United States        Office of Policy        November 1988
             Environmental Protection    Planning and Evaluation
             Agency          Washington DC 20460
&EPA       Region 3/OPPE/State of
             Maryland Radon Risk
             Communication Project:

             An Evaluation of Radon Risk
             Communication Approaches

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          Region 3/OPPE/State of Maryland Radon
                Risk Communication Project:

An Evaluation  of  Radon  Risk  Communication  Approaches
                      Prepared  by the

        United  States Environmental  Protection Agency
           Office of Policy, Planning, and Evaluation
                Program  Evaluation  Division
                      November  1988

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Acknowledgments
          This project was initiated by Stan Laskowski, Deputy Regional Administrator
   for Region 3, but was a joint effort between Region 3, EPA Headquarters, and the State
   of Maryland. Nancy Zahedi and Carol Deck were the Program Evaluation Division's
   (PED) Project Managers, following Eileen Sheehan's  move to Region 9. They were
   assisted at various times by other PED staff, including Katherine McMillan, Patricia
   Haman, Eileen Fesco, Tim Jones, Walter Simon, and summer interns Patricia Castillo,
   Mary Kae Eckert, and Susan Mayer. Bill Desvousges and Hillery Rink of the Research
   Triangle Institute also participated in the study through a Cooperative Agreement.

          We would like to acknowledge  the support and assistance of Jesse Baskerville,
   Lew Felleisen, Bill Belanger, Lee Blackburn, and Kristen McNamara of Region 3.
   Special thanks go to the Maryland Department of the Environment radon staff: Roland
   Fletcher, Richard Brisson, and Leon Rachuba, who were extremely cooperative and
   helpful despite the many other pressing demands on their time.  We would also like to
   acknowledge the valuable contributions of Ann Fisher, Steve Page, and other Advisory
   Group members, whose participation made this project more relevant to the needs of
   risk communicators.

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                        EXECUTIVE SUMMARY

Introduction

      The Environmental Protection Agency (EPA) and States are faced with
the challenge of communicating to the public the importance of testing
homes for radon.  Toward this end, a radon risk communication outreach
effort was undertaken in Maryland in the 1987/88 heating season by the EPA
and Maryland Department of the Environment (MDE).  The purpose of this
effort was to develop communication materials and to test communication
methods that could be easily adapted by States and EPA Regional Offices.

      Different outreach activities were conducted in two test communities
from January to March 1988. One community, Hagerstown, received media
outreach through radio and newspapers, and a radon insert in utility bills.  A
second community, Frederick, received the same outreach as Hagerstown,
combined with a community outreach component.  A third community,
Randallstown, served as a comparison community and received no special
communications.  During this period, a local Washington, D.C. television
station (WJLA) also embarked on a major radon public awareness campaign
which overlapped with the EPA-MDE outreach activities. The effects of this
campaign were therefore also included in the analysis of the communication
efforts and impacts.

      A pre-outreach and post-outreach survey were conducted of
approximately 1500 homeowners for each survey.  This survey asked
respondents where they obtained radon information and looked at
respondents' radon awareness,  knowledge, attitudes, and testing behavior.
Calls to the Maryland radon hotline were also monitored during this period
as  an additional means of determining where people had heard about radon.
Findings

      The principal findings of the study follow.  More information on
recommendations for risk communicators interested in applying the lessons
learned to a communications program can be found in the Conclusions
Section, pages 63-66.

1.  Differences  Between Communities

      Frederick—where people were exposed to news media from the EPA-
MDE Project as well as from WJLA, unsolicited mailings, and community
outreach activities—showed the greatest changes between the pre- and post-
outreach surveys with respect to awareness, knowledge, attitudes, and testing
behavior. Testing in Frederick increased by 9%. From a public health

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perspective this would conceivably represent only a small reduction in total
health risk if those facing radon risks take proper mitigating action.
However, from the perspective that EPA is trying to persuade the public to
test for radon and then mitigate when risks are high, this represents an
encouraging increase in testing within such a.short time period.  Changes in
Hagerstown—where  news media and unsolicited mailings were used—and in
Randallstown—the'comparison community—were  substantially smaller.

2.  Effects of News Media

      People's exposure to news media presentations about radon accounted
for most of the radon awareness measured in the surveys.  WJLA's campaign
was particularly effective in increasing knowledge, awareness, and testing.
Newspapers also were found to be a widely used source of radon information,
with radio a less frequently used source.

      While a television campaign is not a realistic communication method
for EPA and States, due to the financial resources needed for an extended
campaign, newspapers are a low-cost source of information that can be very
effective in communicating about radon.  Although radio does not reach as
many people as newspapers, it is also a method than can be easily and
inexpensively used to communicate about radon through public service
announcements.

3.  Unsolicited Mailings

      Unsolicited mailings—at least in the form of utility bill inserts—will not
produce the widespread exposure  to radon information that news media will.
Nevertheless, such inserts are, for EPA and States,  an inexpensive and -
relatively easy means of reaching a large  number of people: The mailing also
seemed to reinforce other communications and successfully motivated some
people who had read it to seek additional information.

4.  Community Outreach

      Community outreach, which consisted of community presentations,
distribution of radon posters and flyers, and organization of community
events, contributed to the increased awareness, knowledge, and testing
observed in Frederick.  While no individual element of this outreach had an
identifiable major impact, the combination of these activities was effective as
it helped increase informal communication about radon and personalize the
risks.

      Elements of the community outreach were more resource intensive
than may be realistic for EPA and States.  However, other groups, or
intermediaries, can be successfully used to carry out a community outreach

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communication strategy. The State of Maryland is working with the
University of Maryland Cooperative Extension Services to distribute radon
flyers, display radon posters, and use the radon slide show in community
presentations. Other service groups or organizations, such as the American
Lung Association, American Medical Association, and League of Women
Voters, can be tapped to communicate about radon. Involvement of local
officials can also be an effective communication device, particularly when
given local news coverage; for this project, local officials tested their homes
for radon.

5. Informal Communication Channels

      Use of informal communication channels, such as talking to  a friend,
relative or co-worker, appeared to be an important element in explaining why
certain individuals were more aware, knowledgeable, and concerned about
radon. Such informal channels help people to personalize the risk, i.e., feel
that they are potentially at risk from radon.  Communication activities on the
part of the EPA or States which help increase informal communications and
personalization of the risk will be most effective in promoting greater
concern and testing for radon.

6. Impact of Respondent Characteristics

      The characteristics of people surveyed appeared to have an influence
on their response to the message being presented. Education levels, income,
race, and sex  showed some relationship to the indicators used to measure
project effectiveness.
Radon Materials Available

      Radon materials available for use or adaptation by radon
communicators as a result of this Project are:

            Five radio public service announcement scripts.
            A 15-minute radon slide show (also available in video).
            Four radon posters.
            A radon flyer.

      Requests for information on these materials should be addressed to:
Peyton Davis, Office of Radiation Programs, EPA, Washington, D.C. 20460,
(202) 475-9605.

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                          Table of Contents
I.   INTRODUCTION 	1

    A.   Origin of Project	1
    B.   Participants	1
    C   Project Goals	2
    D.   Main Messages	2
    E.   Outreach Approaches	3
    F.   Test Communities 	4
    G.   Evaluation Design	4
    H.   Project Duration	7
H.  DESCRIPTION OF OUTREACH METHODS AND THEIR
    IMPLICATIONS	8

    A.  Selection of Methods	8

    B.   Media	9
         1.   Radio: What Was Done	9
         2.   Radio: How it Worked	9
         3.   Radio: Resources Needed	9
         4.   Newspapers: What Was Done	10
         5.   Newspapers: Resources Needed	10

    C.   Unsolicited Mailings:  Utility Bill Inserts	11
         1.   Unsolicited Mailings: What Was Done  	11
         2.   Unsolicited Mailings: How it Worked	11

    D.   Community Outreach	14
         1.   Distribution of Radon Posters and Flyers:  What Was
             Done	14
         2.   Distribution of Radon Posters and Flyers: How it
             Worked 	14
         3.   Distribution of Radon Posters and Flyers:  Resources
             Needed	17
         4.   Community Presentations:  What Was Done	18
         5.   Community Presentations:  How it Worked	18
         6.   Other Community Events:  What Was Done	20
         7.   Other Community Events:  How it Worked	20
         8.   Community Outreach: General Assessment	21

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IE.  WJLA-TV RADON AWARENESS CAMPAIGN	22

    A.   Main Components of WJLA Campaign	22
    B.   Sale of Radon Test Kits	23
    C   Impact on the EPA-MDE Project	24
IV. EVALUATION OF RADON RISK COMMUNICATION METHODS AND
    MATERIALS	26

    A.   Objectives of Evaluation	26

    B.   Surveys	27
         1.   Where-When-How They Were Conducted	27
         2.   Questionnaire	27
         3.   Sample Selection and Survey Procedure	28
         4.   Response Rates	28
         5.   Sample Description	29

     C.   Principal Findings	31
         1.   Differences Between Communities	31
         2.   Effects of News Media	31
         3.   Unsolicited Mailings	31
         4.   Community Outreach	31
         5.   Respondent Characteristics	31

     D.   Indicators of Outreach Effect	32
         1.   Awareness	33
         2.   Sources of Information	37
         3.   Knowledge	42
         4.   Attitudes	49
         5.   Testing	54

     E.   Summary	59
 V.   CONCLUSIONS	63

     A.  What is Available	63
         1.   Radon Communication Materials	63
         2.   Information About Communication Outreach Methods
             Tested	63

     B.   What Was Learned	64
         1.   Community Approach	64
         2.   Unsolicited Mailings	64

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         3.   Media Approach	
         4.   Information Communication Channels.
                                                65
                                                65
    C.   Final Thoughts on the Evaluation of Risk
         Communications	
                                                66
VI. APPENDICES	67
    Appendix 1:
    Appendix 2:
    Appendix 3:
    Appendix 4:

    Appendix 5:
    Appendix 6:
    Appendix 7:
    Appendix 8:
    Appendix 9:
    Appendix 10:
    Appendix 11:
    Appendix 12:
    Appendix 13:
     Appendix 14:
     Appendix 15:
Advisory Group Members
Survey Questionnaire Form
Hotline Survey Form
Summary of Risk Communication Literature and
Theory
Summary of Focus Group Findings
Radio PSA Scripts
Frederick News-Post Articles
Hagerstown Herald-Mail Print Ads
Sites of Radon Poster and Flyer Distribution
Frederick Community Group Presentations
Radon Slide Show Script
WJLA Radon Flyer
Graphs for Hagerstown and Randallstown follow-
up survey tester/non-tester performance on
knowledge  questions.
Regression  Model.
Categorization of Respondent Responses:  Reasons
for Not Testing.

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                     List of Tables and Figures

Table 1:    Summary of Community Exposure to Outreach Activities	 6
Table 2:    Demographics: Baseline and Follow-up Survey	30
Table 3:    Changes in Awareness:  Statistical Test Results	35
Table 4:    Where Callers Obtained the Radon Hotline Number	40
Table 5:    Knowledge About Radon by Community	45
Table 6:    Attitudes About Radon	52
Table 7:    Changes in Attitudes About Radon:  Statistical Test
           Results	54


Figure  1:   Utility Insert	12/13
Figure  2:   Radon Posters	15/16
Figure  3:   Percentage of Respondents Who Had Seen or Heard About
           Radon in Past Few Months	34
Figure  4:   Percent of Respondents, by Educational  Level, Who Had
           Seen or Heard About Radon in Past Few Months	35
Figure  5:   Percent of Respondents, by Income, Aware of Radon	35
Figure  6:   Percent of Respondents, by Race, Who Had Seen or Heard
           About Radon in Past Few Months	36
Figure  7:   Percent of Respondents, by Sex, Who Had Seen or Heard
           About Radon in Past Few Months	36
Figure  8:   Baseline Survey - Of Those Respondents Who Had Seen
           or Heard About Radon, Percentage Who Had Seen or Heard
           About it in the Ways Below	37
Figure  9:   Follow-Up Survey - Of Those Respondents Who Had Seen
           or Heard About Radon, Percentage Who Had Seen or Heard
           About it in the Ways Below	38
Figure  10:  Of Those Respondents Who Had Seen or Heard About Radon,
           Percent Who Saw Utility Inserts	40
Figure  11:  Of Those Respondents Who Had Seen or Heard About Radon,
           Percent Who Saw Poster or Attended Presentation	42
Figure  12:  Percent of Frederick Respondents Who  Answered the
           Indicated Number of Questions Correctly	45
Figure  13:  Percent of Hagerstown Respondents Who Answered the
           Indicated Number of Questions Correctly	45
Figure  14:  Percent of Randallstown Respondents Who Answered the
           Indicated Number of Questions Correctly	46

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Figure 15:   Number of Knowledge Questions Answered Correctly by
           People Who Hadn't Talked to Someone About Radon	46
Figure 16:   Number of Knowledge Questions Answered Correctly
          .by Those Respondents In Frederick Who Tested/Didn't
           Test for Radon	48
Figure 17:   Percent of Respondents, by Education Level, Who Felt It Is
           Important to Test Home for Radon	53
Figure 18:   Percent of Respondents, by Sex, Who Agreed It Is Important
           to Test.Home for Radon	53
Figure 19:   Percentage of People in Baseline and Follow-Up Who Had
           Tested for Radon	54
Figure 20:   Percentage of Testers and Non-Testers in the Follow-Up
           Survey Who Had Talked to Someone About Radon	55
Figure 21:   Do Testers and Non-Testers Use Their, Basement as a Living
           Area	56
Figure 22:   Years of Education for Testers'and Non-Testers	57
Figure 23:   Annual Income for Testers and Non-Testers	57
Figure 24:   Age of Testers and Non-Testers	58
Figure 25:   Why Respondents Had Not Tested: Changes Between
           Baseline and Follow-Up Surveys	;...	60

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                             I. INTRODUCTION
  A. Origin of Project

         Naturally occurring radon gas has only recently emerged as an important
  health concern.  Since radon in homes is a problem that falls outside the sphere
  of a conventional regulatory approach, the Environmental Protection Agency
  (EPA) and State agencies are turning to risk communication techniques to
  inform the public about the risks associated with radon gas in homes. EPA
  recommends that everyone living in homes or lower floors of apartment
  buildings test for radon so that they will be aware of the levels of radon in their
  homes and can take remedial action, as needed, to reduce their risks. Available
  evidence shows that relatively few homes (less than 5% in most areas) have been
  tested for radon. This suggests the need for proactive communication strategies
  so that people can make informed decisions about testing their homes  for radon.

         Early last year, EPA Region 31 decided to develop a radon risk
  communication outreach effort for the 1987/88 heating season. Because the
  Program Evaluation Division (PED) had already completed a study of EPA's use
  of risk advisories,2 the Deputy Regional Administrator asked PED to participate
  in planning and evaluating Region 3's radon  risk communication effort.
  B. Participants

         The Project Team consisted of several PED staff members. They worked
  closely with Region 3 staff from the Air Management Division and Office of
  Public Affairs, and, under a Cooperative Agreement, with a team from the
  Research Triangle Institute (RTI).

         Because communication with the public about radon risks is  primarily
  the responsibility of State governments, a study such as this required the full
  cooperation and support of a State radon office.  The Maryland Department of the
  Environment (MDE) agreed to participate in the project (in this report, the
  project will also be identified as the EPA-MDE Project).  The Pennsylvania
  Department of Environmental Resources participated in an advisory capacity.
      1 Region 3, based in Philadelphia, covers the States of Pennsylvania, Maryland, Virginia, West
Virginia, Delaware and the District of Columbia.

      ^Evaluating and Improving EPA's Risk Advisory Programs. May 1987, Program Evaluation
Division, OMSE, OPPE. One of the principal findings was that, "With few exceptions, EPA programs have
not evaluated their risk communication efforts. There have not been systematic checks to learn if people
received, read, and understood materials EPA distributed."

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       An Advisory Group representing several EPA Program Offices, Regions 2,
3, and 5, and the States of Maryland and Pennsylvania worked closely with the
PED Project Team. Members of the Advisory Group provided advice about the
design of the project, and reviewed plans, prototype materials, and other
documents.  Their participation enabled PED to build on their knowledge and
ensured that the project would meet the needs of radon risk communicators.
EPA's Office of Radiation Programs played a particularly crucial role in assisting
in the development of communication materials.  (See Appendix 1 for a list of
Advisory Group members).
C. Project Goals

    The specific goals of the project were to:

     -  Produce and test innovative and cost-effective radon risk
        communication methods and materials.

     -  Evaluate the effectiveness of these methods and materials.

     -  Share the results of the study with interested parties.

     -  Make available samples of the prototype materials for use
        by EPA Regional Offices and States, with recommendations
        for effective use.

       An important element of this project was to not only develop outreach
methods and materials that would be effective, but that could also be easily
adapted and used by State agencies and EPA Regional Offices typically working
with limited resources, thus allowing for more proactive outreach. Toward this
end, the Project Team identified methods and materials that are relatively
inexpensive to produce and do not require a large staff to use.


D. Main Messages

       The following messages were emphasized in all the outreach methods
and materials developed for this project:

    - Radon is a serious health risk.

    - You may be at risk and the only way to find out is to test.

    - Testing is easy and inexpensive.

    - If your home has a radon problem, it can be fixed.

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    - The State of Maryland will provide information and a list of
      testing companies through its toll-free radon hotline.

       All materials attempted to personalize the message as much as possible,
i.e., present it in terms relevant to the target audience. For example, all the
materials stressed that high levels of radon had been found in Maryland.  Where
possible (such as in radio scripts), communications mentioned specific
communities or regions in Maryland.  One poster (see pages 15-16) listed the zip
codes of areas in Maryland where levels over 4 pCi/1 already had been reported.
E. Outreach Approaches

       Combinations of three different outreach approaches—a media approach,
unsolicited mailings, and a community approach—were used and evaluated. The
main components of these approaches were:

      - Media outreach in the form of radio public service
       announcements and  newspaper articles and
       advertisements.

      - A leaflet sent to homes through utility mailings.

      - Community outreach, consisting of presentations using a
       radon slide show; placement of radon leaflets and posters in
       libraries, supermarkets, small businesses and other public
       places; and other community events.

       To provide a model for collaboration with organizations that could
supplement State resources, the Project Team also sought to work with groups
such as the American Lung Association (ALA), American Medical Association
(AMA), civic groups, and local leaders, whenever possible.

       At the same time that the EPA outreach was underway, a Washington,
D.C. television station, WJLA, independently embarked on a major radon public
awareness campaign. This campaign combined a month-long television series of
special TV reports and news  stories on radon, with the sale of radon test kits in
local supermarkets at a reduced price. The effects of this campaign surpassed all
expectations and overshadowed many of the EPA-MDE outreach activities,
making the evaluation of the outreach problematic.  A description of the WJLA
campaign is included in this  report; the Project Team has attempted to separate
the effects of the TV campaign from those of the EPA-MDE Project where
possible.

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F. Test Communities

       Radon communication methods and materials were tested in two
communities in Maryland: Frederick and Hagerstown. A third community,
Randallstown, served as a comparison and did not receive any radon
information through the EPA-MDE project (see Map 1 for location of
communities). Hagerstown received media coverage and  unsolicited mailings;
in Frederick, these two approaches were  combined with community outreach.
The choice of these three communities was based on:

       - Indications of elevated radon levels in all three areas.

       - A high percentage of owner-occupied, single-family homes.

       - Similarities in socio-economic characteristics of residents,
       including education  and income levels.

       Frederick, with a mixture of urban and rural households, is located 35
miles from Washington, D.C. Given its proximity to Washington, Frederick is
increasingly taking on the characteristics of a suburb of that city.: Hagerstown is
located 25 miles northwest of Frederick.  It has a very similar population
composition, though not the same ties to Washington, D.C.  The comparison
community, Randallstown, is a well-to-do suburb of Baltimore, located 15 miles
from the city. Table 1 summarizes each community's exposure to the EPA-MDE
Project as well as WJLA outreach activities.
G. Evaluation Design

       One major goal of the project was to evaluate the effectiveness of the
radon risk communication materials and methods.  A questionnaire was
designed to measure individuals' radon awareness, knowledge, attitudes, and
behavior.  Pre- and post-outreach telephone surveys'were conducted in the two
test communities and the comparison community.  Because of the limited
duration of the outreach activities, it was not expected that a large proportion of
people learning about radon through the EPA-MDE Project would-test their
homes during this period. Since the radon risks most homeowners face are long-
term, homeowners have little or no incentive to test immediately.  Radon
testing is something thaMs easily put off. Therefore, evaluating the effectiveness
solely on the basis of testing would not have been an accurate measure of the
effects of the Project. Accordingly, questions about awareness, knowledge, and
attitudes were built into the survey, in addition to questions about testing
behavior. (See Appendix 2 for a copy of the questionnaire).

       In addition to the survey, the MDE kept a log of all calls received on its
radon hotline during the outreach period.  The MDE had established the hotline

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         MAP 1:   MAP OF MARYLAND
                      Pennsylvania
   SCALE
10 20 30  40 50 Miles

I  I  I   I  I
                 HAGERSTOWN
                            RANDALLSTOWN
                              o
                                                      Oi

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                                 TABLE 1:
    SUMMARY OF COMMUNITY EXPOSURE TO OUTREACH  ACTIVITIES
COMMUNITY
EPA-MDE OUTREACH METHOD
 WJLA RECEPTION
FREDERICK
 Radio PSAs
 Newspaper Articles
 Utility  Bill  Inserts
 Radon  Posters and Leaflets
  Distribution
 Radon Awareness Week
 Local  Officials Test Homes
 Radon  Presentations
 WJLA reception good.

 Two Safeway  supermarkets
 in the town  of Frederick carry
 radon test  kits.
 HAGERSTOWN
 Radio PSAs
 Newspaper Print Ads
 Utility  Bill  Inserts
Residents with  an antenna can
view WJLA. but can choose
between D.C., Baltimore and
Pennsylvania  stations.
Nearest Safeway supermarket
carrying radon  kits  is in
Frederick.
 RANDALLSTOWN
 No special EPA-MDE outreach
WJLA reception  is good for
residents without cable TV,
however, residents are more
likely to watch  the local
Baltimore  station  instead.
No radon test kit sales at
Safeways in the area.

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 in 1986 in response to a large upsurge in calls resulting from news coverage of
radon in the Washington, D.C. metropolitan area.  The radon office answers an
average of 1200 radon-related calls a month. The office is equipped to handle up
to two calls at a time on its toll-free number.

       Callers requesting general radon information are mailed copies of two
EPA publications, Citizen's Guide to Radon, Radon Reduction Methods, and a
list of radon testing firms in Maryland and surrounding States.  Staff members
use a special form to record specific  questions or concerns a caller might have,
and more time-consuming  calls are  returned on the office's regular telephone
line.

       For the purpose of this project, the Project Team wanted to keep a record
of where callers had heard  about radon and obtained the hotline number, since a
major message of the outreach was that additional information could be obtained
through that number. A special form was developed (see Appendix 3) and each
staff member used it for radon-related calls, both on the hotline and regular lines.
This allowed for an additional way  to determine which outreach materials
motivated people to seek additional information.
H. Project Duration

       The Radon Risk Communication Project began in July 1987 with the
development of the project design and risk communication materials.  Outreach
took place during the 1987/88 heating season, from January to April 1988. Pre-
and post-outreach surveys were conducted in December 1987 and April 1988,
respectively.  Analysis of the results was timed so that this report could be
available before the 1988/89 heating season.

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                                     8

     II. DESCRIPTION OF OUTREACH METHODS AND THEIR
                           IMPLEMENTATION

        This section describes the outreach methods selected, why they were
 chosen, how they were implemented, their resource requirements, and the
 problems encountered.

 A. Selection of Methods

        A combination of outreach approaches was chosen because previous
 studies have indicated that maximum effectiveness is achieved by using more
 than one communication approach.3 Use of mass media can be very effective at
 creating awareness of an issue, but is less effective in educating and motivating
 individuals.  Some form of more personal interaction, used in conjunction with
 media exposure, usually is needed to elicit changes in attitude and behavior
 about risks.

        Focus groups—small group discussions designed to provide qualitative
 insights—conducted during the early phase of the project showed the importance
 of "personalizing" the risk of radon.  People who already had tested their homes
 for radon perceived it as a threat to themselves and their homes, and had spoken
 to friends and family about radon.4 Given that States and EPA do not have the
 resources to meet with every citizen  who may be at risk from radon, one
 question this project tried to answer is how "personalized" interaction must be to
 be effective.  That is, is it sufficiently effective to reach people in  their homes
 through a mailing, in addition to a media effort, or is face-to-face contact
 necessary?

