Term of Award

Winter 2025

Degree Name

Doctor of Public Health (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Department

College of Public Health

Committee Chair

Asli Aslan

Committee Member 1

Andrew Hansen

Committee Member 2

Jeff Jones

Abstract

Background: Cancer is a leading cause of death in Georgia, with rising incidence in rural counties where many residents rely on unregulated private wells. These wells may contain contaminants such as radon, lead, nitrate, and arsenic, all linked to increased cancer risk. Limited research has explored how environmental exposure awareness influences cancer prevention behaviors such as screening. Guided by the Champion Health Belief Model, this study examined psychosocial and environmental predictors of screening intent among private well owners. Methods: Well Aware was an 11-week quasi-experimental study among 60 private well owners in southeast Georgia. Participants who attended educational listening sessions were categorized as Group 1 (n = 30), and those who completed testing only formed Group 2 (n = 30). All completed pre- and post-surveys assessing CHBM constructs, water knowledge, and cancer screening intent. Descriptive statistics and binary logistic regression identified significant predictors. Results: Perceived susceptibility predicted baseline screening intent in both groups (Group 1 AOR = 3.46, p = .035; Group 2 AOR = 6.72, p = .049). Participants with fewer perceived barriers and those aged ≥65 showed higher intent. After education, self-efficacy became the strongest predictor in Group 1 (AOR = 2.20), with 63.3% intending to screen. After well-testing, environmental indicators were most influential: participants with ≥1 contaminant had higher odds of intent (AOR = 5.00, p = .033), radon >300 pCi/L increased intent (AOR = 4.76, p = .010), and understanding one’s water status strongly predicted intent (AOR = 5.67, p = .001). In Group 2, perceived benefits uniquely predicted intent (AOR = 0.77, p = .011). Conclusion: Environmental risk communication paired with personalized well-water results more effectively increases cancer screening intent than education alone. Integrated community programs that combine education and testing may strengthen preventive health behaviors in rural private-well populations.

Research Data and Supplementary Material

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