Step 1: Engage – Build Partnerships and Engage the Community
Iowa has the highest percentage of homes with elevated indoor radon levels in the country, with seven out of ten homes having levels above the indoor radon action level of 4pCi/L1 set by the Environmental Protection Agency (EPA) (American Lung Association, n.d.). Radon gas is the second leading cause of lung cancer. An estimated 400 deaths per year in Iowa are attributed to radon-induced lung cancer (American Lung Association, n.d.).
PSE Change Solution
The goal of this community-based project was to raise awareness of radon and to provide radon testing and mitigation services for low-income homes in Polk County, Iowa– specifically those whose income was at or below 80 percent of median family income for the state. The project also sought to identify additional community-based resources that could provide families and individuals with financial assistance for home radon testing and mitigation.
The Iowa Cancer Consortium (Consortium) led the project and worked collaboratively with numerous stakeholders, including the Polk County Health Department and other agencies, neighborhood associations, community organizations and local businesses. Actions taken by the Consortium reflect the range of steps in the PSE change process, as follows:
The Consortium employed a multi-pronged approach to engage the community, conducting community outreach through community stakeholders, providing community educational presentations and setting up booths at community events. Specific promotion activities (Step 5: Promote) included:
Development of project promotional materials (project cover letters, participation eligibility criteria, Radon-Free Homes Initiative application forms, income eligibility limits summary documents and copies of the “Radon and You” brochures) in both English and Spanish to facilitate outreach to the project’s intended populations.
Educational outreach in the form of in-person meetings with key representatives of more than 20 community organizations and neighborhood associations to garner their support for the project.
Setting up table displays and booths promoting the project on site at community organizations during community events.
Engaging families, providing them with education on radon, conducting home radon testing and providing radon mitigation when necessary.
The project also included a county-wide assessment to identify existing community resources that were providing, or could potentially provide, families and individuals that did not meet the project participation criteria with financial assistance with radon testing and mitigation within Polk County (Step 4: Review).
The project was funded through grants provided by the EPA and the Department of Housing and Urban Development. The program provided homes that satisfied the eligibility criteria with free radon testing and referred them to the Polk County Healthy Homes Program. Homes with elevated radon levels (≥4pCI/L) were also eligible for further radon testing and radon mitigation through the Polk County Healthy Homes Program. All families that participated in the Radon-Free Homes Initiative received educational information on the impacts of radon on health, as well as a copy of the “Radon and You” brochure (Step 6: Implement).
While the project’s goal had been 48 homes tested, in total, 53 homes completed radon testing. Sixteen of these received radon mitigation and subsequently tested within acceptable limits during post-mitigation radon testing. None of the participating families had ever previously had their homes tested. In addition, evaluation of the project (Step 7: Evaluate) revealed:
The majority of families whose homes were tested indicated they felt more knowledgeable about radon and its impacts on health following participation in the Radon-Free Homes Initiative.
The majority of households indicated that they would recommend radon testing to their other family members and friends and requested additional program application forms and “Radon and You” brochures for distribution through personal networks.
As previously mentioned, project criteria required participating families to have incomes at or below 80% of median family income. During the course of this initiative, project staff learned that the cost of radon testing and mitigation was still unaffordable for low-income families that did not meet the project participation criteria, as well as for families and individuals whose income was just above 80 percent of the median family income. Community members raised questions regarding the availability of additional programs or other opportunities that could offer full or partial financial assistance to cover these expenses. To address this concern, the Radon-Free Homes Initiative expanded the project to include a countywide assessment to identify existing community resources that provided, or could potentially provide, assistance with radon testing and mitigation.
Project staff conducted outreach to local city administration and government agencies, community-based home improvement assistance organizations, and banks within Polk County to identify: (1) Polk County banks offering low-interest loan programs for home radon testing and mitigation; and (2) community-based programs or home improvement organizations providing funding assistance or low-cost services that could potentially offer assistance with home radon testing and mitigation services.
The result of this assessment was the development of a financial resources list for radon testing and mitigation that was made available to the public, community organizations and government agencies within the county.
Success Factors and Key Questions Addressed
Which stakeholders needed to be included in your efforts and how did you assemble them?
Along with the Consortium, other stakeholders included the Polk County Health Department, neighborhood associations, community organizations, local banks, local government agencies and community-based home improvement organizations. The stakeholders were assembled primarily by project staff, the Consortium and the Polk County Health Department, through in-person meetings with key stakeholder representatives.
How did the missions of diverse stakeholders align for the purpose of the PSE change effort?
The mission of this project aligned with the mission of the stakeholders. The Polk County Healthy Homes Program works to improve home health in Polk County through home lead testing and remediation, and testing for radon. Many of the other stakeholders’ missions are to improve the health and well-being of the community and/or to provide services to the community. This project supported those missions.
What resources (tangible and intangible) were needed that stakeholders could provide?
As project lead for the Radon-Free Homes Initiative, the Consortium provided staffing and coordination for the project. The Polk County Health Department managed the Polk County Healthy Homes Program. The neighborhood associations and community organizations relayed radon educational information and Radon-Free Homes Initiative information to their clients and communities and identified families that could potentially participate. Some local banks were able to provide low-interest loans to assist home owners with radon testing and mitigation. A number of community-based home improvement organizations agreed to provide assistance with home radon testing and mitigation services.