Rural Public Library Lending Programs Advance Population-Based Radon Testing

Purpose: To evaluate change in home radon testing after initiation of a public library radon detector lending program (LLP) in four rural counties; and describe the impact of LLP promotions on check-outs. Design: Longitudinal tracking of radon testing and description of LLP promotions. Setting: Four rural Kentucky counties. Sample: 14,697 radon tests pre-LLP (charcoal-based test kits); 12,707 radon tests post-LLP (detector check-outs plus charcoal-based). Intervention: LLP and promotional strategies including direct mail, radio, newsletters, social media, and in-library promotions and training. Measures: Radon detector check-outs (03/2023-11/2024) comparing counties with and without LLP. Analysis: Examined change in radon testing pre- and post-LLP implementation using incidence rate ratios. Evaluated number of check-outs following promotions. Results: There was a 2.5-fold increase in the rate of radon testing in the four study counties (RR=2.5, 95% CI: 2.27-2.76; p<.001), while the testing rate fell in non-study counties. Two study counties exceeded their check-out goals multiple months in a row following direct mail campaigns. Social media, in-library signage, and billboards were reported most effective at promoting the program. The proportion of county-level renter-occupied housing fluctuated, potentially affecting differences in library check outs. Conclusion: LLPs show promise in maximizing access to population-based radon testing. Mailing postcards to residents had a sustained impact on detector check-outs over 3-5 months in some counties.