         After selecting and developing the outreach methods and materials based
 on existing risk communication  theory, the Project Team pre-tested them.  Pre-
 testing is a technique used during the development of communication materials
 to ensure that they are understood by, and relevant to the concerns of, the target
 audience. The materials for this project were pre-tested with citizens during
 focus group sessions and by intercepting  people at a shopping mall to solicit their
 reactions. Many useful insights were gained as a result of the pre-tests and were
 used to develop final versions of the communication materials.
      3See Appendix 4 for a summary of the risk communication literature and theory.

      4See Appendix 5 for a summary of the focus group findings on why some individuals test for radon
and others do not.

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B. Media

       A media approach was included in the communication strategy to
generate broader exposure and awareness. Television is the most effective
medium for raising awareness on a large scale, but it is also the most costly. The
radio and newspaper media were targeted as the most accessible to State radon
offices.

                         1. Radio: What Was Done

       The Project Team developed a series of radio public service
announcements (PSAs) with five different themes  (see Appendix 6). These were
distributed to three radio stations in Hagerstown and two in Frederick. The MDE
Public Affairs Office sent a new PSA script and tape to the radio stations every
two weeks. Three of the scripts were announcer-read, while two contained
dialogue.

                          2. Radio: How it Worked

       Radio stations do not keep records of when, or how many times, a
particular PSA is played.  The radio station directors indicated that most of the
PSAs were played "often"; however, more specific information was not available,
and it was not possible to assess the amount of radio air time achieved.

       Four of the five radio stations indicated that their announcers read from
the script; only one used the tapes. The two 30-second PSAs that included
dialogue were not played by the stations using announcer-read scripts. At least
one of these stations reused the announcer-read scripts in lieu of the dialogue
tapes.

                          3. Radio:  Resource Needs

       The most costly aspect of developing the radio PSAs was producing the
tape recording. The Project Team's experience indicates that this expense can be
avoided by providing written scripts. Distributing the PSAs to the radio stations
required some initial contacts by the MDE Public Affairs Officer, but did not
require much time commitment.

       Radio PSAs appear to be a low-cost activity in terms of dollars and staff
time. Use of scripts also allows for greater personalization of the message and
targeting of specific communities.  For example, some of the radio PSAs
emphasized that radon had been found in Frederick or Hagerstown.

       However, radio PSAs are not likely to result in widespread exposure to
the message, given the lack of control over when they are aired and the
likelihood that people may not pay any attention to the message. One method of

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                                  10

ensuring more radio air time and controlling the times when scripts are read is
through paying for such air time. Paying for radio air time is considerably less
expensive than paying for the same television air time; while fewer individuals
will be reached through radio than TV, the cost is more reasonable given the
budget of State radon programs.

       Radio interviews are another method of obtaining air time. One radio
interview was conducted as part of this project in Frederick on January 18th
during Radon Awareness Week (see "Community Outreach"). Such  interviews
are not difficult to arrange, but do require some advance work by staff, though no
out-of-pocket costs.

                      4. Newspapers: What Was Done

       The Project Team arranged for newspaper exposure as another element of
the media outreach. A number of newspaper articles appeared in Frederick as a
result of this project. These articles primarily covered activities organized in that
city as a result of the community outreach component of the project, such as
Radon Awareness  Week, local officials testing their homes, and community
presentations.  Of eight articles appearing in the Frederick News Post between
January and April 1988, five were a direct result of the project. (See Appendix  7
for copies of the newspaper articles).

       In Hagerstown, the Project Team arranged for newspaper exposure
through free ads. The Hagerstown Herald-Mail reduced the four posters
developed for the community outreach component of the project to 1 /4 page size
and ran one each week during the month of February. (See Appendix 8 for
copies of the newspaper ads). Independent of the project activities, four radon
articles also appeared in the Herald Mail between January and April 1988.

       No special efforts were made to encourage newspaper coverage of radon
in Randallstown, the comparison community.  During this same period, a total
of five radon articles appeared in the Baltimore Sun.

                         5. Newspapers:  Resources Needed

       Arranging for newspaper exposure in the form of articles and print ads
was easy to do. For news coverage, it is often sufficient to alert a local reporter
about specific events underway. The Herald-Mail was also receptive to including
free ads. The Frederick News-Post, on the other hand, was not interested in
printing such,ads.  Individual papers will vary in their policies regarding public
service advertisements; however, it may be easier to obtain free advertising space
in local newspapers and people may pay attention to the ads there even if they
would ignore them in their "big city" paper where so many other items compete
for attention.

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                                     11
  C.     Unsolicited Mailings: Utility Bill Inserts

         The second major method of outreach was to provide unsolicited printed
  information that reached citizens in their homes. Like a media approach, such
  mailings can reach a large number of people at a relatively low cost per person;
  like a community outreach approach, unsolicited mailings can provide more
  detailed and more personalized information than a public service
  announcement.

                    1. Unsolicited Mailings: What Was Done

         Since neither EPA nor State radon programs have the resources to send
  unsolicited mailings to all homeowners, the Project Team looked for a low-cost
  option. Utility bill inserts were selected  as a means of exploring how well
  unsolicited printed information could replace the more resource-intensive
  community outreach approach. Potomac Edison, the electric utility that serves
  both Frederick and Hagerstown, agreed to include a leaflet developed by the
  Project Team in its utility bills (see Figure 1).
                     2. Unsolicited Mailings: How it Worked

        Making this arrangement with Potomac Edison was very straightforward
  and required little effort.  A camera-ready copy of the six-panel leaflet was sent to
  Potomac Edison after the initial telephone contacts. Potomac Edison printed a
  slightly reduced version of the leaflet to fit its billing envelopes. This was
  included in bills sent to approximately  125,000 households in Western Maryland
  during the February and March 1988 billing cycle.5 Potomac Edison needed
  approximately one to two months' lead time to arrange the mailings.

        Although Potomac Edison was the only utility company involved in the
  project, the Baltimore Gas & Electric Company (BG&E) was also contacted. BG&E
  expressed willingness to include radon  inserts in their utility bills, but this was
  not pursued since Randallstown was the  comparison community and is served
  by BG&E.

        States interested in adapting the utility insert used for this Project can do
  so fairly easily. The insert would need to  be modified to include State-specific
  information in place of the specific references to Maryland. The cost would be
  approximately $25-50 to make the State  specific modifications and prepare
      5The utility company has a two-month billing cycle, i.e., each customer receives a bill every two
months.

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                                          FIGURE 1:  UTILITY INSERT
Js YOUR HOME SAFE?
Many Maryland residents are concerned
about elevated levels of radon in their com-
munity. They are testing their homes for
this potentially harmful gas.

The Maryland Department of the
Environment has produced this brochure to
provide residents with important informa-
tion about radon.
        IS RADON?
Radon is a radioactive gas. You can't see,
smell, or taste it. Radon occurs naturally in
all soils. In outdoor air, radon gas is diluted
to low levels. When radon gas seeps into
homes, it can build up to potentially danger-
ous levels.
   RADON A HEALTH HAZARD?
Yes. Scientists estimate that 5,000 to 20,000
lung cancer deaths a year in the United
States may be caused by radon gas. This
would make radon the second leading cause
of lung cancer in the United States.

Radon is one part of a long chain of radio-
active decay. As radon decays, its byproducts
may get trapped in your lungs and release
                                                         radiation. There is
                                                         scientific evidence
                                                         that this radiation
                                                         can damage lung
                                                         tissue.

                                                         This lung tissue
                                                         damage can eventu-
                                                         ally lead to lung
                                                         cancer. The higher
                                                         your radon level,
                                                         and the longer you
                                       are exposed to it, the greater your risk.
                                         s RADON FOUND IN MARYLAND?
                                       Yes. Homeowners in many counties and
                                       Baltimore city have reported elevated levels
                                       of radon. We encourage you to test your
                                       home for radon. The only way to know for
                                       sure whether your home has a radon
                                       problem is to test for radon now.
                                       Some Maryland
                                       homes have radon
                                       levels higher than
                                       200 picocuries per
                                       liter (pCi/1) of air.
                                       (Picocuries per liter is a
                                       measure of radiation.) These levels are 50
                                       times higher than the action guidelines set
                                       by the U.S. Environmental Protection Agency.
                                       By spending your lifetime in a house with
                                       radon levels of 10 pCi/1 you have a lung
                                       cancer risk similar to smoking nearly a
                                       pack of cigarettes a day.
RADON
Is Your Home Safe?
      Test Now and
           Be Sure

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H
OW DOES RADON ENTER MY HOME?
Radon can enter your home through cracks
in your home's foundation, dirt floors, pores
in block walls, floor drains, and sumps.
While radon usually enters through the
basement or lower floors, it also circulates
throughout your entire house.

       Common Radon Entry Points
  3locks
   Cracks in Foundation
Radon levels can vary a lot even in the same
neighborhood. Mostly, radon levels depend
on how. easy it is for the radon to get into
your home and the amount of radon in the
ground under your home.
    "OW DO I TEST MY HOME?
Because you can't see radon, you must use a
radon detector to measure the levels in your
home. It is a simple do-it-yourself home test
that comes with easy-to-follow instructions.
When the test is completed, you send the
detector back to the testing company, which
analyzes it and sends you your results.
The two most common types of radon
detectors are the charcoal detector and the
alpha track detector.

Charcoal detectors cost as little as $12 each
and the alpha track detectors begin around
$25 each. These prices include the test itself
and also the test results which will be sent
to you.
                                                 Charcoal
                                                 Detector

                                                 Recommended
                                                 Test Period:
                                                  2 to 7 days
                                                 Approximate
                                                 Cost:  $12 to $25.
                                                 Alpha Track Detector

                                                 Recommended Test Period:
                                                  3 to 12 months
                                                 Approximate Cost:
                                                  $25 to $50.
                                                 Either type of test can be used to measure
                                                 radon levels in your home. The shorter test
                                                 can provide useful screening information.
                                                 Generally, however, the longer the test
                                                 period, the more accurate the reading.
                                                    OW CAN I GET A RADON DETECTOR?
                                                Radon detectors are available in some
                                                local hardware stores. You can also call
                                                Maryland's RADON HOTLINE
                                                (1-800-872-3666) for more information and a
                                                list of mail-order radon testing firms. Some
                                                companies offer a toll-free number and you
                                                can charge the detector on your credit card.
                                                                                                             FIND A RADON PROBLEM?
Many homeowners in Maryland have found
permanent, cost-effective solutions to their
radon problem. Some homeowners have
successfully reduced their radon levels
themselves for as little as $100. More
difficult problems are more expensive to
fix and may require a contractor. Call the
RADON HOTLINE (1-800-872-3666).
We can give you advice and send you
information on how to reduce your radon
level.
                                                                                                    fi OR MORE INFORMATION
                                                                                                                                                             CO
                                                Call: RADON HOTLINE: 1-800-872-3666

                                                You will receive a list of radon testing
                                                companies and these U.S. Environmental
                                                Protection Agency booklets:

                                                A Citizen's Guide to Radon: What It Is and
                                                What You Can Do About It

                                                Radon Reduction Methods:
                                                A Homeowner's Guide

                                                Or write to:

                                                RADON HOTLINE
                                                Maryland Department of the Environment
                                                Center for Radiological Health
                                                201 West Preston Street
                                                7th Floor Mailroom
                                                Baltimore, MD 21201

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                                  14
camera-ready copy.  This does not include staff time required to make the
modifications and obtain anynecessary approvals.
D. Community Outreach

       Community outreach was conducted over approximately ten weeks in the
city of Frederick by State of Maryland staff. The community outreach
components of the project consisted of distribution of radon posters and leaflets,
presentations to community groups, and the organization of a number of
community events that publicized radon risks and encouraged radon testing.
This outreach supplemented the media outreach and unsolicited mailings as a
means of personalizing radon risk communication messages.
        1. Distribution of Radon Posters and Leaflets: What Was Done

       Four radon posters were developed by the Project Team (see Figure 2),
each of which targeted a different audience and aimed at raising awareness and
encouraging people to seek additional information on radon. The posters,
together with the leaflets developed for the utility bill inserts, were distributed by
the Project Team to local businesses and other places in Frederick (see Appendix
9 for the sites where radon posters or leaflets were displayed). Two colors were
used in the  posters to make them more eye-catching, with "radon" highlighted
in red in the titles.
          2. Distribution of Radon Posters and Leaflets:  How it Worked

       The Project Team contacted some local businesses by telephone, but
because most store managers wanted to see the materials before they would agree
to display them, it was just as efficient to visit stores without calling beforehand.
Such visits appeared to be very effective in obtaining cooperation.  A personal
visit from a representative of the Maryland Department of the Environment
seemed to add importance and credibility to the Project.  It was also more difficult
for a store manager to refuse when asked for cooperation during a personal visit
rather than over the telephone. In general, individuals  contacted were interested
in helping a good cause, especially when it required little effort and no cost.

       Supermarkets/public libraries, pharmacies, and hardware or home
improvement stores are good places for distributing information because people
are already accustomed to getting information there  from bulletin boards and
brochure stands. Also, because of the WJLA/Safeway campaign (see Section III),
many people now associate supermarkets with radon kits. Some  advance work is
needed, however, to place information  in national or regional chains, since store

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                        FIGURE 2: RADON POSTERS
 IS YOUR CHILD SAFE
FROM RADON?
You wouldn't let your child smoke a pack a day.
Yet radon gas in your home can be just as dangerous.
TEST YOUR HOME NOW.
 Call the State of Maryland's Radon Hotline.
         1-800-872-3666
                                       fOU CARE ABOUT
                                      YOUR HEALTH
                                       You Watch
                                      What You Eat
            You Exercise
You Stopped
 Smoking
So why haven't you tested
your home for radon?
D  It's easy   D  Ifs inexpensive


Call the State of Maryland^ Radon Hotline.
         1-800-872-3666

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I
  S YOUR HOME SAFE
FROM
D  Your home may be hazardous to your health.
D  Radon is a radioactive gas that can cause
   lung cancer.
D  A radon test is easy and can cost less than $25.

Test your home now and be sura
 Call the State of Maryland^ Radon Hotline.

          1-800-872-3666
                                          20646   20814   20855   20904   21104  21727
                                          20707   20815   20856   20906   21117  21740
                                          20711
                                                20816  20857  20910
21131   21754
21133   21755
20714  20817  20861   20979
20744  20832  20868   21029   21136   21764
20754  20833  20871   21030   21146   21769
20759  20837  20872   21035   21152   21770
20760  20838  20874   21043   21153   21771
20769  20841  20877   21044   21157   21773
20770  20842  20878   21045   21204   21776
U      20850  20879   21046   21285   21783

    NSAFE  RADON LEVELS
20772  20851  20895   21048   21401   21784
HAVE ALREADY BEEN   '""
20777  20852  20901   21084   21701   21793
FOUND IN  HOMES WITH "794
20781  20853  20902   21093   21716   21797
THESE MARYLAND 21723  21354
20784  20854  20903   21102
ZIP CODES
                                          Test your home now and be sura
                                           Call the State of Maryland's Radon Hotlina
                                                     1-800-872-3666

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                                   17

managers often must receive permission from their headquarters offices to
distribute information or display posters.  The project was most successful with
stores in which the manager was concerned about radon and with owner-
operated businesses.

       Posters and/or leaflets were also placed in public buildings in Frederick
and in businesses such as dry cleaners, hair salons, and convenience stores. In
general, it was necessary to speak with the store manager or owner to ensure
successful placement of materials.  Stores that do not exhibit merchandise in
their windows (e.g., dry cleaners) are much more  willing to display posters than
stores that do.

       The Project Team also attempted, but without success, to place posters or
leaflets in physicians' offices in Frederick. Some physicians cited the large
quantity of health information they receive already as a reason for their
unwillingness.  In general, the physicians in Frederick did not express much
concern about the risks of radon and its presence in their community. Some said
they did not want to "panic" their patients; others did not want patients to ask
questions they did not feel competent to answer.  The Maryland Chapter of the
American Medical Association (AMA) printed a short paragraph in its monthly
Magazine about the availability of radon information through this Project.  Only
one physician responded. This experience suggests that involving physicians in
radon  risk communication efforts will require working closely with State and
local chapters of the AMA to educate them about radon risks.
        3. Distribution of Radon Posters and Leaflets: Resources Needed

       The development and distribution of radon posters and leaflets were very
resource intensive.  The cost of developing each poster was approximately $1500
plus the cost of reproduction.  Development of the radon leaflets was less costly
but still a substantial expense.  The leaflets, however, were used for both the
utility bill inserts and for distribution with the radon posters in Frederick. State
radon offices interested in adapting the posters and leaflet developed for this
Project would find adaptation  costs much lower than the initial development
costs.  Reproduction of the posters for this project cost from $3-8 per poster
depending on size, colors, and paper, and reproduction of the leaflets cost
approximately $60 per thousand.

       Staff time was required for travel to the community and personal visits to
the various locations.  Follow-up visits were also necessary to rotate posters and
replenish the supply of leaflets. Some of these activities could be combined with
visits to the community for other purposes, such  as making a  presentation or
meeting with homeowners.

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                                  18

                4. Community Presentations: What Was Done

       Radon presentations to local groups were another important component
of the community outreach.  These presentations allowed for more in-depth
communication about radon risks. Most State radon offices make presentations
to community groups upon request.  For this Project, proactive efforts were made
to organize and schedule such presentations. To supplement the limited MDE
staff resources, the Project Team also sought to identify intermediaries-e.g., other
knowledgeable officials such as health officials~who could also communicate to
the public about radon risks.

       Between January and March 1988, the MDE staff made nine presentations
to civic groups in the city of Frederick (see Appendix 10 for a list of the
community groups).  A staff member from the Frederick County  Health
Department made one presentation.  Approximately 300 people attended the
nine meetings.  A radon slide show with an accompanying 20-minute audio tape
was developed for use in presentations by State radon officials and
intermediaries (see Appendix 11 for a copy of the slide show script).

       In addition, MDE staff participated in a panel discussion organized jointly
with the League of Women Voters. The two-hour  panel discussion took place
on a Saturday morning in February and was attended by approximately fifty  '
citizens.  The panel members represented different perspectives on radon risks;
they were the Director of MDE's Center for Radiological Health, an EPA Region 3
radon representative, a Frederick pulmonary physician, and  representatives of
the Maryland Association of Realtors and the Masonry Contractors Association.

     .  The meeting was publicized by the League  of Women Voters through the
distribution of flyers and in the local newspaper. The Project Team also secured
the cooperation of the Frederick County school system, which distributed letters
from the MDE for the children to take home to their parents announcing the
event.
                5. Community Presentations: How it Worked

       Contacting organizations and arranging for MDE speakers to make
presentations was time-consuming and problematic. It was often difficult to
locate and contact the specific person responsible for scheduling speakers for an
organization. Also, organizations generally must be contacted months in
advance, because many of them fill their calendars as much as a year ahead of
time.

       While the community groups showed a great deal of interest in the rado~ri
presentations, the process of scheduling these presentations was resource-
intensive and not necessarily a good use of staff time.  Responding to requests for

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                                   19

speakers, as State officials commonly do, requires a time commitment for the
travel and meeting, but does not involve so much preliminary work on the part
of the State staff.

       Working with the League of Women Voters on the panel discussion, on
the other hand, required less staff time because the League did much of the
logistical work. Exposure generated as a result of the panel discussion was as
great if not greater than that achieved with individual civic group meetings.
However, adequate lead time is required to identify a group to organize this type
of event.

       Identifying intermediaries who could and would make presentations was
problematic. Attempts to include local health officials in communicating about
radon risks, along the lines of a program initiated by New Jersey in 1987, were not
successful. The Frederick County Health Department officials contacted were not
interested in an active role.  However, the  MDE staff found the radon slide show
a useful presentation tool and found that it provided a consistent message that
other radon risk communicators can use.   The MDE is therefore planning to use
the intermediary approach with the University of Maryland Cooperative
Extension Services.  The University of Maryland Cooperative Extension Services
has duplicated the radon slide show developed for this Project and provided a set
to the extension services in each county in Maryland. For those  county offices
lacking the audio-visual equipment necessary for the slide show, the Cooperative
Extension Services has agreed to provide such equipment on loan.

       In addition to the slide show, the Cooperative Extension  Services is
reproducing one of the four radon posters for display in each extension office in
Maryland. The radon leaflets also will be reproduced and distributed through the
extension offices.

       Working with intermediaries requires coordination by State staff, but it
expands the number of people who can respond to requests for presentations.
Use of a tool such as the radon slide show also ensures that all parties are
providing the same  message.  The radon slide show, however, delivers a general
message about radon: what it is, how it enters the home, how to test, and what
can be done about the problem. It does not describe individual State programs.
State officials who are concerned that information about their individual State
programs are accurately conveyed must ensure that other communicators are
well informed about their radon programs.

       The radon slide show produced for this Project is available for use by State
radon program officials or intermediaries in the State through the Office of
Radiation Programs  or EPA Regional Offices. This slide show has also been
converted into a video tape by the EPA and is available in that form.

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                                   20

                6. Other Community Events: What Was Done

       Two other community events were organized as part of the community
outreach to further personalize radon risks. The first was Radon Awareness
Week (January 17-23) designed to kick off the community awareness campaign in
Frederick.  The Frederick News-Post printed a photograph of the Mayor signing a
proclamation of Radon Awareness Week, and covered an interview with the
director of the MDE Center for Radiological Health.  Optimally, this week should
have consisted of a series of radon-awareness raising events. Due to time
constraints, the Project Team was not able to organize  such events during the
week.  Substantial lead time and considerable coordination are necessary to
ensure that a series of events take place in a given one-week period.

       A second event that was intended to take place during Radon Awareness
Week but actually took place later, because of scheduling conflicts, was radon
testing by six Frederick officials. The Mayor and five Aldermen agreed to test
their homes as a means of encouraging other Frederick residents to do the same.
As part of this event, a newspaper reporter interviewed the Mayor about why he
was testing his home and took photographs of him placing a charcoal canister in
his basement.
                 7. Other Community Events:  How it Worked

        These events were easy to arrange. The  Project Team contacted the
 Mayor; he agreed to sign a proclamation for Radon Awareness Week. A call to
 the Frederick News-Post resulted in news coverage. The mayor also enlisted the
 support of the Aldermen for the radon testing.  The Project Team arranged for
 press coverage and provided the charcoal canisters.  Efforts were made to
 emphasize that free test kits are not provided by the State of Maryland or the
 EPA, as citizens often believe that free test kits are distributed by the government.

        Of the six radon screening tests by the local officials, two produced
 readings that were  under the EPA action guideline of 4 pCi/1, while four were
 between 4 and 20 pCi/1.  The local officials agreed to talk to a newspaper reporter
 about the results and their next steps. A follow-up article therefore appeared and
 described what the results meant and what would be done next. This provided a
 unique opportunity to address the issue of what an individual should do after
 obtaining radon screening test results. The fact  that four of the six officials had
 readings above the EPA action guideline helped reinforce the message that
 elevated radon levels are found in Frederick and that  residents should test their
 homes.

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                                   21

                8. Community Outreach: General Assessment

       Overall, the community outreach was resource-intensive. Many elements
of this outreach were time consuming and require sufficient staff.  In offices
where staff are already over-extended, such outreach would be beyond the staff
resources available.  For this project, a student intern and EPA staff member on
detail to the MDE  took an active role in organizing many of the community
events since the MDE staff did not have the time to do so.

       State radon offices with limited staff can seek to find additional staff
resources, such as  a  student intern, or work in collaboration with organizations
such as the American Lung Association or civic groups such as the League of
Women Voters or  Rotary Club. The Project Team contacted the ALA and other
civic groups and found them to be very interested in working with the State to
communicate  about  radon risks.  The American  Lung Association and American
Medical Association have financial resources to help produce materials such as
posters, leaflets, or slide shows.  Civic groups, on the other hand, have the
manpower resources to help organize and publicize events. The resources these
groups bring to an endeavor can greatly augment that directly available to a State
radon office.  They also help personalize the message because people living in the
community see that  other residents are concerned about radon.

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                                   22


               III. WJLA-TV Radon Awareness Campaign

       While the EPA-MDE project was in progress during the 1987/88 heating
 season, a Washington, D.C. television  station, WJLA, conducted a month-long
 campaign to encourage people in the area to test their homes for radon. WJLA
 not only communicated to the public about radon risks in January-February 1988,
 it also arranged for test kits to be available at a major supermarket chain for a
 reduced price of $4.75.

       While WJLA anticipated about  20,000 people in the area would test their
 homes as a result of its  efforts,6 some 100,000 radon test kits actually were
 purchased. The WJLA  campaign exhibited many elements of a good
 communication effort.  It also had a tremendous impact on the public's radon
 knowledge and testing  behavior, which was reflected in the EPA-MDE surveys.
 A description of the WJLA efforts follows.
 A. Main Components of WJLA Campaign

        In 1986, Roberta Baskin, an investigative news reporter for WJLA,
 publicized the risks of radon in the Washington, D.C. area after the station
 randomly tested some 40 homes. Two years later, the station decided to embark
 on a major effort to increase the number of homes tested, as a means of assessing
 where local radon problems exist.

