levels in schools and mitigating exposure when levels are high could be an important means of reducing radon exposure among youth but ...