Use of Theory-Driven Report Back to Promote Lung Cancer Risk Reduction

Abstract

Report back is active sharing of research findings with participants to prompt behavior change. Research on theory-driven report back for environmental risk reduction is limited. The study aim is to evaluate the impact of a stage-tailored report back process with participants who had high home radon and/or air nicotine levels. An observational one-group pre-post design was used, with data collection at 3, 9, and 15 months post intervention. Participants from the parent study (N = 515) were randomized to the treatment or control group and this sample included all 87 treatment participants who: (1) had elevated radon and/or air nicotine at baseline; and (2) received stage-tailored report back of their values. Short-term test kits measured radon; passive airborne nicotine samplers assessed secondhand smoke (SHS) exposure. Stage of action was categorized as: (1) ‘Unaware,’ (2) ‘Unengaged,’ (3) ‘Deciding,’ (4) ‘Action,’ and (5) ‘Maintenance.’ Interventions were provided for free, such as in-person radon and SHS test kits and a brief telephonic problem-solving consultation. Stage of action for radon mitigation and smoke-free policy increased from baseline to 3 months and remained stable between 3 and 9 months. Stage of action for radon was higher at 15 months than baseline. Among those with high baseline radon, observed radon decreased by 15 months (p < 0.001). Tailored report back of contaminant values reduced radon exposure and changed the health behavior necessary to remediate radon and SHS exposure.

Citizen Science Approach to Home Radon Testing, Environmental Health Literacy and Efficacy

“…For those with 2-week average levels at or above the WHO action level (but below the EPA action level), we included in the personalized email a recommendation to test for an additional two months (and how to reset the detector to take a longer-term reading). We invited those with 2-week long-term average radon values at or above the EPA action level to discuss their radon values and benefits of mitigation via telephone or Zoom, using a 20-minute brief problem-solving approach to assess readiness to take action, including the participant’s perceived risk, worry, social norms (“how concerned about radon are people in your community”), response efficacy (“do you know anyone who has mitigated”), and barriers to mitigation (e.g., cost) adapted from a previous lung cancer risk–reduction study ( Huntington-Moskos et al 2021 ). Two members of the RADAR team led the informal conversation with the participant to answer questions and describe the mitigation process, how to contact a certified radon mitigation professional, and how to use the study voucher to partially cover the cost.…”