        What was unique about this effort was its sheer scope. It was a total
 station project involving close collaboration among the News,  Programming,
 Public Service, and Promotion Departments. Television, radio, newspapers, and
 magazines were all used as media for communicating about the public awareness
 campaign and the availability of radon test kits at Safeway Supermarkets.

        The first radon news series was scheduled for the week of January 18,
 1988. Three weeks earlier, the station started airing a series of Public Service
 Announcements (PSAs) on radon. These PSAs ranged from scenes of a child  in a
 gas mask playing with her doll to a discussion of the dangers of radon by Senator
 Warner of Virginia.  Roberta Baskin also appeared in some of these and took on
 the role of radon spokesperson for the station.

        During the week of January 12th, the Promotion Department began
 promoting the various news stories that would appear the following week. A
 commercial publicizing the sale of radon test kits at Safeway also first aired
 during this week.  The campaign was called "Radon Watch."
      6According to WJLA 20,000 was the largest number of test kits that had been previously
distributed as the result of any single television public awareness campaign. This campaign required the
viewer to send a $10 check to the station to receive the radon detector.

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                                   23
       Roberta Baskin kicked off the campaign with a three-part news series the
week of January 18th. Each segment was featured on the 5 p.m. and 11 p.m. news
broadcasts and was repeated on the 12 p.m. news the following day. The news
series was also promoted on radio from January 18th to 20th, and a full-page ad
appeared in the Washington Post TV Magazine January 18th, publicizing the
campaign and availability of the radon test kits. The first news broadcasts were
aimed at educating people about radon risks and informing them about how to
obtain the radon test kits through local Safeway stores.

       During the next month, Roberta Baskin continued to talk about radon on
the local news, and brief promotional "Radon Watch" spots were featured
regularly. The public awareness campaign ended with another three-part series
focusing on the radon test results, hot spots, and mitigation.  A full-page ad
appeared in the Washington Post on February 16 to publicize the final radon
news reports, and radio promotion also took place February 15-19.

       In addition to these  activities, WJLA worked closely with the American
Cancer Society and American Lung Association, both of which were listed on the
PSAs as sources of further information. These two organizations distributed
some 75,000 brochures to households in the  D.C. metropolitan area as part of
their regular mailings (see Appendix 12).  The February 1988 issue of a magazine
produced by the station, Showcase Magazine, also featured an article on the
radon campaign and  how to get the test kits. Some 400,000 copies of the
magazine are mailed to households in the D.C. area.

       Finally, WJLA also coordinated with EPA's Office of Radiation Programs
and with State radon program officials and featured several interviews with EPA
and State officials as  a means of providing more credibility to the WJLA message
about radon.  Toll-free hotline numbers for  State radon programs in Virginia,
Maryland and Washington, D.C.  were provided as part of  the television news
series.

       Almost a month after the  public awareness campaign and sale of radon
test kits ended, WJLA aired on March 12 a half-hour  special on radon in the
Washington, D.C. metropolitan area.  Ratings for this program indicated that
over 76,000 households tuned in, a large number for  this kind of program.
B. Sale of Radon Test Kits

       In conjunction with the public awareness media campaign, WJLA
provided for the availability of radon test kits at a special low price. Where radon
test kits cost on average between $10 and $25, WJLA offered them for $4.75. The
price was reduced and the purchase location as convenient as possible~at local
Safeway Supermarkets.

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                                    24
       Initially, WJLA arranged with AirChek, a radon testing firm, for
 distribution of 20,000 radon test kits through Safeway Supermarkets in the D.C.
 Metropolitan area, with a contingency plan for up to 50,000 test kits.7  Within
 two days of the first delivery of test kits to Safeway Stores-which coincided with
 the first news series on January 18~the radon test kits were sold out.
 Arrangements were then made for a total distribution of 75,000 test kits through
 the Safeway Stores.  Radon test kits were delivered to the stores each Saturday
 morning, only to be sold out within hours.  In the D.C. area many people lined
 up outside the Safeway stores each Saturday morning waiting for delivery of the
 kits. Even in those  distribution areas outside the metropolitan area, such as
 Frederick, test kits were  sold out quickly.

        By the end of the campaign in February, the 75,000 test kits had been sold
 and demand remained high.  WJLA then arranged to have more radon test kits
 available for purchase at a price of $7.75 through a coupon in the Washington
 Post, which appeared only once and was discussed on the air. It resulted in the
 sale of another 25,000 test kits.

        Of the  100,000 test kits purchased as part of the WJLA radon awareness
 campaign, 70,000 had been returned for analysis by July 1988.  AirChek estimates
 that additional kits  will continue to trickle in each month, with a possible
 upsurge in the next heating season, though some portion of the remaining kits
 are likely never to be sent in.
  C Impact on the EPA-MDE Project

        The WJLA campaign targeted the Washington, D.C. metropolitan area.
  Given their proximity, Frederick residents are more likely than people in
  Hagerstown or Randallstown to watch WJLA.  Hagerstown residents with an
  antenna can also pick up WJLA, but can choose between Washington, D.C.,
  Baltimore and some Pennsylvania stations.  Randallstown, a Baltimore suburb,
  is outside the WJLA viewing area, but WJLA reception is good in Randallstown
  although residents are more likely to watch ABC on Channel 13 which features
  local Baltimore news, than on Channel  7 with Washington local  news.
  Randallstown residents with cable TV, however, do not pick up WJLA.

        Radon test kits were available in some Safeway stores outside the D.C.
  area. The two Safeway stores in and near Frederick sold approximately 6,000 test
  kits.  Since no Safeway store is located in Hagerstown, the nearest  Safeway for its
  residents interested in buying a Safeway test kit was in Frederick. No radon test
  kits  were distributed through Safeway stores in the Baltimore area.
      'AirChek uses a charcoal bag and 7 day test for measuring radon levels. The $4.75 kit purchase
price included the analysis of the test results. AirChek's usual retail price is $11.95.

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                                     25
        Of the radon test kits analyzed by AirChek for this "Radon Watch"
 campaign, 669 were from Frederick, 93 from Hagerstown, and 10 from
 Randallstown.8   This indicates that Frederick residents were more aware of the
 WJLA campaign and/or had better access to the Safeway test kits. To put these
 numbers in perspective, the test kits analyzed for the cities of Frederick and
 Hagerstown represented over half of all the AirChek test kits for Frederick and
 Washington Counties during this period.  Test kits from Randallstown,
 however, represented less than 10 percent of all AirChek kits for Baltimore
 County (excluding Baltimore City).

        The EPA-MDE Project post-outreach survey provided a further indication
 of the impact of the WJLA campaign in the three communities.  This is discussed
 in the next section.
      8The AirChek data was actually for a 16-month period from January 1987 to April 1988. However,
the vast majority of their database resulted from the WJLA Radon Watch campaign and sale of test kits.

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                                  26


    IV.    EVALUATION OF RADON RISK COMMUNICATION
                      METHODS & MATERIALS

      This chapter presents an evaluation of the radon risk communication
methods and materials developed and tested during this Project.  The chapter is
organized as follows:

      - An explanation of the objective of the evaluation process.

      - A description of the methodology of the surveys conducted
       in Frederick, Hagerstown, and Randallstown.

      - A summary of the major findings with respect to differences
       among the communities; the use of mass media, unsolicited
       mailings, and community outreach techniques; and the
       effect of survey respondent characteristics.

      - A detailed discussion of indicators of the effect of the EPA-
       MDE outreach activities, including changes  in people's
       awareness, knowledge, and attitudes about radon; people's
       sources of information on radon; and whether people tested
       for radon and what reasons people gave for  not testing.
 A. Objectives of Evaluation

       To assess the effectiveness of the EPA-MDE outreach methods, the Project
 Team undertook two carefully designed surveys—one before and one after the
 outreach activities were conducted. Analysis of calls to the MDE hotline
 provided an additional means of assessing the effectiveness of the outreach
 activities.   The major objectives of the evaluation were:

       - To determine where people obtained  their radon information
        and how this influenced their knowledge, attitudes and
        testing behavior.

       - To measure changes in radon awareness, knowledge,
        attitudes and testing between the two  surveys and how these
        were influenced by project outreach activities.
        To characterize the type of individual who is concerned about
        radon and has tested, and the type of individual who has not
        tested as a means of better communicating to different
        audiences.

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data on:
                            27

To meet these evaluation goals, the survey was designed to produce


  Perceptions of risks from radon—compared to other
  environmental risks.

  Sources of radon information.

  Attitudes about radon.

  General knowledge about radon.

  Testing behavior.

  Reasons for not testing.

  Socio-economic characteristics of respondents.
 B. Surveys
                 1. Where-When-How They Were Conducted
        The population for the surveys was homeowners in Frederick,
 Hagerstown, and Randallstown.  People who did not own their residence were
 excluded, since it is not necessarily a renter's responsibility to test, and since
 renters, compared to owners, are less able to take remedial action if a radon
 problem is found.

        The pre-outreach (i.e., baseline) survey was conducted December 4-30,
 1987, and the post-outreach (i.e., follow-up) survey was conducted April 4-25,
 1988.  Both were conducted by telephone rather than mail due to time constraints
 and the need to screen for homeowners. Interviews lasted, on average, 15
 minutes.  The Research Triangle Institute (RTI) conducted the surveys.
                              2. Questionnaire

       The questionnaire used for the surveys is in Appendix 2. The same
 questions were asked in both the baseline and follow-up surveys, with the
 exception of those about where respondents had seen or heard about radon. For
 these questions, the follow-up survey included a number of open-ended
 questions that were not on the baseline survey (see Q. 4 follow-up).

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                                      28

                       3. Sample Selection and Survey Procedure

       Two samples for each community were drawn independently for the
baseline and follow-up surveys.  Thus, two different groups of respondents were
interviewed.  This survey design, while only allowing for the identification of
overall changes between surveys, was chosen to eliminate the risk of
sensitization of respondents which might have occurred if the same respondents
were interviewed twice.9

        A random digit dial technique was used to select the telephone numbers
 to be called.10  Persons answering calls were screened to determine whether they
 were homeowners.  After determining that they had reached a homeowner (or
 family or group of homeowners), interviewers used a randomized code to choose
 a household decision-maker to interview (to avoid interviewing only people
 who were most likely to answer phone calls). Only adults over 18 years of age
 were considered eligible.  At least three attempts to contact the chosen
 interviewee were made before a telephone number was abandoned.


                                    4. Response Rates

         The survey design called for interviews of 500 homeowners in each
 community in each survey.  The actual numbers of respondents are shown
 below:

                              Baseline                 Follow-Up
                       Number     Percent *    Number       Percent*

         Frederick        523         56.2         481            56.4
         Hagerstown      530         63.8         534            67.4
         Randallstown    495         47.9         513            55.0

         * Percentage of eligible homeowners contacted who agreed to participate
 in survey.
           Communicating Radon Risk Effectively: Radon Testing in Maryland. Survey Plan. Research
Triangle Institute, November 1987, pp. 10-1 4 for more discussion on sample choice. As an auxiliary study
to this project, EPA's Office of Policy Analysis also interviewed the respondents from the baseline survey
for the follow-up, thus creating a dependent, or panel, sample. This panel sample allows for the
measurement of specific changes in the same sample between the baseline and follow-up surveys.  For
more information on the analysis of the panel data see, Communicating Radon Risk Effectively: Radon
Testing in Maryland. Overview and Summary of Survey Results: Final Report. Research Triangle Institute
(RTI), October 1988 (hereinafter referred to as Overview and Summary of Survey Results).
          is technique uses active hundred-blocks which represent potential working telephone
numbers.  Most of the hundred blocks that were associated with governmental or commercial numbers were
screened out in advance, thus also excluding most of the non-working hundred blocks from the actual
survey calls.

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                                       29

         The low response rates for the surveys make it difficult to generalize
  findings to the general populations in the three communities.11  However,
  people's unwillingness to participate in the survey appeared to be a function of
  their general unwillingness to answer any telephone inquiries, possibly as a
  result of the increase in  telemarketing and phone solicitations.  Comparing the
  demographic characteristics of the survey populations and census data would
  indicate that the survey  population was very similar to the general population in
  the three communities (see Table 2).  Thus, for the purposes of this study, it is
  assumed that those who participated in the survey were not significantly
  different from those who refused to participate.
                               5. Sample Description

         Table 2 summarizes demographic data for the baseline and follow-up
  samples.  Noteworthy differences among the  three communities included the
  following:

         - Mean educational level and income were highest in
          Randallstown.

         - On average, Hagerstown respondents were older and had
          lived in their homes longer than those in the other
          communities.

         - One-third of the Randallstown respondents were non-
          white, compared  to only 5-7 percent in the other two
          communities.

         Overall, more women than men participated in the surveys, with
  women comprising more  than half the samples in all three communities.
  Approximately 75% of the samples were non-smokers.

  C. Principal Findings

         Here is a quick summary of the Project Team's major findings regarding
  the effectiveness of the EPA-MDE outreach activities and the impact of survey
  respondents' characteristics on their awareness and knowledge of radon and
       11A response rale of 70% or more is generally considered a good response rate. The lower
response rate may have been due to several factors. The baseline survey took place around Christmas-a
time when many people may be unwilling to take the time to respond to questions. There may also be an
urban/rural aspect to the response rates.  Hagerstown, which is more rural than the other two communities,
had higher response rates in both surveys. Urban dwellers may be less willing to answer telephone
inquiries.  Finally, in an effort to avoid bias, interviewers did not indicate that the survey was about radon
but were more vague, thereby possibly contributing to the lower response rate.

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                                                             TABLE 2

Age
Baseline
Follow-up
Education
Baseline
Follow-up
Income*
Baseline
Follow-up
Years Lived at Address"
Baseline
Follow-up
Value of Home*
Baseline
Follow-up
Sex (%male)
Baseline
Follow-up
Race* (%white)
Baseline
Follow-up
Frederick
Mean Census
45.87 43.16
45.29
13.89 12.4
13.68
$36,400 $35,400
$36,500
11.84 13.88
1 1 .44
$106,000 $74,000
$111,000
41 45
36
95 94
92
Hagerstown
Mean Census
49.72 46.04
50.1
12.86 12.1
12.54
$30,600 $27,400
$29,600
15.71 18.12
16.21
$77,000 $48,000
$80,000
38 46
36
97 97
97
Randallstown
Mean
44.49
45.11
14.42
14.44
$42,200
$43,000
12.98
12.63
$96,000
$100,000
41
45
67
66
Census
42.81
12.9
$46,800
11 .48
$86,000
48
86
Census Information:
  Age - Weighted mean for persons 18 years of age or older.
  Education - Median years of school completed for persons 25 years of age and older.
  Income - From 1980 Census Data Tape adjusted for increase in income through 1985.
  Value of Home - From 1980 Census Data Tape adjusted for increase in value through second quarter of 1986.

*Census data restricted to homeowners.
                                                                                                                           CO
                                                                                                                           o

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                                  31

their testing behavior.  These findings are elaborated and supported in Section D,
with a more detailed summary of the major findings in Section F.

                  1. Differences Between Test Communities

       Frederick-where people were exposed to news media including the
WJLA campaign and access to low-cost radon kits in local supermarkets,
unsolicited mailing, and community outreach activities-showed  the greatest
changes between the baseline and follow-up surveys with respect to awareness,
knowledge, attitudes, and testing behavior.  Changes in Hagerstown-where news
media and unsolicited mailings were used-and in Randallstown-the
comparison community—were substantially smaller.
                          2. Effects of News Media

       People's exposure to news media presentations about radon accounted for
most of the radon awareness measured in the surveys.  WJLA's campaign was
particularly effective in increasing knowledge, awareness, and testing.
Newspapers also were found to be a widely used source of radon information,
but radio was found to be used far less frequently.
                           3. Unsolicited Mailings

       Unsolicited mailings—at least in the form of utility bill inserts—will not
produce the widespread exposure to radon information that news media will.
Nevertheless, the mailing seemed to reinforce other communications and
successfully motivated some people who had read it to seek additional
information.
                          4. Community Outreach

       No individual element of the community outreach had an identifiable
major impact, but the combination of several community outreach activities in
Frederick, which may have led to increased informal communication about
radon, appeared to have an effect on knowledge, awareness, and testing.
                   5. Impact of Respondent Characteristics

       In this study, as in other evaluations of risk communication efforts, the
characteristics of people being addressed were found to have an influence on
their response to the message being presented.

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                                 32


     - Survey respondents who had talked to other people about radon
       tended to be more knowledgeable about it and more likely to
       have tested than those who had not talked to  anyone else. This
       was true in the baseline survey but was even more apparent in
       the follow-up.

     - Respondents who had called the State's hotline were more
       knowledgeable about radon than those  who had not, and a larger
       percentage of testers than non-testers had called the hotline.

     - Awareness, knowledge, and testing increased with increases in
       respondents' educational  levels and income.

     - Respondents'  race and sex were somewhat important.  Whites
       showed more awareness and knowledge about radon and were
       more likely to have tested their home.  Males showed slightly
       more awareness and knowledge  than females, but females were
       more likely to say that testing  is  important.

      The next section presents the Project Team's analysis of the data collected
for this Project insofar as it is relevant to radon risk communication.
D. Indicators of Outreach Effect

      Two major goals of this project were to develop cost-effective and
innovative risk communication materials and to evaluate their relative
effectiveness.  The main measures used to assess the effectiveness of the radon
outreach approaches were respondent awareness, knowledge, attitudes and
testing behavior.

      Changes in these measures between the baseline and follow-up surveys
provide a tool for determining the effectiveness of the different outreach
approaches.  Frederick consistently showed greater changes than Hagerstown and
Randallstown did.  Also, while Randallstown respondents in general were not as
aware or knowledgeable about radon as Hagerstown respondents, the actual
changes between baseline and follow-up are very close for these two
communities.

      The changes, in and of themselves, are not sufficient to indicate the full
extent of the EPA-MDE Project's  impact. Due to the Project's short time frame,
the survey probably underestimates the impact of the communication activities,
since changes will occur gradually over time as other communications  reinforce
those of the project.  The WJLA campaign also coincided with the EPA-MDE

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                                      33

  outreach activities.12  Where the EPA-MDE outreach was low resource and
  modest in nature, the WJLA campaign was multi-media, high resource, and high
  profile. As the baseline survey data indicate, the three communities were also at
  different stages of awareness, knowledge, attitudes, and testing at the outset. This
  may have had an impact on the changes observed.

         This section describes the changes that occurred between the pre- and
  post-outreach surveys, and attempts to assess the causes of those changes.
                                   1. Awareness

         An important goal of any risk communication program is to increase
  awareness of the risk. Without awareness, it is impossible to achieve any of the
  desired changes-e.g., learning or behavior modification-in the target group.  For
  this Project, awareness was defined as whether an individual had seen or heard
  anything about radon in the three months preceding the survey.

         Figure 3 shows that Frederick had the highest level of awareness in the
  follow-up survey; 9 out of 10 people interviewed had heard about radon in the
  few months preceding the survey (i.e., during the outreach period).  In
  Hagerstown, almost 8 out of 10 people interviewed had heard about radon
  during this period. In the comparison community, Randallstown, 7 out of 10
  people had heard about radon.

         Figure 3 also shows  that there were substantial changes in awareness
  between surveys.13  In Frederick, awareness increased by 18 percent-from about
  72 percent in the baseline survey to 90 percent in the  follow-up. The increases in
  Hagerstown and  Randallstown were similar-about 13 percent and 12.5 percent,
  respectively.  As  shown in Table 3, all of these changes are statistically significant
  at the standard 0.5 levels  of significance.  While the increase in awareness in
  Frederick  and Hagerstown follows the pattern that might be expected in
  communities where outreach is effective, that in Randallstown is greater than
  expected.
       12Attempts were made to model the potential confounding influence of the WJLA campaign as part
of the data analysis. For a discussion of those findings, see Overview and Summary of Survey Results.
RTI.
       13 The greater increase in awareness in Frederick is not easily attributable to a single factor, but
could be related to several factors including the WJLA campaign and the EPA-MDE outreach efforts.

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                                   34
                             Figure 3

              Percent of Respondents Who Had Seen or
              Heard About Radon in the Past Few Months
            100 n
            80 -
            60 -
            40 -
            20 -
                      90
                                              72
                baseline
                follow-up
                 Frederick   Hagerstown Randallstown
                              TABLE  3
         CHANGES  IN AWARENESS  :   STATISTICAL TEST

               Changes in Awareness Proportions by Community

    Have you seen or heard anything about radon in the past few months?
                    (Yes/Total - "Don't Know")
              Baseline
              proportions  Ratio
Follow-Up
388/522
350/526
291/493
74.3
66.5
59.0
433/480
481/531
357/509
90.2
90.5
70.1
-5.29*
-3.64*
-3.11*
Frederick
Hagerstown
Randallstown

Note:  This is not an exact Z Statistic as non-response was high. It can be
considered an exact test if it is assumed that respondents were no different,
demographically, than the non-respondents.
The sample proportions were tested at the 95% confidence level  (Z Statistic of
-1.96 < z < 1.96 if null hypothesis is true).

*Z Statistics for sample proportions that are statistically different.
       There appeared to be a relationship between certain respondent
 characteristics-education, income, race, and sex-and awareness of radon  As
 educational levels increased, respondents were more likely to have seen or heard

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                                 35


something about radon (see Figure 4). Awareness was also greater at the higher
income levels than at lower income levels (see Figure 5).

                            Figure 4
         Percent of Respondents, by Educational Level, Who
        Had Seen or Heard About Radon in Past Few Months
                                          84
                                                      baseline
                                                      follow-up
              <12 Years  12-15  Years  16+ Years


                         Figure 5
       Percent of Respondents, by Income, Aware of Radon
    100
     80-
     60-
    40-
    20 -
                                                         baseline
                                                         follow-up
          <$25,000  $25,001-$50,000   $50,000 +
White respondents were more likely to be aware of radon than non-white
respondents (see Figure 6) and men more likely to be aware than women (see
Figure 7).

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                                 36
                          Figure 6
       Percent of Respondents, by Race, Who Had Seen
         Or Heard About Radon in Past Few Months
        100
        80 -
        60 -
                     baseline
                     follow-up
         40 -
         20-
                  White
Non-White
                          Figure 7
       Percent of Respondents, by Sex, Who Had Seen
           Or Heard About Radon in Past Few Months
          100
                                                        baseline
                                                        follow-up
                     Male
    Female
      Calls to the State of Maryland hotline during the project outreach period
were high. In January, there were 932 calls during the last 10 days of the month
alone, 1,697 calls in February, and 2,730 calls in March compared to the usual
hotline average of 1,200 a month. The large increase in hotline calls during the
EPA-MDE outreach period suggests that this was a period of particularly high
radon awareness  and concern.

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                                      37
                             2. Sources of Information

         In addition to measuring whether respondents were aware of radon, the
  Project also looked at where people obtained their information about radon.
  Hotline callers and survey respondents all were asked about this. Hotline callers,
  having obtained a phone number to make their call, would be expected to
  remember where they had heard about radon, particularly if they obtained the
  hotline number as a result. Survey respondents were asked where (in general)
  radon information had been obtained. Less accurate recall is expected for general
  information than when a specific item was obtained (i.e., a  phone number).

  Media

         Among respondents in the pre-outreach survey, newspapers were
  identified as the main source of information.  Television, radio, and magazines
  were less important sources (see Figure 8).14

                             Figure 8

          Of Respondents Who Had Seen or Heard About  Radon,
           % Who Had Seen or Heard About it in the Ways Below
      100
                                                            baseline
                                                             Frederick
                                                             Hagerstown
                                                             Randallstown
           newspaper
                                    radio
magazine
         In the follow-up survey, television was identified as important a source of
  radon information as newspapers (see Figure 9) in all three communities.
  Exposure to television increased substantially between the baseline and follow-
  up surveys with increases of 24 percent in Frederick, 19 percent in Hagerstown,
  and 15 percent in Randallstown. In Frederick, newspapers were cited as a source
       14This is consistent with the findings of a New Jersey study in 1986, Public Response to the Risk
from Radon. Report to the Division of Environmental Quality, New Jersey Department of Environmental
Protection,  Sandman, P.M., Klotz, M.L., & Weinstein, N.D. (1987), Table 5, p. 20. This report is also the
principal work describing differences between those who test and those who do not, and as such provides
many interesting insights about the public's perception of radon.

