The Montana Radon Study: social marketing via digital signage technology for reaching families in the waiting room

Abstract

Objectives: I tested a social marketing intervention delivered in health department waiting rooms via digital signage technology for increasing radon program participation among priority groups.

Methods: I conducted a tri-county, community-based study over a 3-year period (2010-2013) in a high-radon state by using a quasi-experimental design. We collected survey data for eligible participants at the time of radon test kit purchase.

Results: Radon program participation increased at the intervention site (t38 = 3.74; P = .001; 95% confidence interval [CI] = 4.8, 16.0) with an increase in renters (χ(2)1,228 = 4.3; P = .039), Special Supplementary Nutrition Program for Women, Infants, and Children families (χ(2)1,166 = 3.13; P = .077) and first-time testers (χ(2)1,228 = 10.93; P = .001). Approximately one third (30.3%; n = 30) attributed participation in the radon program to viewing the intervention message. The intervention crossover was also successful with increased monthly kit sales (t37 = 2.69; P = .01; 95% CI = 1.20, 8.47) and increased households participating (t23 = 4.76; P < .001; 95% CI = 3.10, 7.88).

Conclusions: A social marketing message was an effective population-based intervention for increasing radon program participation. The results prompted policy changes for Montana radon programming and adoption of digital signage technology by 2 health departments.

FIGURE 1—

Screenshot of 1 frame of the radon intervention message displayed with digital signage technology: Montana Radon Study, 2010–2013. Note. The silent message (2:52 minutes) was displayed on a flat-panel monitor as part of a 10-minute message loop in the Women, Infant, and Children Clinic waiting room of the intervention county.

FIGURE 2—

Radon test kit sales as a measure of health department radon program participation in 3 Montana counties: Montana Radon Study, 2010–2013. Note. Pre-intervention data collection began in Gallatin County February 1, 2009, in Ravalli County May 1, 2010, and in Flathead County April 5, 2011. The radon risk-communication message delivered via digital signage technology began in Gallatin County August 22, 2011. During a 13-month period ending September 30, 2012, Gallatin County was the intervention site, Flathead County was the experimental-control site, and Ravalli County was the standard-control site. Beginning October 1, 2012, the intervention was extended to Flathead County. Ravalli County continued as the control site for the 6-month crossover observation period. I conducted an independent-samples t test to evaluate program participation before and after the intervention in the 3 settings during the initial 13-month observation. The test was significant for the intervention county (t₃₈ = 3.74; P = .001; 95% confidence interval [CI] = 4.8, 16.0) and was not significant in either the experimental control (t₃₁= -1.8; P = .08; 95% CI = -.31, 5.25) or the standard control (t₂₉ = .30; P = .76; 95% CI = -1.7, 1.3) counties. I conducted an independent-samples t test to evaluate program participation in Flathead County before and after the intervention crossed over. The test was significant for Flathead County (t₃₇ = 2.69; P = .011; 95% CI = 1.2, 8.5) and was not significant at the standard control site (t₃₅ = 1.96; P = .06; 95% CI = -0.72, 3.9).