Academic journal article American Journal of Health Education

Results of a Test and Win Contest to Raise Radon Awareness in Urban and Rural Settings

Academic journal article American Journal of Health Education

Results of a Test and Win Contest to Raise Radon Awareness in Urban and Rural Settings

Article excerpt

Background: Radon is a leading cause of lung cancer, but few test their homes to determine radon levels. Purpose: The study assessed feasibility and success of a Test and Win Contest to promote radon testing in rural and urban communities. Methods: The prospective, quasi-experimental study tested a novel contest to raise radon awareness. Paid and earned media recruited homeowners who received a free test kit and were eligible to win free home mitigation. Urban homeowners with the 5 highest radon levels and rural participants with the 3 highest won free radon mitigation systems. Cross-sectional surveys were completed via Internet or phone at enrollment. Results: Most returned the radon test kits (71% urban; 86% rural). Participation was more prevalent in the rural location most likely due to longer media recruitment (6 weeks vs. 11 days) and more money spent on media advertising ($1.86 vs. $0.21 per eligible household). The contest attracted 102 per 10 000 households to test for radon in the rural area compared to 19 per 10 000 households in urban counties. Discussion: The contest was a feasible and successful population-based strategy in both locations. Translation to Health Education Practice: The Test and Win Contest is a promising health education strategy to promote radon testing.


Radon is a leading cause of lung cancer, second only to smoking. (1-3) It is estimated that 15% of lung cancer cases in men and 53% in women are not caused by firsthand smoking. (4) Radon exposure is linked to 15400 to 21800 cases of lung cancer in the United States each year, (3) or approximately 10% of lung cancer cases. (5) The combination of first- and secondhand smoke and radon exposure increases the risk of lung cancer nearly 10-fold. (6)

Radon is a naturally occurring, colorless, odorless, and tasteless radioactive gas derived from the decay of thorium and uranium, which are common elements found in rock and soil. (3) Radon gas becomes entrapped in houses and other buildings by seeping into cracks in foundations or basements or by entering through sump pumps or other drainage systems. (6) Though most people have heard of radon, very few test their homes for the radioactive gas. One study reported that 82% of respondents had heard of radon but only 15% had tested for radon. (7)

The US Environmental Protection Agency (EPA) and the US Surgeon General both recommend that all homes be tested for radon gas. (1,6) Radon can be detected with a simple home test kit and easily controlled through well-established venting techniques. Radon levels greater than 4 picocuries per liter (pCi/L) are at the action level requiring mitigation as designated by the EPA. (6) If radon levels > 4.0 pCi/L are detected, properly installed mitigation systems reduce the risk of exposure. When individuals are provided with evidence of elevated radon levels, they are more likely to mitigate. (8-10) However, proper mitigation systems are expensive to install. Depending on the region of the United States, mitigation costs can range from $1250 to $1750 for an average home with a basement and up to $2500-$3000 for a home on a crawlspace. In addition to the fact that most people do not test their homes for radon, affordability and access to radon mitigation may be a barrier to taking action to fix the problem.

Population-based strategies designed to promote health reach large numbers of people by focusing on changing the environment (11) and have been shown to be effective in raising awareness and changing health behaviors. (12,13) Quit and Win Contests promote smoking cessation (14) and our team has reported these contests to be both efficacious and successful in attracting large numbers of smokers to make quit attempts (15) regardless of socioeconomic status. (16) In our controlled trial of a Quit and Win Contest, 494 tobacco users joined the contest in an attempt to quit; 25% of those in the contest were nonsmokers at 12 months post-baseline compared to 7% of controls. …

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