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                                    38
 of information by a larger percent of respondents than television, as compared to
 Hagerstown and RandaUstown where a slightly higher percentage of respondents
 cited television.
                          Figure 9

       Of Respondents Who Had Seen or Heard About Radon,
       % Who Had Seen or Heard About it in the Ways Below
    100
     80 -
                                                        follow-up
                                                         Frederick
                                                         Hagerstown
                                                         RandaUstown
         newspaper
radio     magazine
        Much of the increase in TV can be attributed to the WJLA public
 awareness campaign.  A number of newsworthy events during this period led to
 increased TV visibility for radon; however, information about these events
 appeared mainly in short spots on the news.15

        As seen in Table 4, television was the main impetus for calls from
 Frederick and Hagerstown  to the radon hotline. With the exception of
 Hagerstown in February, where 29 percent of callers cited newspaper and 25
 percent cited television as a source of information on the hotline, TV resulted ir
 almost half of all calls to the hotline from Frederick and Hagerstown.
 Newspapers were also an important source of calls.

        Comparison of the baseline and follow-up survey results indicated there
 was a slight increase in the percentage of respondents in Frederick and
 Hagerstown who cited radio as a source of radon information, but this was too
 small to indicate that the Project's radio PSAs had any impact (see Figures 8 and
 9).  Radio accounted for a very small percentage of calls to the Maryland hotline
 in both Frederick and Hagerstown (Table 4).
      15A number of news stories resulted from the release of the National Academy of Sciences report
in early January 1988.  Increased testing of schools for radon also led to greater visibility of radon durinq the
heating season.

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                                           TABLE 4
                          WHERE HOTLINE CALLERS HEARD ABOUT RADON
Sources of   	JANUARY*
Information   Frederick
                     FEBRUARY
                              MARCH
Hagerstown   Frederick   Hagerstown   Frederick   Hagerstown
T.V.               1 3
Newspaper         1 1
Radio               1
Utility inserts       0
Flyers              0
Posters             0
Other**            2

Total (all calls)     27
     34
     24
     2
     0
     0
     0
     20

     80
26
 8
 8
1 3
 6
 6
 2

69
1 7
20
 6
1 3
 1
 0
12

69
51
1 6
 1
1 0
 4
 4
1 0

96
47
32
 4
15
 2
 3
1 0

113
*JANUARY calls only reflect calls during the last 10 days of the month (records were not kept prior to that).
"OTHER includes: public meeting, phone book, health department, EPA, Safeway.

NOTE:  A total of 8 calls were recorded from Randallstown during these three months.
      These were attributed to T.V., newspaper, and other.
CO
(£>

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                                     40
 ytility Bill Inserts

        Respondents were asked in the baseline and follow-up surveys whether
 they had seen anything about radon in a utility bill. The mailing of utility bill
 inserts about radon was only carried out by one utility company as part of the
 EPA-MDE outreach.  Since this mailing began in February 1988, no positive
 responses were expected in the baseline survey which took place in December
 1987. However, a small percentage of baseline respondents incorrectly reported
 seeing such inserts (see Figure 10).
                            Figure 10
          Of Those Respondents Who Had Seen or Heard
          About Radon, Percent Who Saw Utility Inserts
                                                           baseline
                                                           follow-up
                  Frederick    Hagerstown   Randallstown

        Residents of Frederick and Hagerstown received radon utility inserts,
  while those in Randallstown did not.  Therefore, respondents in the two test
  communities were expected to recall this source. An increase in the numbers of
  respondents citing utility bills did occur in Frederick and Hagerstown.
  Randallstown still had a percentage of respondents citing utility bills, though this
  percentage was very close to that in the baseline survey.  If the same percentage of
  respondents in the three communities can be assumed to erroneously cite utility
  bills as a source of information in both the baseline  and follow-up surveys, this
  would mean that in actuality 12.8 percent (18.5 - 5.7) of the respondents in
  Frederick saw the utility inserts, 4.2 percent (13.6-9.4) in Hagerstown and 0.4
  percent (10.7-  10.3) in Randallstown."
      16These figures may understate the impact of the utility inserts since the panel data showed higher
levels of recall for utility inserts.

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                                      41

         Another measure of the relative impact of the utility bills was obtained
  from the radon-related phone calls received by the MDE (see Table 4). Of those
  Frederick residents who called the State, 13 (18.8 percent) of the callers in
  February and 10 (10.4 percent) of callers in March had obtained the number from
  the utility insert.17  In Hagerstown, 13  (18.8 percent) of callers in February and 15
  (13.2 percent) of callers in March had obtained the phone number from the
  inserts. No callers from  Randallstown  cited utility inserts.
  Community Outreach

         Measuring the impact of the community outreach was difficult.  This
  outreach component consisted of the distribution of posters and  leaflets, radon
  presentations, as well as some community events.  The survey sought to identify
  the impact of the community outreach by asking if respondents recalled a radon
  poster or had attended a presentation. Posters were displayed only in Frederick.
  Also, while it is possible that a respondent in any of the three communities could
  have attended a radon presentation, special efforts were made to conduct such
  presentations in Frederick.  In addition to direct questions on these outreach
  components, some open-ended questions were included on the follow-up to help
  identify any other community activities that had served as sources of
  information about radon.

         Only a small percentage of the respondents cited radon posters or
  presentations as a source of information  (see Figure II).18 While these figures
  are too low to be conclusive, Frederick respondents were marginally more likely
  to have seen a poster or to have attended a presentation.  The Project Team did
  not expect these percentages to be large,  given the modest scope of the
  community outreach, and the survey data do not allow any definitive
  conclusions to be drawn about the effects of the community outreach. However,
  some of the open-ended questions did result in an occasional respondent in
  Frederick saying that he or she had seen a poster on display, or had picked up a
  radon leaflet at one of the locations listed in Appendix 9.  A number of Frederick
  respondents also recalled reading or hearing about local officials testing for
  radon.
       17Utility radon inserts were included in the February/March mailings by Potomac Edison.
       18The data obtained on this information source is likely to be on the conservative side since the
survey attempted not to prompt people in their responses by asking open-ended rather than more targeted
questions. The results of regression analysis of the data, especially for the panel data, indicate that the
community outreach played a role in explaining the observed changes between surveys. See Overview and
Summary of Survey Results. RTI.

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                                   42
                         Figure 11
        Of Those Respondents Who Had Seen or Heard About
        Radon, % Who Saw Poster or Attended Presentation
           20
           15 -
           10 -
            5 -1
                 c\i
r--
co
oo
c\i
                                                        follOW-UD
                                                         Poster
                                                         Presentation
                Frederick   Hagerstown Randallstown

       The hotline data provide some additional information on the
community outreach activities. As shown by this data, Frederick callers were
more likely to cite posters or leaflets than Hagerstown callers (see Table 4).
Hagerstown callers would not have been expected to see either leaflets or posters
unless  they were in Frederick, as this component of the outreach took place only
in Frederick.

       Some of the newspaper effects already described for Frederick (based on
the survey data and hotline records) may also potentially be attributed to the
community outreach component of the project since a number of newspaper
articles were a direct result of community events organized for the project.  It is
not possible to separate out the different newspaper sources of information,
except  to note that testing by local officials was cited by a number of Frederick
respondents when describing what they recalled seeing in the newspaper.
                               3. Knowledge

       Changes in knowledge of radon are another means of assessing the
impact of the Project's risk communication program. The survey included seven
questions measuring respondents' knowledge of radon.  These included
questions on what radon is, how to measure it, associated health effects and
testing and mitigation. Each respondent was asked to pick the best of three
choices or "don't know," if that was  his or her best answer.

       Table 5 summarizes respondent performance on each of the knowledge
questions in the baseline and follow-up  surveys. Several interesting patterns

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                                                 TABLE 5

                    KNOWLEDGE ABOUT RADON BY COMMUNITY (PERCENTAGE CORRECT)
                              Frederick
                             Hagerstown
                                           Randallstown
Questions
Where does radon in
homes come from?
What kind of odor
does radon have?
What affects level of
radon measured?
How can one test for
radon?
When do health problems
from radon occur?
Baseline
Survey
61
73
25
28
33
Follow-Up
Survey
71
84
40
65
42
Baseline
Survey
49
66
1 9
22
31
Follow-Up
Survey
57
71
24
44
31
Baseline
Survey
42
63
1 6
24
32
Follow-Up
Survey
49
67
21
46
31
What kinds of health
problems does radon
cause?

What can one do to
reduce radon levels
in the home?
54
56
70
70
48
43
59
53
41
41
48
50
                                                                                                                 CO

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                                  44


emerge. First, Frederick, which received both the media and community
outreach, had much higher levels of knowledge in the follow-up than the
comparison community, Randallstown. Knowledge about radon was generally
higher in Hagerstown than in the comparison community, but the differences
between surveys were much smaller than those in Frederick.

       Second, the largest difference between surveys occurred for Question 15,
"How can one test for radon?" This was one of the main messages of the EPA
communication program (and of the WJLA campaign). In Frederick, 37 percent
more people answered this question correctly in the follow-up. Both Hagerstown
and Randallstown showed improvements in the range of 20 percent.

       Third, people showed more knowledge of general characteristics-it occurs
naturally and has no odor-than more technical issues-what affects the level
measured and when do health problems usually occur.  Performance on the
knowledge questions was at least in the 70 to 80 percent range for the general
questions, but declined to the 40 to 45 percent range for the more technical ones.
This suggests that there is still more to be done in communicating information
about measurement factors and the timing of  health, problems.

       Fourth, Frederick and Hagerstown homeowners also improved
significantly on being able to identify the health problems caused by radon (Q. 17),
and knowing what can be done to reduce radon levels (Q. 18). Frederick
respondents showed the greatest improvement at 16 and 14 percent, respectively.
The improvement in Hagerstown was 11 and 10 percent, respectively.
Randallstown improved slightly less at 7 and 9 percent, respectively.

       Figures 12-14 indicate the percentage of respondents in each community
who answered the indicated number of questions correctly in the baseline and
follow-up surveys.  Overall, the percentage of respondents answering five or
more  questions correctly increased in  all three communities between the two
surveys.

       In the baseline survey, Frederick respondents were generally more
knowledgeable about radon than Hagerstown and Randallstown respondents; in
the follow-up, however,  Frederick respondents' general level of knowledge had
also increased more than that of Hagerstown and Randallstown respondents.
Thus, a larger percentage of respondents in Frederick answered  five or more
questions correctly (57 percent) as compared to Hagerstown (35 percent), and
Randallstown (30 percent). Changes between the baseline  and follow-up surveys
were very similar for Randallstown and Hagerstown.

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                        45
                 Figure 12
  Percent of Frederick Respondents Who Answered
    the Indicated Number of Questions Correctly
      01234567
                                              baseline
                                              follow-up
                 Figure 13
Percent of Hagerstown Respondents Who Answered
   the Indicated Number of Questions Correctly
     01234567
                                             baseline
                                             follow-up

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                                 46
                       Figure 14
       Percent of Randallstown Respondents Who Answered
            the Indicated Number of Questions Correctly
                                                     H  baseline
                                                     0  follow-up
      Performance on the knowledge questions also appeared to bear a
relationship to whether a respondent had spoken to someone about radon or
called the toll-free number. Figure 15 shows that for all respondents in the
follow-up survey, over three-fourths of those who talked to someone about
radon answered 5 or more questions correctly, compared to about one-third of
those who had not. Testers in Frederick performed better than those in
Hagerstown

                    Figure 15
      Number of Knowledge Questions Answered Correctly
      by People Who Had Talked to Someone About Radon
                       2.90%
                               14.50%
     43.10%
                                              Number of
                                            questions correct

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                                     47

  and Randallstown.  Testers in Randallstown performed as well as those in
  Hagerstown.

        Respondents who had called the toll-free radon hotline also answered
  more questions correctly than those who had not. It should be noted that this
  group was very small relative to the sample as a whole. However, the personal
  contact involved in speaking to someone~a friend, relative, or co-worker~about
  radon or to a government official through the radon hotline, appears to play an
  important role in promoting  knowledge or learning about radon.

        Respondents who had tested their home answered more knowledge
  questions correctly than non-testers. Testers in Frederick performed best, with
  almost three-fourths answering 6 or 7 questions correctly, compared to less than
  one-third of the non-testers (see Figure 16).  In Hagerstown and Randallstown,
  almost one-half of the testers  answered 6-7 questions correctly, as compared to
  under 20 percent of the non-testers.19

        Use of cross-tabulations20  supplemented by statistical analyses21 of the
  performance on the knowledge questions yielded some additional insights about
  performance on the knowledge questions as a function of the EPA outreach
  program, various socio-economic factors, and potential confounding factors such
  as television and the WJLA-TV campaign.  Additional implications  of the
  analyses were:

        - Homeowners in Frederick and Hagerstown had higher levels of
          radon  knowledge than those in Randallstown, even after taking
          into  account exposure to the  WJLA-TV campaign and various
          socio-economic factors.

        - People who recalled seeing radon programs on television had
          greater knowledge than those who did not recall seeing such
          programs.

        - White respondents and  male respondents had higher
          knowledge than non-whites and females.

        - Respondents  with higher education and higher income levels
          performed better than those with lower levels.
      19See Appendix 13 for graphs on Hagerstown and Randallstown follow-up survey tester/non-tester
performance on knowledge questions.
      20Cross-tabulations allow for comparisons of two different sets of data, e.g., comparing
educational levels and testing behavior, or age and performance on knowledge questions.
      21 See Appendix 14 for a table of the regression results. More details can be found in Overview and
Supriman/ of Survey Results. RTI.

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                   48
                   Figure 16
    Among Respondents in Frederick Who Had Tested,
How Many Knowledge Questions Did They Answer Correctly?
                 Follow-Up Survey
                       3.8%
                           2.6%
                                            Number of
                                         Knowledge Questions
   Among Respondents in Frederick Who Hadn't Tested,
 How Many Knowledge Questions Did They Answer Correctly?
                  Follow-Up Survey
                                             Number of
                                          Knowledge Questions

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                                   49
                                4. Attitudes

         Whether people's attitudes about radon change as they become more
aware of, and knowledgeable about  the problem, was one of the questions
explored in the Project.  For this purpose, "attitudes toward radon" were defined
as respondents' perceptions about testing and mitigation.

       To determine respondents' attitudes about radon testing  and mitigation
they were asked to rate on a 4-point scale (strongly agree, agree, disagree, strongly
disagree) their position on three statements.  A fifth response choice was "don't
know." These statements were:

      - "It is important to test my home to find out if I have a radon
        problem."

      - "If I had a radon problem, it would be costly to fix."

      - "Even if a radon problem was fixed my home would still be
        worth a  lot less."

       These three statements correspond closely to the risk communication
messages, which  emphasized the importance of testing, that remediation need
not be expensive, and that remediation can be effective.  If the messages were
accepted, the proportion agreeing to the first statement would increase, and the
proportions disagreeing to the second and third would increase.

       Table 6 provides information on the percentage of respondents in each of
the three communities who agreed or disagreed with each statement in the
baseline and follow-up surveys. In  all three communities, a higher percent of
respondents in the follow-up survey said it was important to test their home for
radon.  Frederick respondents, however, were more likely to say it is important
to test for radon (76 percent) relative to Hagerstown (66 percent)  and
Randallstown (67 percent). Frederick also showed the greatest increase in this
attitude between surveys.

       A change in attitude about the cost of fixing a radon problem also
occurred between the baseline and follow-up surveys. Overall, the percentage of
respondents disagreeing that it would be costly to mitigate for radon increased, a
trend consistent with the  radon outreach communications.  The follow-up
showed that respondents in Frederick were more likely to disagree with this
statement than those in the other two communities and less likely to give "don't
know" as a response.

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                                                             TABLE 6
                                Frederick
Basellne(%)
"Important to Test"
- agree"
- disagree"
- don't know
"Costly to Fix"
- agree*
- disagree"
- don't know
"House Worth Less"
- agree"
- disagree**
- don't know

65
25
1 0

53
22
25

44
41
1 5
Follow-Up(%)

76
1 7
7

38
37
25

28
61
1 1
                                                   ATTITUDES ABOUT RADON
Haqerstown
Randallstown
Baseline(%)
63
23
1 4
51
1 8
31
42
40
1 8
Follow-Up(%)
66
20
14
39
27
34
32
47
21
Basellne(%)
66
21
1 3
43
20
37
33
47
20
Follow-Up(%)
67
21
12
39
24
37
32
46
22
                                                                                                                                  Ul
                                                                                                                                  o
'Includes response categories "strongly agree" and "agree"
"Includes response categories "disagree" and "strongly disagree"

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                                   51
       The project stressed that mitigation costs are affordable and in line with
other home-related expenses. Frederick respondents, in the follow-up survey,
were more likely to demonstrate this attitude than Hagerstown and
Randalls town respondents.

       The final attitude statement deals with people's perceptions of the value
of a home mitigated for radon.  Overall, the percentage of respondents who
disagreed with this statement increased between the baseline and follow-up
surveys.

       In the baseline survey, the larger percentage of respondents in
Randallstown (47 percent) who disagreed with the statement was larger than that
in Hagerstown (40 percent) and Frederick (41 percent). By the follow-up,
however, a larger percentage of Frederick respondents disagreed with the
statement (61 percent), compared to Hagerstown (47 percent) and Randallstown
(46 percent).  While the "don't know" responses increased slightly in Hagerstown
and Randallstown between surveys, they decreased in Frederick.

       Overall, Frederick respondents exhibited the more informed attitudes
about radon testing and mitigation than did Hagerstown and Randallstown
respondents.  Frederick respondents also demonstrated the greatest overall
changes in attitudes in the  desired direction between the baseline and follow-up
surveys.

       Table 7 summarizes the results from statistical tests to determine whether
the proportions of people having these three attitudes changed between the
baseline and follow-up surveys. The results indicate that the risk communication
messages were received and accepted by a significantly higher proportion of
respondents in the EPA-MDE outreach communities. In Frederick, the
proportions increased in the desired direction for all three questions, while in
Hagerstown significant changes were measured in the second and third case.
There were no significant differences in the comparison community.

       Cross-tabulations of the socio-economic characteristics of respondents and
their attitude about the importance of radon testing indicated that a relationship
existed between  attitude and education and sex of respondents.  Figure 17 shows
that as educational level increased, respondents were more likely to say that it is
important to test their home for radon.  The percentage of respondents in each
educational category who said it was important to test also increased between the
baseline and follow-up surveys.

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                                           52
Table 7: Changes in Attitudes About Radon:   Statistical Test Results
Frederick
Hagerstown
Randallstown
                        "It is important to test my home to find out if I have a radon problem."
                                    (Strongly Agree or Agree/Total   "Don't Know")
                 Baseline
                 Proportions      Ratio
342/467        73.2
333/452        73.7
326/428        76.2
                              Follow-up
                              Proportions
366/445
351/460
346/456
               Ratio
82.2
76.3
75.9
Z  Statistic

   -2.67*
   -0.78*
    0.13
 Frederick
 Hagerstown
 Randallstown
                             "If I had a radon problem, it would be costly to fix."
                             (Disagree or Strongly Disagree/Total  "Don't Know")
                 Baseline
                 Proportions      Ratio
115/392        29.3
 92/363         25.3
 99/311         31.8
                              Follow-up
                              Proportions
177/358
144/353
123/325
               Ratio
32.7
40.8
37.8
Z  Statistic

   -5.44*
   -4.33*
    -1 .44
                     "Even if a radon problem were fixed, my home would still be worth a lot less."
                                (Disagree or Strongly Disagree/Total   "Don't Know")
Frederick
Hagerstown
Randallstown
Baseline
Proportions
212/442
21 1/433
233/394
Ratio
47.9
48.7
59.1
Follow-up
Proportions
291/427
250/419
238/400
Ratio
68.1
59.7
59.5
Z Statistic
-5.43*
-2.92*
-0.04
 Note: This is not an exact Z Statistic as non-response was high.  It can be considered an exact test if it is
      assumed that respondents were no different, demographically, than the non-respondents.
      The sample proportions were tested  at the 95% confidence level (Z Statistic of -1.96 < z < 1.96 if
      the null hypothesis is true).
 *Z  Statistics for sample proportions that are  statistically different.

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                                 53
                       Figure 17
       Percent of Respondents in Each Education Level Who
           Felt It Is Important To Test Home for Radon
         100
                                                   •  baseline
                                                   ED  follow-up
              <12  years  12-15  years 16+  years

      Female respondents were also more likely to agree that it is important to
test for radon than male respondents.  As shown in Figure 18, 73 percent of the
women and 66 percent of the men in the follow-up said it is important to test.
This percentage showed an increase over the baseline levels, though the increase
was larger for women than for men.

                        Figure 18
          Percent of Respondents, by Sex, Who Agreed
              It Is Important to Test Home for Radon
         100
                                                   H  baseline
                                                   0  follow-up
                   male
female

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                                    54
                                   5. Testing

        The most important indicator of risk communication effectiveness is the
 extent of change in the desired behavior-in this case, homeowners testing their
 homes for radon as a result of the EPA-MDE outreach activities.

        In the baseline survey, levels of testing in the three communities were
 very similar, with  a slightly higher level in Frederick,  where 6.9 percent of the
 respondents had tested for radon as compared to Hagerstown's 5.3 percent and
 Randallstown's 4.5 percent. Overall levels of testing increased between the
 baseline and follow-up surveys, with the most substantial changes occurring in
 Frederick (see Figure 19).  Hagerstown and Randallstown showed only slight
 increases over baseline testing levels.

                        Figure 19
           Percent of People in Baseline and  Follow-Up
                    Who  Had Tested for Radon
                                                           baseline
                                                           follow-up
               Frederick  Hagerstown Randallstown

        As the  data shows, testing levels improved over the Project's four-month
 period. The more dramatic increase in Frederick—of 9.4 percent—indicates that
 some event(s) led to increased concern about radon and willingness to test. It is
 likely that the WJLA campaign played a major role in the increased testing.
 However, the data on sources of awareness indicate that a number of EPA-MDE
 outreach activities, such as newspaper coverage of community events, utility bill
 inserts, and posters did have an impact.  The Project's cumulative effect appears
 to help explain some of the increased testing observed.22

        One factor that differentiates between testers and non-testers is whether
 they had talked with a friend, neighbor, or co-worker about radon. Figure 20
      22For more detailed information on statistical modeling used to determine the effects of the EPA-
MDE outreach on testing, see Overview and Summary or Survey Results. RTI.

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                                   55
shows that 80 percent of testers in Frederick and 71 percent of testers in
Hagerstown had talked with someone about radon while only 45 percent and 33
percent of non-testers had discussed radon. In Randallstown, the percentage
difference between testers and non-testers is 34 percent but levels are 20 percent
lower.
                           Figure 20
              Percent of Testers and Non-Testers in the
           Follow-Up Survey Who Had Talked to Someone
                           About Radon
           100
                                                         testers
                                                         non-testers
                 Frederick   Hagerstown  Randallstown
       The EPA-MDE risk communication program stressed that people should
call the Maryland toll-free number for further information on radon. While
only 3 percent of the total sample had called this number, 14 percent of the testers
had done so compared to only 1.7 percent of the non-testers. It is not possible to
demonstrate a direct relationship between calls and testing behavior, since some
testers may have called the number after obtaining their test results; however, it
appears that the message directing individuals to a knowledgeable information
source (i.e., the Maryland Department of the Environment) was received, and
this may have facilitated the decision of some people to test for radon.

       A number of other characteristics appeared to distinguish testers from
non-testers.  These are described for the aggregated sample rather than for each
community, since this allowed for a larger pool of testers.

       In the follow-up survey, respondents who used their basement as a living
area were more likely to test than those who did not (see Figure 21).  This
distinction was not apparent in the baseline, which may indicate that those who
use their basements became more motivated to test as a result of
communications during the Project.  While people who don't use their

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                                       56
  basements also should test their homes, radon levels tend to be highest in the
  basement (or lowest level of the house). Therefore, those who use their
  basements should be more concerned than those who do not, and this shift from
  baseline to follow-up  is consistent with the radon risk communication messages.
                             Figure 21
            Percent of Testers/Non-Testers Who Use Their
                      Basement As a Living Area*
                                                               follow-up
             100
             80 -
             60 -
40 -
             20 -
                         yes                 no         Use Basement

           'Categories do not equal 100% due to no response/bad data
                                                             •  testers
                                                             D  non-testers
         Income and education also appeared to bear some relationship to testing
  behavior (see Figures 22-23).  Testers were more likely to have 16+ years of
  education than non-testers, and to have incomes over $25,000.23
      23This was true in the follow-up survey. In the baseline survey, testers were more likely to have
incomes greater than $50,000 compared to non-testers. Differences were not apparent at other income
levels.  It should also be noted that statistical modeling indicated that testing was influenced more by talking
about radon with someone and personalizing the risk than by income or education. See Overview and
Summary of Survey Results. RTI.

