Outreach programs, peer pressure, and common sense: what motivates homeowners to mitigate wildfire risk?

In recent years, altered forest conditions, climate change, and the increasing numbers of homes built in fire prone areas has meant that wildfires are affecting more people. An important part of minimizing the potential negative impacts of wildfire is engaging homeowners in mitigating the fire hazard on their land. It is therefore important to understand what makes homeowners more or less willing to take action. The research presented here comes from a study that interviewed a total of 198 homeowners in six communities in the western United States about the activities they had undertaken to mitigate their fire risk, the factors that contributed to their decisions, and their future intentions. The current paper reports on findings from the first half of the longitudinal study, after 3 years we will return to interview the current homeowner on the same properties to assess maintenance actions and facilitating and limiting factors. Overall we found a body of individuals who understand the fire risk, are taking numerous mitigation actions, and think that these actions have reduced their risk. These homeowners typically did not expect the government to do it for them: they wanted information about what to do and, in some cases, assistance with the work, but saw taking care of their property primarily as their responsibility. Responses also show that key information sources and motivating factors vary by location and that it is not inherently necessary to have relationships between community members to create defensible space.

Effect of genetic cancer risk assessment on surgical decisions at breast cancer diagnosis.

HYPOTHESIS: Breast cancer gene (BRCA) mutation status affects patients' surgical decisions when genetic cancer risk assessment is offered at the time of breast cancer diagnosis, prior to definitive treatment. PATIENTS AND INTERVENTIONS: Outcomes following genetic cancer risk assessment were studied for women newly diagnosed as having breast cancer who were prospectively enrolled in an institutional review board-approved hereditary cancer registry during a 1-year sampling frame. BRCA gene analysis was offered to subjects with a calculated mutation probability of 10% or higher. Review of medical records and telephone survey were used to document surgical treatment decisions following genetic cancer risk assessment. RESULTS: Thirty-seven of 233 women in the registry were enrolled at the time of a breast cancer diagnosis. The interval from diagnosis to genetic cancer risk assessment ranged from 3 to 60 days. The mean calculated probability of a BRCA gene mutation was 21% across the cohort. Two women were not tested because of low prior probabilities of mutation detection, and 3 declined owing to intercurrent psychological stressors. Of the remaining 32 patients, no BRCA gene mutation was detected in 22 (69%), 3 (9%) were found to carry a variant of uncertain significance, and 7 (22%) had a deleterious mutation. All 7 subjects with a deleterious mutation opted for bilateral mastectomy, whereas 20 of 22 patients with negative test results chose stage-appropriate treatment (P<.001). CONCLUSIONS: Genetic cancer risk assessment at the time of breast cancer diagnosis significantly affected women's treatment decisions. Although need and feasibility are demonstrated, the logistics of genetic cancer risk assessment during breast cancer diagnosis prove challenging.