IntroductionTobacco smoke and radon are the leading causes of lung cancer. The FRESH intervention was a randomized controlled trial of 515 homeowners to promote stage of action to reduce radon and air nicotine levels. MethodsWe studied 515 participants, 257 in a treatment group and 258 in a control group. Treatment participants received free radon and air nicotine test kits, report back, and telephone support, and those participants whose homes had high radon levels received a voucher for $600 toward mitigation. Both groups were asked to retest 15 months post intervention. We examined differences in stage of action to test for and mitigate radon and adopt a smoke-free–home policy and in observed radon and air nicotine values by study group over time.ResultsHomeowners in the treatment group scored higher on stage of action to test for radon and air nicotine and to mitigate for radon during follow-up than those in the control group at 3 months and 9 months, but the effect of the intervention diminished after 9 months. We saw no difference between groups or over time in observed radon or air nicotine values. Of homeowners in the treatment group with high radon levels at baseline, 17% mitigated, and 80% of them used the voucher we provided.ConclusionThe null finding of no significant change in observed radon or air nicotine values from baseline to 15 months may reflect the low proportion of radon mitigation systems installed and the decline in stage of action to adopt a smoke-free home policy. Including a booster session at 9 months post intervention may improve the remediation rate.

Women who smoke during pregnancy face psychosocial barriers to cessation, and women with opioid use disorder (OUD) face amplified barriers. We pilot tested a Perinatal Wellness Navigator (PWN) program for a group of high-risk perinatal women ( N = 50; n = 42 with OUD) that consisted of (a) one-on-one tobacco treatment, (b) comprehensive assessment of cessation barriers, and (c) linkage to clinical/social services. Outcome measures were assessed at baseline and postintervention. Participants smoked 10 fewer cigarettes per day ( p = .05) at postintervention and were less dependent on nicotine ( p < .01). Mean postnatal depression scores ( p = .03) and perceived stress ( p = .03) decreased postintervention. Participants received at least one referral at baseline ( n = 106 total), and 10 participants received an additional 18 referrals at postintervention to address cessation barriers. The PWN program was minimally effective in promoting total tobacco abstinence in a high-risk group of perinatal women, but participants experienced reductions in cigarettes smoked per day, nicotine dependence, stress, and depression.

We combined 71,930 short‐term (median duration 4 days) home radon test results with 1:24,000‐scale bedrock geologic map coverage of Kentucky to produce a statewide geologically based indoor‐radon potential map. The test results were positively skewed with a mean of 266 Bq/m 3 , median of 122 Bq/m 3 , and 75th percentile of 289 Bq/m 3 . We identified 106 formations with ≥10 test results. Analysis of results from 20 predominantly monolithologic formations showed indoor‐radon concentrations to be positively skewed on a formation‐by‐formation basis, with a proportional relationship between sample means and standard deviations. Limestone (median 170 Bq/m 3 ) and dolostone (median 130 Bq/m 3 ) tended to have higher indoor‐radon concentrations than siltstones and sandstones (median 67 Bq/m 3 ) or unlithified surficial deposits (median 63 Bq/m 3 ). Individual shales had median values ranging from 67 to 189 Bq/m 3 ; the median value for all shale values was 85 Bq/m 3 . Percentages of values falling above the U.S. Environmental Protection Agency (EPA) action level of 148 Bq/m 3 were sandstone and siltstone: 24%, unlithified clastic: 21%, dolostone: 46%, limestone: 55%, and shale: 34%. Mississippian limestones, Ordovician limestones, and Devonian black shales had the highest indoor‐radon potential values in Kentucky. Indoor‐radon test mean values for the selected formations were also weakly, but statistically significantly, correlated with mean aeroradiometric uranium concentrations. To produce a map useful to nonspecialists, we classified each of the 106 formations into five radon‐geologic classes on the basis of their 75th percentile radon concentrations. The statewide map is freely available through an interactive internet map service.

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.

Homeowners who were provided free radon and air nicotine test kits, given their results, and engaged in a brief telephonic problem-solving consultation tended to show a greater increase in readiness to take action to test and remediate by 3 months compared with those who received standard public health practice. Both groups showed an increase in stage of action for all four outcomes over time.