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                                    57

                        Figure 22

            Years of Education for Testers and Non-Testers
           100
                                                      • testers
                                                      D non-testers
                <  12 years  12-15   years  16+  years


                        Figure 23

             Annual Income for Testers and Non-Testers
          100
                                                         testers
                                                         non-testers
               <  $25,000  $25-50,000  $50,000 +
       Testers were likely to be younger than non-testers (see Figure 24).  In the
baseline, testers were more likely to be less than 35 years of age than non-testers,
though by the follow-up, those in the 35-39 year age group were also more likely
to be testers. White respondents were also more likely to test than non-white
respondents. No strong relationship was observed between smoking habits and
testing behavior, as respondents who were non-smokers were only marginally
more likely to test than smokers.

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                                   58


                        Figure 24

                Age of Testers and Non-Testers
          100
                                                      •  testers
                                                      D  non-testers
               < 35 years 35-49  years 50+  years
       The changes in reasons homeowners gave for not testing for radon also
provide some insights on the effectiveness of the risk communication program.
Only 5 to 10 percent of the baseline and follow-up samples, respectively, had
tested for radon. The remaining respondents were asked to identify why they
had not tested.  The reasons given have been categorized as follows:24
Uninformed:


Antitester:

Fatalists:

Not in Area:


Not in Home:
Respondent had never thought about it (and related
responses).

Respondent had some negative view of testing.

Respondent did not think anything could be done.

Respondent did not think radon was a problem in his or her
geographic area.

Respondent did not think radon was a problem in his or her
own home.
Procrastinator:     Respondent had not gotten around to testing.

Other:            All other responses, including "don't know."
    24See Appendix 16 for a description of the responses included in each category.

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                                      59

         Figure 25 summarizes the changes in rationales given by non-testers
  between the baseline and follow-up surveys. In both Frederick and Hagerstown,
  the largest change occurred in the "procrastinator" category; 16 percent and 11
  percent more respondents, respectively, said they hadn't gotten around to it.  In
  the comparison community, Randallstown, the change in this category was only
  4 percent.

         Another category where interesting changes occurred was the decreased
  use of the reason that radon was "not in my area". This was true in all three
  communities, with the largest decrease in Frederick.  However, use of the
  rationale that radon was "not in my home," actually increased in all  three
  communities—particularly in Frederick and Randallstown, where 8 percent more
  respondents in both communities used this reason.   This was not  consistent
  with the risk communication message that radon can be present not  only in any
  community but also in any home.

         Finally, Frederick respondents in the follow-up survey were less likely to
  say that they just had  not thought about testing  (or related "uninformed"
  rationales) than respondents in the baseline, indicating greater awareness of
  radon and testing. The greatest change between surveys for this category also
  occurred in Frederick.

         In summary, changes in the rationales for not testing would indicate that
  there was a movement away from "never thought about it," to procrastination.
  This was particularly true for respondents in Frederick, and to a lesser extent,
  Hagerstown.25  A less expected change was the increased percentage of
  respondents, particularly in Frederick and Randallstown, who gave as a reason
  "not in my home."26  This  change was not consistent with the message that all
  homeowners should test to  find out if they have  a problem, and indicates that
  there are other factors  causing people not to personalize the risk from radon.
  This is an area for further investigation and reinforces the importance of
  personalizing radon risks through a  communication  message.
  E. SUMMARY

         The data indicate that exposure to radon communications increased
  substantially during the Project period. The increased exposure resulted from the
  EPA-MDE outreach activities as well as the WJLA campaign, leading to changes
  in respondent awareness, knowledge, attitudes and testing behavior.
      25Given the short time span of the Project and the relatively unfamiliar nature of radon risks, this
was a very positive change to observe between the two surveys.
      26lt is not clear why some people feel personally at risk while others deny their own vulnerability.
"The Precaution Adoption Process," by Neil D. Weinstein, Health Psychology. 1988, 7(4), p. 362 describes
this phenomenon, ft remains a challenge for risk communicators to move people from an understanding of a
risk to personalization of the risk.

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                              60
                           Figure 25
    Why Respondents Had Not Tested: Changes Between
                 Baseline and Follow-Up Surveys
                           FREDERICK
                                                   24
 Uninformed  Antitesters
                    Fatalists   Not In Area  Not In Home ProaastJnatois  Other/Don't
                                                         Know
                         HAGERSTOWN
                                                  18
                                                        15
                                                            13
Uninformed  Antitesters    Fitalisu    Not In Area  Not In Home  Procrastinmtors  Other/Don't
                                                         Know
                        RANDALLSTOWN
                                                        18
                                                            14
Uninfonned  Amitesiers   Fatalists   Not In Area  Not In Home Procrasnruuors Other/Don't
                                                         Know
                  BASELINE   0 FOLLOWUP

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                                   61
       Newspapers and television were the main information sources cited by
respondents. Although the impact of television exceeds that of other media,
newspapers can also be a very effective means of communication. Radio reaches
a smaller audience than T.V. and newspapers and is thus a less effective means
of communicating.

       The utility inserts were recalled by a fairly small audience (about l/5th of
respondents).  However, if judged by the calls to the radon hotline, they do help
provide an incentive for some individuals to seek further information on radon.

       The community outreach activities were more difficult to assess.
Nonetheless, this outreach appears  to have played a role in disseminating radon
information and/or reinforcing other communications about radon during the
same period. The nature of the EPA-MDE community outreach in Frederick is
likely to have  contributed to informal communication and talking about radon,
which  plays an important role in explaining  several indicators of effectiveness.
The testing of homes by local officials, in particular, seems to have had an impact
since this was specifically cited by a number of respondents as something they
recalled.

       The greatest exposure to radon communications, both as a result of the
project outreach and the WJLA radon campaign, occurred in Frederick. This
exposure had an impact on the changes observed between the baseline and
follow-up surveys, since Frederick showed the greatest changes for all  the
effectiveness indicators as compared to Hagerstown and Randallstown.
Awareness in Frederick increased by 18 percent between the baseline and follow-
up surveys, while performance on the knowledge quiz (percent answering three-
fourths or more of the questions correctly) improved by 24  percent.  The percent
of respondents who said it is important to test increased by 11 percent,  and testing
for radon increased by 9 percent.

       Changes in these indicators  also occurred in Hagerstown, though these
were of a lower magnitude than those in Frederick. This may either be attributed
to the  greater exposure to WJLA in Frederick, given its proximity to Washington,
D.C. or to the  enhanced Project outreach that included a community component.
Attempts were made to separate the effects of these various efforts through
statistical modeling. As a result, it appears that both this media campaign and
the EPA-MDE Project's community outreach  played a role in explaining the
differences between Frederick and the other  two communities.

       The less expected outcome was the amount of change that occurred for
the effectiveness indicators in Randallstown, the comparison community.
While  Hagerstown respondents performed slightly better than Randallstown
respondents overall on the different effectiveness indicators, the magnitude of

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                                  62


the changes between baseline and follow-up were very similar in both
Hagerstown and Randallstown.

      Given that Randallstown received no special EPA-MDE communications
during this period-compared with Frederick and Hagerstown—and that it
received less exposure to WJLA than the other two communities, it is possible
that the higher-than-expected changes in Randallstown are due to factors
unrelated to the communications themselves. Demographically, Randallstown
respondents were better educated and earned higher incomes than those in
Frederick and more especially, Hagerstown.  As a relationship appears to exist
between education and income and some of the effectiveness indicators, this may
account for the changes observed in Randallstown between the baseline and
follow-up surveys, even though  the special communications were not carried
out.

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                                  63


                         V.    CONCLUSIONS


A. What is Available

                      1. Radon Communication Materials

       The radon materials developed and outreach methods tested in this
Project can be adapted by EPA Regional and State Radon Offices in their radon
risk communication strategies. The materials available as a result of this Project
are:

                 A 15-minute radon slide show with audio cassette
                 or on a video tape.

                 Five radio public service announcement scripts.

                 One prototype radon leaflet-front and  back of an 8"
                 x 11" sheet of paper.

                 Four prototype radon posters.

       The radon leaflet and posters were designed for Maryland  (e.g., provide
the Maryland hotline number), but can be easily adapted  by other States.


        2. Information About Communication Outreach  Methods Tested

       Methods that were tested during the project period are:

                 Use of radio and newspaper media.

                 Unsolicited mailings through utility bill inserts.

                 Use of outside groups to communicate  about radon
                 as a means of supplementing limited State/EPA
                 manpower resources.

                 Communicating about radon through  a more
                 personalized community approach.


       In addition to the EPA-MDE outreach, the WJLA  campaign also provided
a test of a television campaign, combined with the sale of radon test kits at  a
convenient location and at a reduced price.

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                                   64
B. What Was Learned

                          1. Community Approach

       The activities undertaken as part of the community outreach approach
appear to have resulted in some of the desired changes observed in Frederick
during the project period.  Many of these activities, however, if organized by a
State Office, would require significant staff time commitments.

       Organizing and publicizing some community events, such  as local
officials testing their homes for radon, can be a successful communication
technique.  Given limited State resources, such an activity might be most
appropriate in communities where high radon levels have been found and
special efforts are being made to publicize it.  A community approach can also be
applied in the context of major employers within a community as  a means of
reaching a large number of people. This would require fewer resources on the
part of communicators since their  communications would be more concentrated
geographically.

       Use of the radon posters and leaflets is recommended if these are adapted
by the State and made available for reproduction and distribution to othej groups
that are involved in communicating about radon risks. These groups will vary
by State, but might include the American Lung Association, American Medical
Association, State or county health officials, and extension workers.

       The radon slide show can be an effective tool for State officials or others
who communicate about radon.  If intermediaries  are  used, however, the State
should ensure that those intermediaries  are familiar with the State program and
services provided (or not provided) by the State. To assist in this, a State using
the slide show may wish to add a few slides that describe the State  program.
                           2. Unsolicited Mailings

       Distribution of an unsolicited mailing through a utility bill insert was
easy to organize and involved no cost to the State.  While a large number of
individuals will receive the insert, a smaller number are likely to actually read it.
A utility insert does not appear to be an adequate substitute for a more intensive
media or community outreach. However, it did  help disseminate information
about radon and reinforced other forms of  radon communication.

       Given the ease with which the radon leaflet could be adapted and a utility
bill insert arranged, it is recommended that States consider unsolicited mailings
as a low-cost, low-resource method of communicating about radon.  Other

-------
                                   65
methods for distributing unsolicited mailings can also be used, such as through
property tax bills. It is best, however, if such mailings take place during the
heating season, when testing should be performed.
                             3. Media Approach

       A television campaign, as might be expected, is a very effective means of
communicating about radon risks.  The WJLA campaign is an example of a well-
designed, multi-media campaign that emphasized both education about radon
and sale of radon kits in a convenient location at a low price. This combination
resulted in a greater impact than expected by WJLA, the results of which were
observable in the three communities included in this study.  States can
encourage, where appropriate, similar efforts by local TV stations.

       Short of a television campaign like WJLA's, regular television  features
are one means of communicating about radon, but are not necessarily  the most
effective.  Most people appear to usually obtain their information about radon
through newspapers.  Organizing radon communications through newspaper
coverage is therefore a method that EPA Regional or State radon offices can use
and which requires far fewer resources than generating similar exposure on
television.

       Radio is another low-cost means of communicating about radon, but its
effectiveness is lower than that of television or newspapers because a smaller
number of people (about one-third) get their information from this source. This
Project could not determine what effect, if any, the radio public service
announcements had.  Nonetheless, given  the low level of resources needed to
arrange for the use of radio public  service announcements, this is an activity
States can easily include in their radon risk communication strategies.  It is
suggested, however, that scripts rather than the more costly tapes be used. Radio
public service announcements should  be  a supplement to other communication
methods, not the main method.
                    4. Informal Communication Channels

       The information gathered through this Project demonstrates the
importance of encouraging informal communication about radon.  Individuals
who have talked to others about radon are more likely to be knowledgeable about
radon and to test. Thus, the more people who can be reached with a radon
message, the more this message is likely to be spread through informal channels.
The implications for States  that have had little radon risk communication to-
date would be to start with those communication methods that reach a large
number of people (i.e., mass media), before focusing on more personalized

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                                   66

communication techniques or those that target harder-to-reach socio-economic
groups.


C. Final Thoughts on the Evaluation of Risk Communications

       Evaluating the effectiveness of risk communications is an important
aspect of communication that is often overlooked, but it can provide important
lessons for improving communications.  This Project attempted both to develop
and evaluate the effectiveness of radon risk communication materials and
methods.  Thus, in addition to providing some insights about the effectiveness of
the materials, this Project also provides some suggestions about the evaluation of
risk communication strategies by Regional or State offices.

       The type of evaluation undertaken for this Project was much more
ambitious and resource-intensive than that which Regional or State Offices
should try to conduct.  While a quantitative survey can be an effective
evaluation technique,  it also has many limitations, as encountered in this project
(low response rates; confounding factors such as WJLA; a complex project
design), and an expensive price tag. There are a number of more qualitative
techniques that can be used (e.g., recording hotline calls, doing selected
interviews), that would be less costly and still provide useful feedback.

       Where a formal quantitative survey methodology is deemed appropriate,
the survey design should be as simple as possible and focus on the most salient
information.  Even much smaller samples, e.g., a sample of 100, can provide very
helpful information and would be sufficient to  determine the effects of a
program on knowledge and attitudes (though not large enough to measure
changes in testing).  Where resources are limited or a quantitative survey less
appropriate, qualitative evaluation techniques can be used. These can range from
interviews in a community where special communication efforts occurred,
keeping a record of calls to the State, or recording the number of individuals
attending a presentation.  Some form of evaluation should be incorporated into a
communication strategy from the outset; however, it need not be overly
resource-intensive.

-------
Appendices

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                  APPENDICES
Appendix 1:

Appendix 2:

Appendix 3:

Appendix 4:


Appendix 5:

Appendix 6:

Appendix 7:

Appendix 8:

Appendix 9:

Appendix 10:

Appendix 11:

Appendix 12:

Appendix 13:



Appendix 14:

Appendix 15:
Advisory Group Members

Survey Questionnaire Form

Hotline Survey Form

Summary of Risk Communication Literature and
Theory

Summary of Focus Group Findings

Radio PSA Scripts

Frederick News-Post Articles

Hagerstown Herald-Mail Print Ads

Sites of Radon Poster and Flyer Distribution

Frederick Community Group Presentations

Radon Slide Show Script

WJLA Radon Flyer

Graphs for Hagerstown and Randallstown
Follow-Up Survey Tester/Non-tester
Performance on Knowledge Questions

Regression Model: Knowledge

Categorization of Responses for Respondent
Reasons for Not Testing

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              Appendix  1:  Advisory  Group  Members
Name




Miles Allen




Jesse Baskerville




Lee Blackburn




Alan Carlin




Pam Cooper




Don DeBlasio




Ray Feldmann




Lew Felleisen




Ann Fisher




Roland Fletcher




Jason Gaertner




Tim Hartmann




Keith Hinds




Larry Jensen




Miles Kahn




Renate Kimbrough




Larainne Koehler




Mel Kollander




Steve Page




Chris Rice
Office




Office of Public Affairs




Region 3/Air Management Division




Region 3/Public Affairs Office




Office of Policy Analysis




Environmental Results Branch




Region 5/Public Affairs Office




Maryland Department of the Environment




Region 3/Air Management Division




Office of Policy Analysis




Maryland Department of the Environment




Pennsylvania Department of Environmental Resources




Pennsylvania Department of Environmental Resources




Office of Policy, Planning & Evaluation




Region 5/Radiation Representative




Office of Radiation Programs




Office of Regional Operations




Region 2/Office of Radiation Programs




Statistical Policy Branch




Office of Radiation Programs




Office of Public Affairs
Hank Schilling     Office of Legislative Analysis

-------
               APPENDIX 2:

RADON RISK COMMUNICATION PROJECT SURVEY
             QUESTIONNAIRE

-------
          Telephone No                       RTI I.D.                              OMB 2010-0014
                                                                               Expires 5/88
                    Radon Information Effectiveness Survey:
                           Maryland Baseline Screener
                                    Final Interview Code
  01 Ineligible, Not Residential Number      06 Answering Machine/Service      11 Language Barrier
  02 Ineligible, Not Homeowner           07 No Result From Dial            12 Interview Completed
  03 Ring, No Answer                  08 Fast Busy/Computer Tone        13 Partial Data
  04 Nonworking Number               09 Unable to Contact             14 Final Interview Refusal
  05 Double Wrong Connection           10 Physically/Mentally Incompetent    15 Other
Hello, my name is	I'm calling from the Research Triangle Institute (RTI), in North
Carolina. We are. conducting a study on what people know and think about environmental issues. It
won't take much of your time and your answers will be kept strictly confidential. (Additional information,
if necessary: Your cooperation is very important because we want to find out what the general public
knows about environmental issues. This is not a sales call. The study is sponsored by the State of
Maryland.)

1.  Isthis	-	-	?
   Yes	     01  - CONTINUE
   No  	02 - "Thank You," HANG UP
2.  Does this number serve a: (READ ALL CHOICES, MARK ONE.)
   Residence	01  - CONTINUE
   Business/institution	02
   Or something else-	  03
\ - "Thank You," HANG UP
3.  Do you own your residence?
   Yes    	      01  - CONTINUE
   No	    02  - TERMINATE
4.  As part of our study, I need to randomly choose an adult who makes or shares in important
   household decisions. Please tell me the first names of the adult decisionmakers in your household.
   (IF RESPONDENT CAN'T ANSWER, ASK FOR ADULT, REPEAT INTRODUCTION.)

   1. Woman's Name: 	 2. Man's Name:  	
   Third Decisionmaker: 	 Fourth Decisionmaker:
   (TO CHOOSE RESPONDENT, LOOK AT LABEL AND CHOOSE THE FIRST NAME IF THE NUMBER IS A "1"
   OR THE SECOND NAME IF ITS A "2". IF YOU HAVE TWO MEN OR TWO WOMEN DECISIONMAKERS,
   JUST WRITE THE SECOND NAME IN THE MAN'S SPACE AND FOLLOW THE SAME CHOICE SELECTION
   RULE. IF MORE THAN TWO DECISIONMAKERS, THEN CONSULT YOUR RANDOM SELECTION TABLE.
   CIRCLE NUMBER OF PERSON SELECTED.)

   May I please speak to NAME OF SELECTED DECISIONMAKER. (IF NOT AVAILABLE, SCHEDULE A
   CALLBACK.)
   READ INTRODUCTION IF PERSON ANSWERING IS NOT THE RESPONDENT.
                                    TERMINATION
    Thank you very much for your cooperation. Our study involves only homeowners, so I won't
    need any more of your time. Thank you again for your help.

-------
                                                                         OMB 2010-0014
                                                                         Expires 5/88
              Communicating  Radon  Risk  Effectively:
                       Maryland  Baseline  Survey
           Telephone #
         RTI ID #
1.  Compared to other issues the State of Maryland faces, do you think environmental issues are:
   (READ LIST; CIRCLE ONE NUMBER.)

   a. MORE IMPORTANT  	    01

   b. JUST AS IMPORTANT  	02

   c. LESS IMPORTANT	03

   d. DONT KNOW (DON'T READ)  	94
2.  We're interested in finding out how serious you think the risks from some types of pollution are to
   your community and to your household. On a scale from 1 to 10, with 1 meaning NOT AT ALL
   SERIOUS and 10 meaning VERY SERIOUS, please tell me how serious you think the risks from
   each type of pollution are to your community and to your household. (READ LIST, SCALE, AND
   CATEGORIES; PROBE FOR NUMBER.)
                   Not at all
                   Serious
  Very
 Serious
I I I I I I
I I
                                                          10
                                                               Your
                                                            community
                     Your
                   household
   a. LEAD IN DRINKING WATER	

   b. HAZARDOUS WASTES IN LANDFILLS .

   c. RADON IN HOMES	
    For the rest of the interview I'm going to ask questions mainly about one of the sources I
    mentioned—radon in homes. During the past few months, have you seen or heard anything
    about radon? (CIRCLE ONE NUMBER.)
    a. YES   	
    b. NO     	

    c. DONT KNOW (DONT READ) .
01
021
94)
Skip to Question 5
on page 3

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QUESTK13 4   @2>s@35SK SBSVEY

 4A.  In the past few months have you seen anything in a newspaper or magazine or heard anything
     on the radio or TV about radon?
     a- YES  	01 	*> Continue
     b- N0	02 	+> Skip to Question 48

     Was that in the newspaper or magazine, or was it on the radio or TV?
     (CIRCLE ALL THAT APPLY.)
     a. NEWSPAPER	  01    c.  RADIO  	03
     b. MAGAZINE	02    d.  TV	  04


 4B.  Have you seen or heard any public service ads about radon in a newspaper or magazine, or on
     the radio or TV in the past few months?
     a- YES 	01 	+- Continue
     b  NO	   02 	*• Skip to Question 4C

     Was that in the newspaper or magazine, or was it on the radio or TV?
     (CIRCLE ALL THAT APPLY.)
     a. NEWSPAPER	01    c.  RADIO	03
     b. MAGAZINE	   02    d.  TV	04


 4C.  Have you seen a poster, read a utility bill insert, or heard a presentation about radon in the past
     few months?
     a. YES	01 	>• Continue
     b. NO	  02 	*> Skip to Question 4D

     Was that a poster or utility bill insert? (CIRCLE ALL THAT APPLY.)
     a. POSTER   	  01
     b. UTILITY BILL INSERT	02
     c. PRESENTATION 	 03


 4D.  Have you talked about radon with a friend, relative, or coworker in the past few months?
     a. YES   	01 	>- Continue
     b. NO 	  02 	>• Skip to Question 4E

     Was that a friend, relative, or coworker?  (CIRCLE ALL THAT APPLY.)
     a. FRIEND	   01     c. COWORKER   	03
     b. RELATIVE   	02


 4E.  Have you called the State of Maryland toll-free number for radon information?
     a. YES  	   01
     b. NO	  02


 4F.  In the past few months have you learned anything about radon in some other way?
     a. YES	   01  	*• How was that?   	
     b. NO  	02                      	

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QUESTION 4 - FOLLOW-UP SURVEY
  4A.  In the past few months have you seen anything in a newspaper or magazine or heard anything on
      the radio or TV about radon?
      ^  YES       	01  	*- Continue
      b  NO                  	 02  	>• Skip to Question 4C
                                                                    on page 3

  4B.  (1) Was that in a newspaper?
         a YES    	 m  	^ Continue
         k NO  	 02  	*• Skip to Question 4B, part (2)
         Please tell me the general theme or any details about what you saw in the newspaper.
         (PROBE FOR EACH SELECTION TO FIND OUT IF IT WAS A PUBLIC SERVICE
         ANNOUNCEMENT. DO NOT READ LIST.)
                                                                            Public Service
                                                                           Announcement
         BABY WITH CIGARETTES	 01  \                 01
         HOUSE Wrm ARROWS COMING FROM GROUND	  02      Was this a       01
         HEALTH AD WITH FOOD, EXERCISE, ETC.	  03     ^0^°*     W
         ZIP CODES OF AREAS WITH HIGH RADON LEVELS  	 04   ^ ment? |f YES,      01
         ANNOUNCEMENT OF MEETING ABOUT RADON	05       circle 01        01
         STATE RADON HOTLINE TELEPHONE NUMBER	 06                    01
         ARTICLE/STORY/EDITORIAL 	  07                    01
         OTHER (SPECIFY)  	  . . 08  /                 01

      (2) Was that in a magazine?
         a. YES	 01   •  •»• Continue
         b. NO	 02  	*- Skip to Question 4B, part (3)
         Please tell me the general theme or any details about what you saw in the magazine. (PROBE
         FOR EACH SELECTION TO FIND OUT IF IT WAS A PUBLIC SERVICE ANNOUNCEMENT.
         DO NOT READ LIST.)
         SPECIFY 1
         SPECIFY 2
                                                  01
                                                  02
      (3) Was that on the radio?
         a. YES	
         b. NO	
 Was this a
Public Service
 Announce-
ment? If YES,
  circle 01
Public Service
Announcement
     01
     01
                                                            Continue
                                                            Skip to Question 4B, part (4)
                                                            on page3
Please tell me the general theme or any details about what you heard on the radio. (PROBE
FOR EACH SELECTION TO RND OUT IF IT WAS A PUBLIC SERVICE ANNOUNCEMENT.
DO NOT READ LIST.)
         SPECIFY 1
         SPECIFY 2
         SPECIFY 3
         SPECIFY 4
                                                  01
                                                  02
                                                  03
                                                  04
 Was this a
Public Service
 Announce-
ment? If YES,
  circle 01
 Public Service
Announcement
     01
     01
     01
     01

-------
    (4) Was that on TV?
       a. YES.	  01   	>• Continue
       b. NO  	 02   	*• Skip to Question 4C
      Please tell me the general theme or any details about what you saw on TV. (PROBE FOR
      EACH SELECTION TO FIND OUT IF IT WAS A PUBLIC SERVICE ANNOUNCEMENT. DO
      NOT READ LIST.)                                                       B wi  c  .
                                                                             Public Service
                                                                            Announcement
       PUBLIC SERVICE AD WITH JOHN GLENN	 01  \   Was this a       01
       LITTLE GIRL WITH GAS MASK	 02
       PUBLIC SERVICE AD WITH SENATOR WARNER OF VIRGINIA	  03
       PUBLIC SERVICE AD WITH A FAMILY	  04
       ROBERTA BASKIN ON WJLA-TV/CHANNEL 7 RADON WATCH	  05
       OTHER (SPECIFY) 	  . .  06
Public Service     01
 Announce-
ment? If YES,      01
  circle 01        01
                01
                01
4C. Have you seen a poster, read a utility bill insert, or heard a presentation/slide show about radon in
    the past few months?
    a.  YES	 01   	^ Continue
    b.  NO	 02   	>• Skip to Question 4D
    Was that a poster, utility bill insert, or a presentation? (CIRCLE ALL THAT APPLY.)
    (1) POSTER 	 01
          Please briefly describe the poster or posters you saw. (CIRCLE ALL THAT APPLY. DO NOT
          READ LIST.)
          BABY WITH CIGARETTES	 01
          HOUSE WITH ARROWS COMING FROM GROUND	 02
          HEALTH AD WITH FOOD, EXERCISE, ETC.	 03
          ZIP CODES OF AREAS WITH HIGH RADON LEVELS	 04
          OTHER (SPECIFY)	.  . 05
    (2) UTILITY BILL INSERT	 02
    (3) PRESENTATION/SLIDE SHOW  03
          What organization was responsible for this presentation/slide show?	
4D. Did you see any other printed information about radon?
    a.   YES 	  01  	>• Continue
    b.   NO 	  02  	*• Skip to Question 4E
                                                                     on page 4

    Where did you get this printed information? (CIRCLE ALL THAT APPLY. DON'T READ LIST.)
    THE STATE OF MARYLAND	 01
    THE U.S. ENVIRONMENTAL PROTECTION AGENCY	 02               Who published this
    WJLA-TV CHANNEL 7/RADON WATCH	 03               information?
    AMERICAN LUNG ASSOCIATION/AMERICAN CANCER SOCIETY . 04
    AT A LOCAL STORE OR MERCHANT	 05
                                                             Specify
    AT THE LIBRARY	 06  -
    A REAL ESTATE AGENT/TRANSACTION	 07  - SpQcjfy  -
    TESTING COMPANY	 08  	Spec//y  >
    OTHER (SPECIFY)	. . 09  	»>
    DONT KNOW 	 94

-------
4E. Have you talked about radon with a friend, relative, or coworker in the past few months?
    a. YES	 01   	>• Continue
    b. NO  	 02   	*> Skip to Question 4F

    Was that a friend, relative, or coworker? (CIRCLE ALL THAT APPLY.)
    a. FRIEND	  01    c. COWORKER	 03
    b. RELATIVE	   02
4F.   Have you called the State of Maryland toll-free number for radon information?
     a. YES	 01
     b. NO	  02
4G.  In the past few months have you learned anything about radon in some other way?
     a. YES	  01 	*• How was that?   	
     b. NO	 02                      	

-------
5.   Information about radon comes from many sources. If you wanted to know more about radon,
    which government agency would you contact? (DO NOT READ LIST; CIRCLE THE AGENCY.)

    a. MARYLAND DEPARTMENT OF THE ENVIRONMENT	  01
    b. MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE	   02
    c. LOCAL HEALTH DEPARTMENT	  03
    d. U.S. ENVIRONMENTAL PROTECTION AGENCY 	  04
    e. OTHER (SPECIFY)	 05
    f. DONT KNOW (DON'T READ)	  94
6.   If you wanted to learn about radon-related health problems, which of the following sources would
    you trust the most to give you that information? (READ LIST; CIRCLE ONE NUMBER.)

    a. MARYLAND DEPARTMENT OF THE ENVIRONMENT	  01
    b. MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE	   02
    c. LOCAL HEALTH DEPARTMENT	   03
    d. U.S. ENVIRONMENTAL PROTECTION AGENCY	   04
    e. FAMILY DOCTOR	   05
    f. SOME OTHER SOURCE (SPECIFY)	  06
    g. NO ONE (DONT READ)	  07
    h. DONT KNOW (DON'T READ)	  94
7.   People have different opinions about radon. How much do you agree or disagree that the
    following statements are your opinion? (READ ANSWER CHOICES AFTER FIRST STATEMENT.)

Strongly
agree
	 01 ..
Agree
. . . 02 . . .
Disagree
. . . . 03 . .
Strongly
disagree
... 04 . ...
Don't
know
...94
    a. IT IS IMPORTANT TO TEST
      MY HOME TO FIND OUT IF
      I HAVE A RADON PROBLEM
    b. IF I HAD A RADON PROBLEM,
      IT WOULD BE COSTLY TO FIX	01	02	03	04	94
    c. EVEN IF A RADON PROBLEM
      WAS FIXED, MY HOME WOULD
      STILL BE WORTH A LOT LESS	01	02	03	  04	 94

-------
 8A.  Have you had your home tested for radon? (CIRCLE ONE NUMBER.)
     a YES	01   	^ Continue
     b N0                                                  °2 j 	* Skip to Question 9
     c. DONT KNOW (DON'TREAD)   	  94)

 8B.  When did you get your results?    	/	
     (If "don't know", enter "94/94")    MONTH/YEAR

 8C.  Were the results over 4 picocuries per liter?
     a YES	 01   	*• Continue
     b. NO	
     C. DONT KNOW (DONT READ)	
                                                            >  	>• Skip to Question 11
                                                          94)           K
                                                               Skip to Question 11
8D. Did you do followup testing, anything to fix the problem, both, or nothing?
    a.  FOLLOWUP TESTING	  01
    b.  FIX PROBLEM  	02
    c.  BOTH	03
    d.  NOTHING	  04
    e.  DONT KNOW (DON'T READ)	94

9.   People may have various reasons for deciding not to have their home tested for radon. What is
    the main reason you have not had yours tested. (DON'T READ LIST; ALL THAT APPLY.)
    a.  NEVER THOUGHT ABOUT IT	   01       i.  WOULD RATHER NOT KNOW IF
    b.  DIDNT KNOW IT WAS POSSIBLE . .   . .  02         THERE IS A PROBLEM	°9
    a  DONT THINK I HAVE A PROBLEM              '"  NOTHING CAN BE DONE ABOUT
    c.  UUIN I i niiNrv i n/we M rnuDLCM                 RADON ANYWAY                         1f)
       IN MY HOME	03         HAUUN ANYWAY	1U
    d  DIDNT KNOW HOW TO TEST          04      k'  F1XING A PROBLEM IS TOO EXPENSIVE	11
    e.  THOUGHT TESTING WAS TOO                 L  CONCERNED ABOUT CONFIDENTIALITY	12
       EXPENSIVE	   05      m. JUST HAVENT GOTTEN AROUND TO IT . .   . . 13
    f.  DONT THINK TESTS ARE RELIABLE     06      n.  OTHER (SPECIFY)	 14
    g.  NOT INTERESTED  	07      o.  DONT KNOW (DONT READ)  	   94
    h.  DIDNT KNOW IT WAS A
       PROBLEM IN THIS AREA	  08
10.   Suppose your local health department was offering a radon test for a one-time cost of $10, $25,
     $50, $100. The cost would cover two radon detectors, the results, and a booklet about radon.
     Would you take part in such a radon testing program? (CIRCLE ONE NUMBER.)
     a. YES	01
     b. NO	02
     c. DONT KNOW (DONT READ)	    94

11.   Suppose you are just moving to this area and you want a home like the one you're in now. You
     have narrowed the choice to two houses that are almost identical. The only difference is that
     House 1 has radon levels 2, 5 times higher than the government's guidelines for action, while
     House 2 has no radon but costs an additional $5,000, $10,000, $15,000, $20,000 Which house
     would you buy? (CIRCLE ONE NUMBER.)
     a. HOUSE 1	     	        01
     b. HOUSE 2   	    . .   . .     . .      	              02
     a DONT KNOW (DONT READ)    	      	           94

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Some people have heard a great deal about radon while others have heard very little. We're interested
in learning how much people know about radon. For the next group of questions, I am going to read
you three choices. Please tell me which answer you think is best. If "don't know" is your best answer,
then say that.
                                                                               Record
                                                                             Responses
12.   Where does most radon in homes come from?
     a. INDUSTRIAL POLLUTION 	 01
     b. NATURAL URANIUM IN SOIL	 02
     c. OR HOME APPLIANCES  	 03
     d. DONT KNOW (DON'T READ)  	 94

13.   Which  of the following best describes radon? Radon has:
     a. A SLIGHT ODOR	   01
     b. A STRONG ODOR	 02
     c. OR NO ODOR AT ALL	 03
     d. DONT KNOW (DONT READ) 	 94

14.   When radon is measured in a home, which of the following will affect the level?
     a. THE TIME  OF YEAR IT'S MEASURED	 01
     b. THE AMOUNT OF INDUSTRIAL POLLUTION AROUND THE HOME	 02
     c. OR THE NUMBER OF APPLIANCES IN THE HOME	 03
     d. DONT KNOW (DONT READ)  	,	 94

15.   How can you test your home for radon?
     a. YOU CAN DO IT WITH A HOME TEST	 01
     b. ONLY TRAINED PERSONNEL CAN TEST	 02
     c. OR YOU CANNOT TEST FOR RADON	 03
     d. DONT KNOW (DON'T READ)   	  94

16.   When do health  problems from being exposed to radon usually occur?
     a. WITHIN A FEW WEEKS	  01
     b. IN A FEW YEARS	02
     c. OR NOT FOR 10 TO 30 YEARS	03
     d. DONT KNOW (DONT READ)	94

17.   What kind of health  problems are high levels of radon exposure likely to cause?
     a. MINOR SKIN PROBLEMS  	  01
     b. EYE IRRITATIONS	    02
     c. OR LUNG CANCER	  03
     d. DONT KNOW (DONT READ) 	    94

18.   What can homeowners do to reduce high radon levels in their homes?
     a. REMOVE THE APPLIANCES CAUSING THE PROBLEM	  01
     b. HIRE A CONTRACTOR TO FIX THE PROBLEM  	02
    c.  OR THERE IS NO WAY TO FIX THE PROBLEM  	03
    d. DONT KNOW (DONT READ)  	94

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19.  People sometimes describe themselves in various ways. For each statement I read please tell me
    if these things are true about you always, often, sometimes, or never. (READ LIST AND SCALE;
    CIRCLE ONE NUMBER FOR EACH STATEMENT.)
                                      Always
         Often
        Sometimes
           Never
        Don't
        know
    a. I TRY TO FIX THINGS
      AROUND THE HOUSE  	01	  02
    b. I EXERCISE AND/OR WATCH
      WHAT I EAT TO PROTECT MY
      HEALTH   	
    c. I ASK MY PHYSICIAN A LOT
      OF QUESTIONS ABOUT MY
      HEALTH   	
01.
01.
02
02
    d. I WAIT UNTIL I HAVE A LOT OF
      INFORMATION BEFORE I DECIDE
      TO BUY SOMETHING LIKE A NEW
      APPLIANCE 	 01	02
    a I QUESTION INFORMATION FROM
      EXPERTS OR OTHER AUTHORITIES
01.
02
                      03
03
03
                      03
03
                        04.
04.
04.
                        04.
04.
                     94
94
94
                     94
94
20.  Please tell me how active you are in each of the following types of organizations or activities.
    (READ LIST AND SCALE; CIRCLE ONE NUMBER FOR EACH STATEMENT.)
    a. CIVIC CLUB (KIWANIS, LEAGUE OF WOMEN VOTERS)  .

    b. CHURCH OR RELIGIOUS ORGANIZATION

    c. VOLUNTEER ACTIVITIES (RED CROSS, UNITED WAY)
OTERS) . .

D WAY) . .
Very
active
01
. 01
01 ...
Somewhat
active
	 02
02
	 02 	
Not at all
active
03
03
	 03 	
Don't
know
94
94
... 94

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Now, we have just a few more general background questions.

21.  About how many years have you lived at this address?	YEARS


22.  Is your home a: (READ LIST; CIRCLE ONE NUMBER.)
    a. SINGLE-FAMILY HOME	  01       d. TOWNHOUSE  	    04
    b. MOBILE HOME	  02       e. CONDOMINIUM  	   05
    c. DUPLEX	  03       f. DONT KNOW (DON'T READ)	  94


23.  To the best of your knowledge was your home built: (READ LIST; CIRCLE ONE NUMBER.)
    a. BEFORE 1940	  01       c. AFTER 1976	03
    b. BETWEEN 1940 AND 1976	  02       d. DONT KNOW (DONT READ)	    94


24.  Are you planning to move during the next  year? (CIRCLE ONE NUMBER.)
    a. YES	  01
    b. MAYBE  	  02
    c. NO	  03
    d. DONT KNOW (DONT READ)  	  94


25.  Does your home have a basement? (CIRCLE ONE NUMBER.)

    a. YES	  01
    b NO                                                02)
                                                          | 	*• Skip to Question 27
    c. DONT KNOW (DONTREAD)  	94'       On page 8
26.  Is any part of your basement used as living space by you or your family?
    (CIRCLE ONE NUMBER.)
    a. YES  	- 	01
    b. NO	  02
    c. DONT KNOW (DONT READ)  	94

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27.  How many people are there in your household? 	

28.  How many children under 12? 	

29.  Do you smoke cigarettes or other tobacco products? (CIRCLE ONE NUMBER.)
    a.  YES  	 01
    b.  NO	°2

30.  Does anyone else in your household smoke? (CIRCLE ONE NUMBER.)
    a.  YES	   01
    b.  NO  	 °2

31.  What was the highest grade of school that you completed? (CIRCLE ONE NUMBER.)
    a.  NO SCHOOL	01       e. SOME COLLEGE (13-15)	05
    b.  GRADE SCHOOL (1-8)	 02       f.  COLLEGE GRADUATE (16)	06
    c.  SOME HIGH SCHOOL (9-11)	03       g. POSTGRADUATE (17+)	 07
    d.  HIGH SCHOOL GRADUATE (12)  ... 04


32. What is your age?	YEARS


33. Is your racial or ethnic background (CIRCLE ONE NUMBER.)
    a.  WHITE OR CAUCASIAN	 01       d. ASIAN OR PACIRC ISLANDER .... 04
    b.  BLACK OR NEGRO	 02       a NATIVE AMERICAN INDIAN	05
    c.  HISPANIC	 03


34. (ASK ONLY IF UNCLEAR.) What is your sex? (CIRCLE ONE NUMBER.)
    a.  MALE	 01
    b.  FEMALE	02
35.  I'm going to read a list of income categories for FAMILY income from all sources BEFORE taxes
     during 1986. Please tell me to stop when I get to yours. (CIRCLE ONE NUMBER.)
     a. $5fX>0 OR UNDER  	  01       e. $35,001 - $50,000	  05
     b. $5,001 - $15,000	02       f. $50,001 - $65,000	   06
     c. $15,001 - $25,000  	  03       g. $65,001 - $80,000	  07
     d. $25,001 - $35,000	  04       h. $80,001 AND OVER	08
36.  If you had to sell your home today, what do you think your home and property would sell for?
     $	(PROBE FOR APPROXIMATE)
                       Thank you very much for your cooperation.
                     Your answers will be most helpful in this study.

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                 APPENDIX 3;   RADON HOTLINE SURVEY FORM
Hotline call:  	 yes  	no                 Date:
Name of Caller:



Street Address:



City, Zip Code:
Where did you hear about radon?  (do not read list)





	Newspaper                              	Television



	Utility insert                         	Phone directory



	Poster                                 	Public meeting



	Radio                                  	Radon flyer



	Family/friend/neighbor                 	Magazine



	Other (specify)	

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                    APPENDIX 4:




SUMMARY OF RISK COMMUNICATION LITERATURE AND THEORY

-------
                        LITERATURE REVIEW:

COMMUNICATING ABOUT RADON RISKS—MESSAGE, SOURCE, AUDIENCE, MEDIA


     To   learn  more   about  designing  effective   radon  risk
communication materials, the Project Team reviewed previous
efforts to communicate  about radon and other health risks.  The
team examined results of radon communication studies done  in New
York, New Jersey, and Maine, and other relevant radon and  risk
communication literature, and held discussions with individuals
involved in radon or risk communication programs.   The key
findings relevant to radon  risk communication are classified here
by:  a) message content, b)  source of message, c) target audience
and d) method of communication.


Message Content

     Many people  seriously  underestimate  the health consequences
of radon and the likelihood of their own exposure.  Comparing
radon to other more commonly encountered risks, such as cigarette
smoking, may put the risk in perspective.  However, caution
should be used in comparing voluntary and involuntary risks.

     Individuals need  to be made  aware  that radon is  a serious
risk, and also that they can do something about it.  A message
must make it clear that it  is simple and relatively inexpensive
to test for radon, and  that high levels of radon can be reduced
at a cost comparable to other home repairs.   Finally,  people
should be told where they can get more information.

     To overcome an individual's  perception of immunity  ("it won't
happen to me"), radon risks need to be put in personal terms.
One way to personalize  a radon risk is to develop a message that
identifies specific geographic areas in which the audience lives.
If the message about radon  risk is localized as much as possible
to the State, county, or even community level, people are more
likely to take the risk seriously.
Source of Message

     A risk communication  message  is more likely to be heeded if
it comes from a source that is trusted and perceived to be free
of vested interests in the outcome.   In a community context,
credibility can be heightened if the  source is endorsed by a
local leader.  Similarly,  endorsement by a credible resident or
peer, such as a homeowner who has tested for radon, can be
     1For a more comprehensive discussion of the risk communication
literature  review and  references,  refer to  the  OPPE/Region III
Radon Risk Communication Project Interim Report. November, 1987.

-------
peer, such as a homeowner who has tested for radon, can be
effective in communicating a risk message.

     The person who  presents  a message should be  someone who is
viewed as knowledgeable about the subject of radon.  In the
context of a community presentation on radon, the presenter
should be capable of fielding audience questions.  The person's
ability to communicate well, however, is as important his
expertise.
Target Audience

     A message is most effective when  it  is targeted to a specific
audience or sub-group of the population than when it attempts to
reach everyone at the same time.  Data from other radon studies
suggest that the typical tester is likely to be a well educated
non-smoker about 40 years of age with children under ten.  There
is some indication that women are more likely to buy test kits
than men.
Methods of Communication

     Two  of  the more  common  approaches for  communicating  about
health risks are through the mass media and through a community
outreach program.  Each of these approaches has strengths and
weaknesses.

     In  general,  people tend  to get  most of  their  information
through the mass media, whether they read newspapers, watch
television,  or listen to the radio.   Media reach large numbers
and  diverse  types  of  people.   A media approach  is  usually
successful in  raising  the  general level of awareness of a  given
issue, but is  less  successful  at disseminating a complex message
and  educating  the  public.   While  public  service  announcements
(PSAs) can have  some impact in communicating  about  health risks,
their results  tend  to  be  limited,  especially if the PSA is not
given  sufficient air  time or  is  played  at odd  hours.   Paid
advertisements are more effective because one  can choose the times
when they will be aired, but their cost is usually prohibitive.

     A community approach,  on the other hand,  allows for specific
targeting of a message to the audience, making the message more
relevant to  those hearing it.   Complex messages can be conveyed
more easily, and personal contact or the use of respected local
and community leaders adds legitimacy to the effort.

     The community approach, however, does not  reach  as many people
in the short term as a  media approach.   It  takes more time for the
message to be disseminated, because  it requires more face to face
contact.   The  community  approach  can  also  be  very  resource
intensive.

-------
     In   reviewing   the  literature   on  evaluations  of   risk
communication projects, it appeared that neither a mass media nor
a community approach, on its own, could guarantee success  without
unrealistically large expenditures of financial and human
resources.  Generally, a combined media and community approach is
thought to be most effective, although few successful case
studies exist.

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          APPENDIX 5:



SUMMARY OF FOCUS GROUP FINDINGS

-------
                           FOCUS GROUPS
     Although  radon  is only a  recently  identified environmental
risk, there has been intensive public communications about radon
in some parts of the country.  In these areas where radon
awareness has been heightened, some individuals have chosen to
test their homes, while others have not.   The project team
believed that some valuable information could be gained by
convening focus groups of individuals who had tested and not
tested in communities where radon awareness is high.

     Focus groups  are  qualitative research tools  that  provide a
forum for group discussions.  While the qualitative evidence from
focus groups  is suggestive  only and  cannot  be  extrapolated to
larger groups, it can yield valuable insights into citizens'
perceptions and motivations.  For the purposes of this study,
four focus groups were convened—two in Westminster, Maryland and
two in York, Pennsylvania.  In Westminster, one group consisted
of testers and the other group of non-testers.  In York, testers
and non-testers were mixed and the groups were divided on the
basis of education, with one group of college-educated and
another group of high school-educated participants.  The focus
group sessions sought to probe why some individuals had tested on
the basis of available information and why others had not.

     Copies of the focus  group  reports are available through the
Program Evaluation Division.  Although findings from these groups
cannot be extrapolated to the entire population, some interesting
findings relevant to the project design emerged.

Personalizing the Risk

     The focus groups showed the importance of "personalizing" the
risks of radon.  In both Westminster and York, individuals who
tested perceived radon as a threat to themselves and their
homes.  With one exception, all testers had spoken with neighbors
or family about radon or knew someone else who had tested before
they made the decision to test.

     Non-testers,  on the other  hand,  distanced  themselves  from
radon risks.  They dwelled on the unknowns about radon and found
a variety of reasons to justify inaction, even when they were
concerned about potential health risks.  While non-testers in
Westminster conceded that radon was a serious problem in their
community and neighborhood, most believed radon was a less
serious problem in their own homes.  Non-testers in York believed
radon was a problem only in neighboring Lancaster, where there
had been more publicity on radon than in their community.  Non
testers in both York and Westminster did not know anyone who had
tested and had not discussed radon with others.

-------
Knowledge of Radon

     Knowledge and. awareness of radon were similar for testers and
non-testers with a college education.   The key difference
appeared to be whether the risk had been personalized.  For the
group of high school-educated non-testers in York, however,
knowledge and awareness of radon was very limited.  Many of these
participants harbored a variety of misconceptions about radon
which may have inhibited a decision to test.

Health Risks

     Concerns about health risks associated with radon can motivate
individuals to test their homes.  These concerns
sometimes center around the potential risk to children.  College
educated non-testers questioned the validity of existing risk
data and how standards have been established, and believed that
existing information is inadequate to justify concern.  A number
of the high school-educated non-testers and one tester in York,
however, mistakenly associated radon with acute respiratory
problems rather than an increased risk of lung cancer.

     The perception that radon is just another one of a multitude
of potential environmental hazards also inhibits testing.  Some
non-testers commented that there was no reason to assign a higher
priority to radon than to other indoor or outdoor air pollutants.
A non-tester in York also believed he faced a much higher risk
from nearby Three Mile Island and that radon was not very serious
in comparison.

Property Value Concerns

     Concerns  about property values were  both a motivating and
inhibiting factor in radon testing.  Testers spoke of wanting to
test if they foresaw a move in the future or to give themselves a
chance, if necessary, to "get out from under it before this thing
got blown out of proportion."  For testers, the potential
implications of radon levels on property values motivated them to
learn about their levels early.  Non-testers, on the other hand,
felt that if they did not test their home they would not be
obliged to disclose the results of their test when selling.  For
them, the concern about property values was a disincentive when
considering testing.

Perception about Testing and Mitigation

     People who have tested view the process  as  simple, convenient
and inexpensive.  Non-testers on the other hand, were not as
clear on the cost of tests, where to obtain them, and how to use
them.  When informed of the actual cost of the test, all said it
was so low it would not be a consideration in their decision.
Convenience also appears to be a factor influencing testing.
Some non-testers stated they would purchase a test if it were
easily available, such as in a grocery or hardware store.

-------
     Perceptions about mitigation appear to  have  some bearing on
the testing decision, particularly for non-testers.   Many non-
testers perceive that mitigation is impossible, expensive,
complicated, and likely to make them vulnerable to unscrupulous
contractors.  These perceptions lead non-testers to prefer not to
know if they have a problem.

Length of Residence in Community

     According to the focus  groups, the  length of residence  in a
community may have an impact on the decision to test.  New
residents in a community were more likely to test than long-term
residents.  Long-term residents believed that because they had
not yet been adversely affected by radon, they had no reason to
worry-  New residents, however, were more likely to pay attention
to information about their new area, including information on
environmental risks.

Where Radon Information is Obtained

     Newspapers  and television were  the main sources  of  radon
awareness and information.  All but one tester in the focus
groups had discussed radon with friends or family.  Articles
publicizing a toll-free telephone number enabled some testers to
obtain additional information from their State government.  Non
testers obtained their information from the similar newspaper
articles and television programs,  but did not discuss it with
other individuals.  Understanding of the substantive information
presented in newspaper articles was more limited among the
high school-educated non-testers as compared to the college-
educated non-testers.  This former group was also less likely to
read about radon in the newspaper.

Credibility of Source

     Among testers,  EPA and the  state  environmental agency were
rated very highly in terms of perceived credibility of
information.  Those who had contacts with either EPA or  the state
agency appeared to be satisfied with the information and services
they had obtained.  Non-testers did not rate EPA and the State as
highly as testers did, but still perceived them as the most
credible sources of information.

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               APPENDIX 6:




RADIO PUBLIC SERVICE ANNOUNCEMENT SCRIPTS

-------
Responsible homeowner (:30)
(no music, man's voice)

You're a pretty responsible homeowner, right?  You try to protect

your investment and your family.   Or  do you?  Have you tested your

house for radon? Radon  is a radioactive gas that seeps into houses

from the ground. High levels can cause lung cancer.  But there are

things you  can do.   A simple test  can tell  you  if you  have  a

problem.  If you do, it can be fixed.  To find out more, call the

State of Maryland radon hotline.   1-800-872-3666.   That's

1-800-872-3666.



Responsible homeowner (:20)
(no music, man's voice)

You're a pretty responsible homeowner, right?  You try to protect

your investment and your family.   Or  do you?  Have you tested your

house for radon? Radon  is a radioactive gas that seeps into houses

from the ground.  High  levels can cause lung cancer.  To find out

more, call the  State of Maryland radon hotline.  1-800-872-3666.



Responsible homeowner (;10)
(no music, man's voice)

Have you tested your house for radon?  Radon is a radioactive gas

that seeps into houses from the ground.  High  levels  can  cause lung

cancer.  Call the Maryland radon hotline.  1-800-872-3666.

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If someone told, you (;30)
(music, woman's voice)

What would you do if someone told you there was a chance your

home could contain high levels of a radioactive gas called radon?

First you'd want some answers.  You'd want to know what radon is,

where it comes from, how you could test your home for radon, and

what you could do about it if you did find it.   For answers to

these and other radon questions, call the Maryland radon hotline

at 1-800-872-3666.  That's 1-800-872-3666.



If someone told you (:20)
(no music, woman's voice)

What would you do if someone told you there was a chance your

home could contain high levels of a radioactive gas called radon?

You'd want to know what radon is, where it comes from, how you

could test your home for radon, and what you could do about it if

you did find it.  Call the Maryland radon hotline at

1-800-872-3666.



If someone told you (;10)
(no music, woman's voice)

Some homes in Western Maryland contain high levels of a

radioactive gas called radon.  For more information, call the

radon hotline today.  1-800-872-3666.

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Heard of it (;30)



    music, man's voice)
Radon, ever heard of it?  A lot of people haven't, even though



it's been found in many homes in Western Maryland.  Radon is a



dangerous radioactive gas that can cause lung cancer.  It seeps



into homes from the ground.  The Maryland Department of



Environment urges you to test your home for radon this winter.



To find out how, call the Maryland radon hotline.  The toll-free



number is 1-800-872-3666.  That's 1-800-872-3666.

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Neighbors/easy (;30)








Announcer:     A public service message from the State of



               Maryland.



(outdoor noises, mailbox)








Steve:    Hey Bill, I just got my radon test results in the mail.



          Looks like we're ok.  Have you tested your home yet?








Bill:     Nah, with all those new health hazards they keep coming



          up with, it's not worth the effort.








Steve:    Sorry friend, that's where you're wrong.  This is one



          problem that you can do something about.  You order a



          test kit through the mail, put it in your house' for a



          couple of days,  then send it back to the company for



          analysis.  In a  few weeks, they send you your results.








Bill:     Sounds pretty easy.








Steve:    it is.  And now  we know our home is safe.
Announcer:     For more information, call the Maryland radon



               hotline at 1-800-872-3666.  That's 1-800-872-3666.

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Neighbors/cancer (;30)







Announcer:     A public service message from the state of



               Maryland.







(outdoor noises, mailbox)








Steve:    Hey Bill, I just got my radon test results in the mail.



          Looks like we're ok.  Have you tested your home yet?







Bill:     Nah, with all those new health hazards they keep coming



          up with,  it's not worth the effort.







Steve:    Sorry friend, that's where you're wrong.  Did you know



          that radon causes lung cancer?  And it's been found in



          homes in Western Maryland?  Listen, even if you're not



          worried about yourself, at least do a test for your



          kids' sake.







Bill:     You're really serious about this, aren't you?








Steve:    You bet I am.  And now we know our home is safe.
Announcer:     To find out how you can test your home, call the



               Maryland radon hotline at 1-800-872-3666.  That's



               1-800-872-3666.

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                   APPENDIX 7:

EPA-MDE PROJECT RELATED NEWSPAPER ARTICLES IN THE
               FREDERICK NEWS-POST

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 Frederick News-Post
                                                                                                                          Radon
                                                                     awareness
       By KAREN GARDNER /
          News-Post Staff
                                  1.8
 ^Radori'testing is the best'way to.find
 oiitjl-if-^a1; iome' is . filled  with' the
 dangerpusV  but .'invisible, gas, and  a
 state*/'official'-wants  homeowners  in
 Fre'derickr'-County  to monitor  l,heir
 houses.,
::Radori: t^sts take only a few days, and
 cost' from- -$10  to  $15,  said  Roland
 Fletcher, program administrator for the
 Center for  Radiological  Health.  The
 center (is  a division  of  the  state.
 Department of the Environment and  is
.sponsoring  a radon  awareness  cam-
 paign.
  The  colorless, odorless  gas  is  a
 radioactive  byproduct of  uranium that
 seeps out'.of  the ground, and can: be
 found  anywhere. yRadon  creeps  into
 houses through  cracks in foundations,
 and is trapped inside by walls, and insu-
 lation.
 • Radon  has been pinpointed as the
 second leading  cause of lung cancer,
 behind  smoking,  Mr. Fletcher  said.
   Officials  want  homes  monitored
 "When you look atthe incidents ,of non-
 smokers and-lung ..cancer, you have to
• consider radon," he said. Radon, was
 first discovered as a cause when a. high
 rate of lung cancer was found among
 uranium' workers.         '•''•/
  Up to 20,000 lung canc,er deaths a year
 may have been caused by radon, Mr.
 Fletcher said.
  "We want to  encourage people to do a
 radon testt" he said;;The first step.is an
 activated charcoal device that costs less
 than $15,. he said. If i  more  than-four
 pic'oCuries per  liter are recorded on the
 testing  device, an alpha'tract detector
. test is recommended.
  "That shouldn't cost  much more than
 $35 or $40," he  said. "Then you'll have a
 better idea of what your level is."
  Testing  equipment and results can be
 obtained from radon testers. The center
 will provide a  list of such testers when
 requested.
  People whose homes have results of
 from four to 20 picoCuries per liter need
 to take.a few corrective steps, he said.
. For those who have results of more than
 20  picoCuries, more serious  action is
 recommended.  .                ,
  That's  where the awareness  cam-
 paign comes in. A toll-free radon hotline
 was established by the center, and by
 calling 1-800-872-3666 from 8:30 a.m. to
 4:30 p.m.  weekdays,  advice  can  be
 sought, Mr. Fletcher said.
  Levels  of radon can soar into  the
 thousands,  he. said, but  the highest
 recorded in Maryland was  about  600
 picoCuries. Radon can be found any-
 where, he. added.
  Corrective measures vary, he said.
 "It could be as simple as increasing'
 ventilation," he said. "That  could be
 hard,  however,  during  months  like
 these."
  Other  recommendations include
 caulking  cracks in the foundation flopr
 and patching cracks in underground
 walls.
  "There are simple things homeowners
 can do,"  he said. "If these things don't
 work, then they'll probably have to seek
 a contractor."
  One homeowner  did the work himself,
 Mr. Fletcher said, spending about $100.
 A hired  job may  cost from  $1,200 to
 $1,500, Mr. Fletcher said. In one case,
 he said a  homeowner spent about $3,00p,
 but correcting  radon  leaks  usually
 shouldn't cost that much, he said.
  Contractors that correct radon leaks
 are the  same  ones  that  build club
basements, and porches,  he  said.  The
state  doesn't  recommend  individual
contractors, but will check the reputa-
tions of contractors for homeowners, he
said.
  The center is using 19 homes in Fred-
erick and : nearby  counties  in  an
experiment to find the best and easiest
methods to lower radon levels in homes.
State  and federal Environmental Pro-
tection Agency funds are paying the
contractors to perform the experiment.
  One of those methods being tested is a
perforated  exhaust pipe,  beginning
underground and extending outside the
house. An exhaust fan could be  acti-
vated .to purge the  home  of radon
through the pipe.
  Radon exists throughout the atmos-
phere, but is  dangerous  to  the lungs
when particles are trapped in a closed
atmosphere, Mr. Fletcher said.
  His office is distributing posters  and
literature  on~ radon. Public service
announcements are being broadcast on
local radio stations,  and Feb.  20, the
League of Women Voters  is sponsoring
an information session on radon. That
will be at the first-floor meeting room in
Winchester Hall, from  9:30 to 11:30
.a.m.       ;
  An 'EPA booklet  on radon is  also
available free from the center.

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 OAN 3 0 1988
                   Frederick News-Post
                                Radon
Frederick   mayor
promotes   initiative
on   radon  testing
     By KAREN GARDNER
       News-Post Staff

  What better way to publicize radon
testing in Frederick than to test the
mayor's house?
  That's exactly what tb.e_staje
Department of the  Environment
decided. Jiny canisters that could slip
into a pocket were distributed to Mayor
Ronald N. Young and the five  city
aldermen at City Hall yesterday.
  i/Lr. Young ttieti led. an entourage of
state officials to, his house on 14th Street
to uncap the canister.
.  In two days, Mr. Young will recap the
canister, placed in his basement, and
the activated charcoal will be sent to a
lab to be tested. If radon, a colorless,
odorless gas linked to lung cancer,, is
present, it will show up on the charcoal
when tested. Results will be ready, in
about two weeks.
 Uader_the direction of Roland
Fletcher, chief of the state's center for
radiological health, Mr. Young put the
"uncapped canister on  a  basement
bookcase, where it won'tbe disturbed by
a resident cat and dog.
 "We're testing your lower level," Mr.
Fletcher said. "That's the worst case
scenario."
 Mr. Young said the test would help
hinTouTlis well as give a-plug tor the
educational emits ot Mr.  Fletcher's
efface. "I'm trying to support .the pro-
gram, but it will be good to find out what
we have here," he said.
 The kits cost from $12 to $25. Charcoal
is treated, or activated, to become more
absorbent. The same kind of charcoal is
used in military masks to keep soldiers
from breathing chemical-gases. Radon,
a gas formed from radioactive decay of

      (Continued on Page A-4)

-------
                                                                         Staff photo by Annette Leln
 A tiny canister will collect radon in the house of Frederick Mayor Ronald N. Young to determine the level of
 the gas in the "home. A high level of radon, produced by decaying uranium, has been shown to  cause lung
 cancer in non-smokers.

 Frederick  mayor  probes  house

 for   radon;    Hopes   others  will   test
    (Continued from Page A-l)

 uranium, is attracted to the charcoal in
 the test kits.
  "You  can collect a representative
 sample in. two days," Mr. Fletcher said.
 Radon has a four-day half life. After
 four days, half the radon collected
 begins to decay. Tests are valid as long
 as the kits aren't opened for longer than
 seven days.
  Radon has been found to be present in
 homes, seeping through cracks in the
 foundation or porous cinder-block walls.
 Because radon rises from the earth, its
 highest concentrations are likely to be in
 the lowest level.
  The radioactive gas is a chief cause of
lung cancer among people who don't
smoke.
  What the kits reveal  is  how much
radon, measured in  a  unit  called a
picoCurie, is present in the home. The
kits give a fairly accurate picture, Mr.
Fletcher said.

  If more than 20 picoCuries per liter of
air is measured,  a second test is
recommended, one that takes anywhere
from three months to a year. An alpha
tract  detector  is used  for  the  more
serious test.
  If the level is still found to be above 20,
corrective measures  that  usually
involve  sealing cracks are recom-
mended. Readings  of under 100 can
usually be reduced for less than $100 if
one is a bit handy, Mr. Fletcher said.
  The highest reading found in Mary-
land was about 600, he said. Such levels
usually need the attention of a contrac-
tor to reduce.
  Radon is most likely to be present in a
home in the winter, when a house is
closed to prevent heat  from escaping.
The insulation that keeps down heating
costs also prevents  radon  from
escaping, Mr. Fletcher said.

  Mr. Fletcher is urging people to test
their homes under a special program set
up jointly by his"office and the federal
Environmental  Protection Agency.
Pennsylvania  and Virginia ~&re
parttc1pating~on a limited basis.  If the
program is successful,  it will pypand
into other states.

  Radon  can  be found  anywhere
uranium   concentrations are located.
Because  those concentrations can't be
pinpointed tests  are encouraged  to
determine if a home  is free  of the
carcinogenic gas.

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               03193
                                                                  Radon
       Frederick  News-Post
Speaker  tells  FOP
how  to   handle   radon
      By KAREN GARDNER
         News-Post Staff

  The odds against radon doing human
damage seem huge. But they're not, a
state environmental official  told the
Fraternal Order of Police last night.
  Radon is  a  byproduct of  uranium
decay. Uranium,   found  in  trace
amounts on all parts  of the earth's
surface, decays into radium, and then-
radon. Radon then breaks into particles
which won't do any damage unless they
accumulate.
  That's what radon particles do when
they're in closed up areas like  homes
and  other  buildings,  said Roland
Fletcher,  chief of the  state office of
radiological health for the Department
ofthe_ Environment.
  "About 25 members of the FOP came to
hear Mr. Fletcher discuss the dangers
of radon accumulation in homes. Most
homes  probably have  relatively  low
levels of radon. But to make sure, the
state is urging homeowners to invest in
a test kit,"one that costs anywhere from
?5 to ?15, and check  the radon level.
 J "Radon is diffused  in  the  air in
i quantities that normally  won't' hurt
j 'ou," Mr. Fletcher said. "But when you
atllow the particles to accumulate, that's
v,yhen the damage can begin."
 > Radon causes more lung cancer than
anything but smoking, and is the leading
c^mse among non-smokers.
  .VThe byproduct of decaying uranium
ga^s,  radon leaks into homes and build-
ings  through cracks in  the foundation.
In Winter, when houses are often closed
to outside air,  radon levels are usually
the .highest.
  The . smallest crack  is • enough  for
radon to get into a  house. In order for
radora to be present beneath a  house,
trace deposits of uranium must exist,
and the soil must be porous enough to
allow -the  gas to seep to the earth's
surface.
  Insulation isn't the  cause of radon
infiltration. "If your home is well insu-
lated, and it can  get in, perhaps it can't
get out," Mr. Fletcher said.
  The damage radon does results from
years of accumulation of deposits in the
lungs. "If there's one thing we want to
caution people about, it's that you have
time," he said.
  But homes should be tested in case the
radon level needs to be reduced. If the
result is a level that's low but still above
average, the solution may be as simple
as keeping a crawl space ventilated. Or,
it could involve opening cellar windows
year round if the area isn't regularly
used.
  For higher  levels, perforated  pipes
with fans  may be installed under the
house to direct the g-as outside, where
it's harmless. For  a'nyone building  a
house, Mr. Fletcher, suggested install-
ing a couple of extra pipes beneath the
house and aiming .them outside.
  After the house is built, a test will
show the  level of radon.- If that level
should be reduced, fans can be installed
in the pipes to direct the radon outside.
If the level of  radon" in, the home  is
-harmless, the pipes can be capped.
  In an existing house, "a lot depends on
how good -your' builder"-was,"  Mr.
Fletcher said.
  Two  weeks  ago, Safeway  grocery
stores began  marketing radon testing
devices for $4.75. In the chain's stores in
the Washington  area and in Maryland,
37,500 have  already been purchased.
"Those  things are  selling like
hotcakes," Mr. Fletcher said.

-------
                                      FEB 2 2 1988
                            Frederick News-Post
                                                                          Radon
Frederick  County   radon  levels   near  average
       By PHILIP OLINICK
       '  News-Post Staff

  Radon levels  recorded  so  far  in
Frederick County are about average
compared with tests in other parts of the
state, although there  have been some
very high levels recorded  around the
county, according  to  Maryland
Department of the Environment data.
  Last  month 11 out of  112  homes
voluntarily tested in Frederick County
had ratings more than 25 times greater
than federally recommended levels for
radon gas.
  The highest level recorded is still in
Carroll  County, where one house had
radon levels about 157 times  greater
than the federal maximum.
  The Department of the Environment
has "good data" only in four counties:
Frederick, Montgomery, Howard and
Carroll, said Ronald Fletcher, program
administrator  of the department's
radiological health division.
  A governor's task force will report to
the state legislature about radon on July
1. The Department of the Environment
hopes to have collected sufficient data
on the rest of the state before the task
force presents its report.
  About 30  people attended  a  radon
seminar Saturday in Winchester Hall
In addition to Mr. Fletcher, an.expert
panel included an Environmental Pro-
tection Agency representative, a Carroll
County builder, an American Medical
Association  representative  and a
Maryland Association of Realtors rep-
resentative who is on the governor's
radon task force.  The  seminar was
organized by the local League of Women
Voters chapter.
  Martin Hill, the  Carroll County
builder, told the  audience  he  thinks
builders should "take  the  basic
precautions in construction that are not
costly."
  In the homes he builds he makes it
easier for homeowners to install retrofit
devices which can help purge radon,
should they  happen  to  record  high
levels. The different construction tech-
niques cost about $300 per home, he
said.
 ; Without the investment, Mr. Hill fears
that legally he could be found negligent.
He said that none of the hundreds of
homes he has built, which have been
tested for radon, have had high levels.
  Many contracto£S_,are^
-------
                     WR09 1988
                                             Frederick News-Post
                                                                Radon
Frederick  city  officials
check   homes  for  radon
     By KAREN GARDNER
        News-Post Staff

  Radon exists within  homes  in
Frederick, if a testing of the homes of
six city officals is any indication.
  Four of six homes tested for radon,
owned by the  city's  mayor and five
aldermen, had levels of radon high
enough that corrective measures may
need to be taken.
  "None of them had such high levels
that there's an immediate threat to
their health,"  said Nancy Zahedi,  an
official with the Environmental Pro-
tection Agency. The EPA is joining
with  the state to publicize radon
testing in Maryland.
  The tests were conducted by the
state Center for Radiological Health,
as a publicity effort  to  get  other
homeowners to screen their homes for-
radon.
  Levels from 4 picoCuries of radon
per liter of air to 20 picoCuries are
considered  high enough that minor
corrections should be made to the
house's  structure.  That  usually
involves sealing cracks in the  foun-
dation or opening a window hi a crawl
space.
  Levels from 2 to 15 picoCuries were
found among the homes owned by the
mayor  and  aldermen.  "That
reinforces that the City of Frederick
is an area where you should test your
home," Ms. Zahedi said.
  "I  have  radon,"  said  Alderman
   .ene Phillips, who lives at 305 Col-
   " Place. "It's much like termites I
          Mrs.  Phillips'  home
       j a level of 6.5 picoCuries,
       above the  safe level of 4'
                                picoCuries.
                                 -"Their  suggestion was  that  we
                                should test for a longer period," she
                                said. "We're going to try to get a year
                                test, and  see how  the house goes
                                through the year. Then we'll see what
                                steps we need to take from there."
                                 Aldermen  James M.  Murphy's
                                home,  at 1089 Rocky Springs Road,
                                registered a level of 14.5 picoCuries.
                                That's  high enough  that a long-term
                                test is being, recommended. Levels
                                from 20 to 100 picoCuries are con-
                                sidered more  serious, with  more
                                costly  corrective measures possible.
                                Levels  over 100 picoCuries are con-
                                sidered very  serious. The highest
                                level found in a Maryland residence,
                                according  to the EPA, is around 600
                                picoCuries.
                                 "Mine was a little  high," Aldermen
                                William 0. Lee, of 98  McMurray
                                Place,  said. His home registered 15
                                picoCuries.  One other  alderman
                                registered a level above 4 picoCuries.
                                 Mayor Ronald N.  Young,  who
                                tested  the house he owns on 14th
                                Street,  found  only  a  level  of  2
                                picoCuries, so no further testing will
                                be needed on that house;
                                 "It's something everyone is getting
                                concerned about," Mrs. Phillips said.
                                "I  want to go ahead with the next
                                step; Ihave two children. I'm happy
                                that we did it. If I hadn't done it for
                                this program, I don't know if I would
                                have done it."
                                 Radon test kits retail for up to $25.
                                Made of activated charcoal, the kits
                                absorb radon for two or three days
                                before  the sample is  sent to a lab to4>e
                                tested. Test results take about two
                                weeks.

-------
                  APPENDIX 8:

NEWSPAPER PUBLIC SERVICE ADVERTYISEMENTS IN THE
            HAGERSTOWN HERALD-MAIL

-------
The Herald-Mail, March 1, 1988
  S YOUR HOME SAFE
FROM RADON?
 D Your home may be hazardous to your health.
 D Radon is a radioactive gas that can cause
   lung cancer.
 H A radon test is easy and can cost less than $25.

 Test your home now and be sure.

  Call the State of Maryland^ Radon Hotlina

          1-800-872-3666

-------
The Herald-Mail, March 9, 1988
    20646
    20707
    20711
    20714
    20744
    20754
    20759
    20760
    20769
    20770
20814  20855
20815
20816
20817
20832
20833
20837
20838
20841
20842
20850
20856
20857
20861
20868
2087]
20872
208^4
20877
20S7K
20879
    UNSAFE RAI
    20772   20851   20895
20904
20906
20910
20979
21029
21030
21035
21043
21044
21045
21046
            tit
             11104  21727
21117
21131
21133
21136
21146
21152
21153
21157
21204
21285
21740
21754
21755
21764
21769
21770
21771
21773
21776
21783
         N LEVELS
       21048   21401  21784
    HAVE ALREADY BEEN   21791
    20777   20852   20901   21084   21701   21793
    FOUND IN HOMES WITH 21794
    20781   20853   20902   21093   21716   21797
    THESE MARYLAND 21/23   21854
    20784   20854   20903   21102
    ZIP CODES
    Test your home now and be sura
     Call the State of Maryland^ Radon Hotline.
               1-800-872-3666

-------
tainment
           The Morning Herald
           Thursday, March 17,1988
         B7
  YOU CARE ABOUT
 YOUR HEALTH
   You Watch
  What You Eat
You Exercise
You Stopped
 Smoking
 So why haven't you tested
 your home for radon?
    It's easy    D It's inexpensive
  Call the State of Maryland^ Radon Hotline.
           1-800-872-3666

-------
    MAR 2 5 1988
Radon
                          Hagerstown Me
Is YOUR CHILD SAFE
FROM RADON?
You wouldn't let your child smoke a pack a day.
Yet radon gas in your home can be just as dangerous.
TEST YOUR HOME NOW.
  Call the State of Maryland's Radon Hotline
          1-800-872-3666

-------
                           APPENDIX 9;

         SITES OF RADON POSTER AND PAMPHLET DISTRIBUTION

Downtown Offices and Stores:

Library
Post Office
Frederick county office building, including health clinic
Charities building
Chamber of Commerce
American Heart Association
Carmack J's Supermarket on Market Street
YMCA
Adult Recreation Building on North Bentz Street
Convenience Store on North Bentz Street


Offices and Stores along Patrick Street/Highway 40:

Group of realty offices along Patrick Street
Mart in's Supermarket
Hillcrest Deli
Giant Supermarket in Westridge Square
84 Lumber in Frederick Shoppers Square
Dry Cleaners in Frederick Shoppers Square
Hechingers
Carmack J's Supermarket


Offices and Stores along Highway 15 in Frederick Shopping Center

People's drugstore
Hardware store
Supermarket
Hair Salon
Doctor's office. Amber Ridge Medical Center (they never indicated
  whether they actually used the materials)

-------
     APPENDIX in-   COMMUNITY GROUP PRESENTATIONS IN FREDERICK






Date         Organization




1/6/88       Clover Hill Women's Association



1/18/88      SERTOMA Club



1/21/88      Lions Club



2/2/88       Fraternal Order of Police



2/10/88      Active Telephone Pioneers



2/20/88      League of Women Voters Panel Discussion



2/24/88      Retired Members of Telephone Pioneers



3/15/88      American Lung Association



3/17/88      Worthington Manors Community Association



4/25/88      National Cancer Institute

-------
      APPENDIX 11:




RADON SLIDE SHOW SCRIPT

-------
                RADON SLIDE SHOW SCRIPT
Graphic - Title
Slide of  Sherlock Holmes
looking through magnifying
glass for radon
Graphic - cigarette pack;
radon seeping into house
Graphic   -  Uranium   to
Radium to Radon to home
Title: Radon:   What  it is and
what you can do about it.

Radon is a radioactive gas that
is as natural as air and water,
but cannot be  detected by our
senses.   You can't  see,  smell
or taste radon.

This colorless, odorless gas is
now  considered  one   of  the
nation's     most    important
environmental threats—one that
places people at risk in their
own homes.

Scientists    believe     that
exposure to elevated levels of
radon in the home may cause up
to 20,000 of the nation's lung
cancer deaths each year, making
radon  the  leading  cause  of
cancer  in non-smokers.   This
has  led  the  American  Medical
Association  to label   radon  a
significant health risk.

Where does radon come  from and
how has  it emerged as one  of
the  most  significant   public
health issues  of today?   This
question should be of  interest
to  anyone  concerned with  the
safety of their home.

Radon  gas  is   formed  by  the
natural decay of radium,  which
results  from   the  decay  of
uranium.     Both   radium  and
uranium    are   very    common
elements present in soils and
rock.

Radon itself is not dangerous.
But  as  it  decays,  the  gas
produces radiation in the form
of microscopic  particles that
can cling to  ordinary household
dust    or    other    airborne
particles.

-------
5.    Picture of outdoors (open
     air)
     Picture  of   inside  of  a
     house
     Diagram of  lungs  and  how
     radon affects it
     Word slide - What Factors
     Influence Your Risks from
     Radon
Outdoors,  radon   is  diluted
quickly   and   poses   little
threat.

Indoors, radon  decay products
can  build  up   over  time  and
become a health hazard.

When  we  breathe,   the  radon
decay   products  can   become
trapped in  our  lungs.  As these
decay   products  break   down
further,  they  release  small
bursts  of   energy  which  can
damage lung tissue and lead to
lung cancer.

Not everyone exposed to  radon
develops lung cancer.   But as
the level  of radon  and length
of exposure increases, so does
the risk.
9.   Photograph of a miner
10.  Photograph  of  a  typical
     housewife.
Your  health  risk  from  radon
depends    on   the    average
concentration of radon in your
home, the  number of  years you
have lived there and the amount
of time you spend at home each
day  and  whether  or  not  you
smoke.

For  years,   scientists   have
known that many uranium miners
have  contracted  lung  cancer
from  being  exposed  to  high
radon levels. While conditions
in people's homes are different
from those in mines, some homes
have  radon levels  as  high or
even higher than in underground
mines.
                                   Also,   preliminary  studies  in
                                   Sweden   suggest   that   women
                                   living in homes with high radon
                                   have more than 2 times the lung
                                   cancer of women living in homes
                                   with  low  radon.     This  has
                                   resulted in a growing awareness
                                   of  radon  in  the home  as  an
                                   environmental health risk.

-------
11.  Word Slide  -  Why Concern
     Now?
12.   Photograph of Pennsylvania
     newspaper headlines  from
     1984
13.   Map of the Reading Prong
14.   Slide of Watras house from
     Newspaper  article
Why  is  radon just now gaining
so  much  attention?    Though
radon has  always been present
in the air at low levels, only
recently have we become aware
that  houses  may  have  high
indoor radon  levels caused by
natural deposits of uranium in
the soil.

This   awareness  emerged   in
December 1984, when  a Boyertown
Pennsylvania resident  set off
the   walk-through   radiation
detector at  the nuclear plant
where he worked. What made the
incident unusual was  that  he
did not pick up the radiation
during  a  day's work;     he
brought  it  with him  from his
home.

The  house  was   built  over  a
geological formation  known as
the Reading Prong, an area rich
in   uranium-bearing  minerals
which   extends    through
Pennsylvania, New  Jersey  and
New York.

Radon levels  in  this house were
recorded  as  high   as  3,000
picocuries  per liter, among the
highest levels  ever measured.
However, even these extremely
high levels  were brought  down
to acceptable levels.

-------
15.   Map of 10 States survey

16.   Diagram - 1 house in 5  in
     red
17.  Word Slide  -  How Do  You
     Know if You Have  a  Radon
     Problem?—TEST
18.   Graphic  Slide  -   Cross
     Section  of  Wall  Showing
     Radon Entry Points
But  since  1984,  high  radon
levels    have    been    found
throughout the U.S.

A  recent  survey  of  10 states
conducted    by    the    U.S.
Environmental Protection Agency
suggests that
on average 1  out  of 5 houses in
those states have radon levels
above the EPA action levels.

This    survey    showed   that
geological  maps   are   a  good,
though not absolute,  indicator
of where elevated radon levels
can be found.

More  importantly,  it  showed
that the only way to know what
radon levels  in  your  home are
is to test.

How does radon enter the home?
Because radon is a gas, it can
find many  ways  into  a house.
It's also  possible for  one home
to have elevated levels while
a neighboring home does not.

The   most   common   pathways
include openings  around water
and gas pipes, sump  pumps and
drains...

As   well    as    cracks    in
foundations  and   the   hollow
interiors of block walls.

-------
J-9.  Graphic - Air Pressure
20.  Graphic   slide
     supply
water
21.  Picture    of    homeowner
     testing for radon
22.  Picture of testing devices
23.   Photo  -  Reading  testing
     instructions
24.   Word Slide:
     Testing is Easy &
     Inexpensive
A   major   factor  that   can
contribute  to the  problem is
negative  air  pressure created
inside  a home, which  can act
like  a  vacuum that  draws in
radon.   This  occurs  when air
pressure  in  the  house  drops
below   the   pressure   in  the
ground,   causing    a   suction
effect that pulls  in radon  from
the ground.

Radon can  sometimes enter the
home through  the  water supply
if  it  comes  from  a  private
well.    So  far,   however,  few
significant  radon levels  have
been found in wells outside of
the Northeastern United States.

Only a test for radon can  tell
you if you have elevated levels
in  your  home.   The  options
range    from   do-it-yourself
testing devices to contracting
with   a   commercial   indoor
testing service.

How can  we measure  a  gas that
can't  be   seen,   smelled  or
tasted?  There are several ways
to measure radon levels in your
home.   The two most  commonly
used  tests   are   the  charcoal
detector   and   alpha   track
detector.

Both types of detectors can be
ordered by mail and come  with
easy to follow instructions.

These   testing   devices   are
placed in the home for 2-7 days
for the  charcoal  detector  and
from 3 months to a year for the
alpha track before  being  sent
to the laboratory  for analysis.
The  charcoal  detector  costs
from  $12-$25  and  the  alpha
track from $25-$50.

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25.   Word  Slide  -  Screening
     Test vs.  Follow-Up Test
26.  Photograph  -  House  with
     windows closed
27.  House with windows open
28.   Word slide - When and How
     to Test
A short term test, such as the
charcoal   detector,    is   a
screening test.   If it shows an
elevated radon reading, then a
follow-up test,  often  with an
alpha   track,   is   strongly
recommended before any action
is taken.

A third  testing  method is the
radon grab sample.   This  is a
5 minute test, but gives  only
a  snapshot  of   the  level  of
radon in your home at  a given
time.    Because  radon  levels
vary  by time  of  day  and  by
season,   a grab   sample  is not
recommended as the only radon
test in your home.

Seasonal variations can affect
radon  levels.    Radon  levels
will be  higher in  the  winter,
during the heating season, when
a house is sealed up,
than in  the spring when windows
are  open and  ventilation  is
good.

This  makes   it  important  to
measure  the  annual  average
radon level  with  a  long-term
test if a screening test shows
high radon.

To do a  screening  test,  place
a testing device  on the lowest
level of  the  home during the
sample  period,   under  closed
house    conditions.
Concentrations  are  generally
higher  in basements than  on
upper floors.   A basement test
during the winter, when windows
are  closed,  may  give  you the
              picture  and  is
             as   a  screening
            you  do  the  test
               fo1 low    the
               to   make   the
                                   worst   case
                                   recommended
                                   test.    If
                                   yourself,
                                   instructions
                                   results  more  accurate.

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29.
Slide  -  Measuring Radon:
pCi/i vs. WL
30.
Word Slide - What Level of
Radon is Safe?
31.
Word Slide:
Influencing
Risk
Other Factors
 Lung  Cancer
Radon measurements are reported
in  two  ways:     in  terms  of
picocuries per liter of air for
radon  (pCi/1)   or as  working
levels for radon decay products
(WL).   As a general  guide,  4
picocuries   per    liter   is
equivalent  to   0.02   Working
Levels.   Most  test  companies
will  report your results  in
picocuries per liter.

What  level  of radon  is  safe?
In   general,    no  level   of
radiation    is    considered
absolutely   safe.      As   a
guideline,     the    U.S.
Environmental Protection Agency
(EPA)   has    established   4
picocuries  per  liter  as  the
recommended action level.  This
guideline  takes  into  account
both health risks and current
technology.    In  most  homes,
levels can be reduced reliably
to 4 picocuries per  liter, and
often below this.
                                   Acceptable   levels  of   radon
                                   exposure   are   hard  to   set
                                   because of  other factors.   For
                                   example,    recent   scientific
                                   studies  indicate that  smokers
                                   exposed  to  elevated levels  of
                                   indoor   radon   have  a   much
                                   greater risk of developing lung
                                   cancer.  Lifestyle and heredity
                                   may also affect a person's risk
                                   of getting  lung  cancer.

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32.   Word    slide    -     EPA
     guidelines <4 pCi/1
33.   Word slide continued
34.   Word slide -  guide:  4-20
     pci/i
35.   Word slide continued
                              The higher the radon  level  in
                              a home, the more urgent  it  is
                              that you take action to control
                              it   in    order    to    avoid
                              unnecessary health  risks.

                              The  Environmental   Protection
                              Agency  provides  this  general
                              guide:

                                 o radon levels less than  4
                                   picocuries   per    liter,
                                   present some risk of lung
                                   cancer.   Reductions  below
                                   4  picocuries per liter may
                                   be difficult.

                                 o if radon levels  exceed  4
                                   picocuries per  liter on  a
                                   screening test,  follow-up
                                   testing  and  remediation
                                   should be done as follows:

                                     -  between  4   and   20
                                        picocuries per  liter
                                        do a one year follow-
                                        up test to determine
                                        annual  average  radon
                                        exposure    before
                                        taking    appropriate
                                        action.
36
Word slide continued
between  20  and  200
picocuries per liter
a follow-up  test of
no more than 3 months
is recommended before
corrective     or
remedial action.

over  200  picocuries
per liter you should
not wait more than a
few  weeks  to  take
corrective action.

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37.  Graphic - Comparative risk
38.   Photograph   of   someone
     standing next  to mailbox
     reading test results
39.   Word Slide - Approaches to
     Mitigation
40.   Photograph of cracks being
     sealed
Exposure  to  4  picocuries  per
liter is  roughly  equal to the
cancer  risk  associated  with
smoking   half   a   pack   of
cigarettes  a   day.     At  10
picocuries per liter, the risk
is about  equal  to smoking one
pack of cigarettes a day.

If you  have  tested  and  had a
follow-up test  which confirms
high annual radon levels,  you
should  take  action  to reduce
these levels.  The good news is
that  radon  problems  can  be
fixed successfully and usually
cost no  more  than  many  other
home repairs.

There    are    three    basic
approaches to   reducing  radon
levels:    prevent  its entry by
sealing   cracks,  holes,   and
other  openings;  remove  the
source by venting the gas from
under your foundation before it
enters your house;  and remove
it from your house by increased
ventilation.     Let's  look  at
some of the ways we can reduce
radon levels.

Sealing  cracks   and  openings
found in the foundation and/or
basement  floor  is one way to
prevent radon entry-

In cases of low  levels  of radon
this  approach  may  be  enough.
In the  case  of  high  levels,
this is one of the first steps
to take.

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41.   Graphic Slide -
     Ventilation
Sub Slat)     Sub slab ventilation has proven
             very  successful  in  reducing
             radon levels  in homes.   This
             method   removes  radon   from
             beneath the  foundation before
             it enters the house.  Pipes are
             inserted  into  holes  drilled
             through the slab upon which the
             house is  built.   Fans  at  the
             end  of  the  pipe  system  draw
             radon away from the house.
42.  Graphic  slide  -  Forced
     Ventilation Diagram
43.  Graphic Slide -  Chart  of
     Estimated    Remediation
     Costs
             Forced ventilation uses fans to
             blow   fresh  air   into   the
             basement and/or  lower levels of
             the house creating positive air
             pressure.

             Done properly, this assures the
             frequent  exchange  of   fresh
             outside    air    for     radon
             contaminated  air.     In  many
             parts of the country this would
             be  a  temporary  solution  to
             bring radon levels down before
             a more  permanent  solution can
             be used.  If done incorrectly,
             exhausting   air    from    the
             basement  could  increase  the
             problem.

             The  cost  of these  mitigation
             techniques  ranges  on  average
             from $200 to $2000.   The best
             system  for  you  depends  on how
             high  your   radon  levels  are,
             what the source of the problem
             is, and whether  or not you have
             the skills  and tools to install
             the system yourself.

             For  example,   if  your  radon
             level is slightly  higher than
             the action guidelines, you may
             only need  to  seal  cracks and
             openings  to the  soil  and/or
             increase  ventilation.     For
             higher  readings,  you  may need
             to  hire a  contractor  who can
             install   wall   or   sub-slab
             ventilation.

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44. f  Word Sli.de  -  What Should
     I Do?

45.  Word slide: test  now and
     be sure
46.   Photograph  of  EPA  radon
     booklets.
              Now that you know about radon,
              what can you do as a homeowner?
              You  should  start  by  testing
              your home for radon.   If  your
              radon   level    is   below   4
              picocuries  per   liter,   EPA
              suggests that you try to reduce
              levels  as  low  as   possible.
              Based  on  current   research,
              reducing   levels    below   4
              picocuries per  liter  can  be
              difficult.

              If it is over  4 picocuries per
              liter,   do   the   appropriate
              follow-up   testing    before
              deciding  how   to   fix   the
              problem.

              Your state or  local  health or
              environmental department offers
              information  and guidance.

              They  can  provide   you  with
              pamphlets on radon and lists of
              reputable testing  firms   and
              contractors.

              These materials will help you
              make  well informed  decisions
              concerning  radon  testing  or
              mitigation,  and are  available
              from the state office.
47.  Word  Slide
     Radon
Test  for
In summary:   Test  for  radon.
Any house can have high levels.
Radon is a serious health risk
and no  home  is immune  to  it.
Most households will  not have
a radon  problem,  but  you will
get valuable peace  of mind by
knowing  whether  your home  is
safe.

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48.   Word Slide - Mitigate  if     Mitigate  if necessary to reduce
     Radon Levels  Greater than     your  radon levels.   If  follow-
     4 pCi/1                       up   tests   indicate    levels
                                   greater  than 4 picocuries  per
                                   liter you  should   definitely
                                   consult  your state  agency  for
                                   advice.    If  follow-up  tests
                                   indicate    levels   below    4
                                   picocuries per liter  and  you
                                   are concerned,  call  your  state
                                   agency.

49.   Photograph -  Family scene     Radon can affect  your  health.
     inside  house   (parents.      But,  once  identified,  it's  a
     kids, dog)                     problem you can control.   Why
                                   not test  now  and  be  sure.

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       APPENDIX 12:




WJLA "RADON WATCH" LEAFLET

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  Together We Can Work to
  Solve the Problem
  Throughout WJLA's Radon Watch cam-
  paign, Baskin will report on the various
  aspects of the radon problem on News
  7. She'll show you what steps to take to
  fix a radon problem in your home and
  she'll discuss what government,
  schools and private industries, like
  builders and realtors, are doing about
  radon. In February, Baskin will track the
  progress of WJLA's radon  testing effort,
  including how many homes were
  tested, what kinds of levels were found
  and what homeowners are doing to
  radon-proof their homes.

  On March  12, WJLA will wrap up the
  campaign with a prime-time, public
  affairs special offering the final results
  of our testing and its impact on the
  community.

  At WJLA, we know that radon is a
   health problem that affects thousands
   of families in our area. That's why we're
   undertaking  this campaign. We urge
   you to stay informed and participate
   during our five week testing effort.
   Together we can help protect your
   family from radon.
f
AMERICAN
LUNG
ASSOCIATIONS
of the Nat. Cap. Area
The Christmas Seal People"
AMERICAN
'CANCER
SOCIETY
            WJLA Washington
                                                  ON yow SIDE
                                                           WJLA Washington

-------
Do You Have A Radon
Problem in Your Home?

Scientists estimate that 5,000 to 25,000
people die each year of lung cancer
attributed to radon. According to the
Environmental  Protection Agency
(EPA), one in every eight American .
homes may be  contaminated with
radon—an invisible, odorless, radioac-
tive gas that rises up from the soil.

High levels of radon have been found in
the Washington Metro area, and if your
house happens to be built on soil that
contains radium, you may be living
with a serious health hazard. The only
way to know if  you have high radon
levels in your home is to test the air.
Once detected, radon levels can be
brought down.
WJLA-TV Thinks You
Should Find Out
That's why WJLA-TV, in cooperation with
area SAFEWAY stores, is making radon de-
tectors available at cost. It's part of our
two-month Radon Watch campaign to
raise awareness of the radon problem in
our area. Our public awareness effort will
contain a variety of elements including
on-going news reports; a prime-time pub-
lic affairs special; community outreach
activities and an intensive on-air public
service campaign conducted in conjunc-
tion with the American Cancer Society
and the American Lung Associations of
the National Capital Area.

Beginning January 18 through February 19
you will be able to pick up an Air-Chek
radon test kit at area SAFEWAY stores at
cost for only $4.75. Normally it would cost
you $10 to $50 to test your home. All you
do is hang the test pouch in your house
for a week and mail it to the designated
address for analysis. No postage neces-
sary. Within two weeks, you'll have your
results and if there's a problem, you'll get
advice on how to take care of it.
Common
Radon
Entry
Points
                                                               water supply
 When you breathe, radon decay prod-
 ucts can become trapped in your lungs.
Why should you test your home now? If it
turns out you and your family are breath-
ing significant amounts of this harmful
gas, you'll want to take action as soon as
possible. And it's relatively easy and inex-
pensive to take care of the problem.

We Continue  to Keep You
Informed
WJLA-TV's consumer editor Roberta
Baskin first told you about radon in the
Washington area two years ago. In a
first of its kind, five  month study, Bas-
kin revealed a significant radon prob-
lem here. Nearly half of the homes
tested in the exclusive News 7 study
were contaminated  at levels above the
EPA's suggested action level. In fact,
some levels were so high, had the
homes been uranium mines, they would
have been shut down for being occupa-
tional hazards. In follow-up reports
since, Baskin has found homes with
radon levels similar to a cancer risk of
smoking four packs  of cigarettes a day.
The good news is that once homeown-
ers learned of the problem, they did
something about it and brought the
radon levels down.
                                               Hang radon test pouch in lowest livable
                                               area of your home.
                                                             drain
                                                Source: EPA

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                   APPENDIX 13
    Among Respondents in Hagerstown Who Had Tested,
How Many Knowledge Questions Did They Answer Correctly?
                  Follow-UP Survey
                       3.2%
                              12.9%
                                           Number of
                                         Knowledge Questions
  Among Respondents in Hagerstown Who Hadn't Tested,
How Many Knowledge Questions Did They Answer Correctly?
                Follow-Up Survey
                                           Number of
                                        Knowledge Questions

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  Among Respondents in Randallstown Who Had Tested,
How Many Knowledge Questions Did They Answer Correctly?
                  Follow-Up Survey
                         7.4%
                                            Number of
                                         Knowledge Questions
  Among Respondents in Randallstown Who Hadn't Tested,
 How Many Knowledge Questions Did They Answer Correctly?
                   Follow-UD Survey
                                              Number of
                                           Knowledge Questions
                                               I 0-1
                                              D 2-3
                                               1 4-5
                                               3 6-7

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Knowledge Models Followup Surveys
(Number Correct on Knowledge Questions (0-7))
Independent followup survey
Independent
Variables
INTERCEPT
EDUCATION
AGE
ASKDOC
FIXiT
WAIT FOR INFO
EXERCISE
SEX
RACE
RESIDENCE TYPE
INCOME
YEARS AT ADDRESS
TOLL FREE NUMBER
UTILITY BILL INSERT
POSTER
TALK ABOUT RADON
TV
FREDERICK
HAGERSTOWN
ROBERTA BASKIN/WJLA
N
AdjR2
F
Model 1
-0.9870
0.1762
-0.0050
-0.1143
-0.0469
0.2021
-0.2563
0.6449
0.5524
0.0855
9.57E-6
0.0066
0.6517
0.2334
0.1823
1.2413
0.7780
0.8521
0.4501
-
1,172
0.3546
36.775
(-2.336)
(7.464)
(-1.117)
(-0.949)
(-0.428)
(1.834)
(-2.166)
(6.035)
(3.387)
(0.600)
(2.858)
(1.168)
(2.150)
(1.437)
(0.708)
(10.571)
(7.198)
(6.001)
(3.069)



Model 2
-0.9460
0.1737
-0.0048
-0.1145
-0.0615
0.2131
-0.2513
0.6570
0.5608
0.0793
9.53E-6
0.0065
0.6573
0.2205
0.1731
1.2368
0.7159
0.8253
0.4214
0.3336
1,172 •
0.3563
35.143
(-2.239)
(7.357)
(-1.084)
(-0.952)
(-0.561)
(1.934)
(-2.126)
(6.147)
(3.442)
(0.557)
(2.851)
(1.139)
(2.171)
(1.359)
(0.673)
(10.546)
(6.347)
(5.795)
(2.863)
(2.009)


Dependent followup survey
Model 1
0.1424
0.1344
-0.0087
-0.1999
0.0136
0.2195
-0.0209
0.4061
0.5899
0.3119
1 .26E-5
0.0048
0.8013
0.2783
0.4546
1.039
0.4929
0.7589
0.4589
-
1,031
0.3016
25.741
(0.334)
(5.681)
(-1.788)
(-1.631)
(0.124)
(1.961)
(-0.175)
(3.762)
(3.795)
(2.168)
(3.806)
(0.799)
(2.727)
(2.062)
(1.925)
(8.937)
(4.462)
(5.190)
(3.121)



Model 2
0.1601
0.1333
-0.0086
-0.2024
0.0101
0.2233
-0.0184
0.4043
0.5913
0.3113
1.27E-5
0.0044
0.8064
0.2692
0.4583
1.033
0.4674
0.7451
0.4474
0.1608
1,031
0.3015
24.420
(0.375)
(5.629)
(-1.761)
(-1.651)
(0.092)
(1.993)
(-0.154)
(3.745)
(3.804) >
(2.164) «
(3.837) g.
(0.743) S*
(2.743) ^
(1.989) *"
(1.940)
(8.861)
(4.089)
(5.065)
(3.030)
(0.870)


Numbers in parentheses are the t ratio.

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   Appendix  15:   Categorization of  Respondent Responses
                   Reasons  for Not  Testing
Uninformed:
Antitesters:


Fatalists:

problem.



Not  in  Area:

Not  in Home:

Procrastinators:
a. Never thought about it.
b. Didn't know it was  possible.
d. Didn't know how to test.
e. Thought testing was too expensive.

f.  Don't think tests are  reliable.
I.  Concerned about confidentiality.

g. Not interested.
i. Would rather not know if there is a

j. Nothing can be done about  radon anyway.
k. Fixing a problem is too expensive.

h. Didn't know it  was a problem in this area.

c. Don't think I have a problem in my home.

m. Just haven't gotten around to it.

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         Bibliography:   Other  EPA-MDE  Project  Reports
Communicating Radon Risk Effectively:   Radon  Testing in Maryland.
      Hagerstown  Focus  Group  Summary. Research Triangle Institute,
      November  1987.

Communicating Radon Risk Effectively:   Radon  Testing in Maryland.
      Overview  and Summary  of Survey Results. Final Report.
      Research Triangle Institute,  October 1988.

Communicating Radon Risk Effectively:   Radon  Testing in Maryland.
      Status  Report.  Research Triangle  Institute, September  23,  1987.

Communicating Radon Risk Effectively:   Radon  Testing in Maryland.
      Survey  Plan. Research  Triangle Institute,  November 1987.

Maryland Radon Information  and  Attitudinal  Baseline Survey:
      Preliminary   Findings. Research Triangle  Institute,  February
      1988.

Maryland Radon Risk  Study:   Focus  Group Findings. Research Triangle
      Institute, September  22,  1987.

Public Orientations Toward Radon  Testing:  Exploratory  Qualitative
      Research. National  Analysts, September 1987.

Radon Risk  Communication Project  Interim Report. Program
      Evaluation Division, Environmental  Protection Agency,  October
      27, 1987.

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