Education and Reminders for Lung Cancer Screening
Recruiting in Palo Alto (17 mi)
+3 other locations
Overseen byGelareh Sadigh, MD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of California, Irvine
Disqualifiers: Lung cancer, Chest CT, Alzheimer's, others
No Placebo Group
Trial Summary
What is the purpose of this trial?The Hispanic/Latinx community (hereafter Hispanic) is the country's second-largest racial/ethnic group, accounting for 19.1% of the total population. However, they remain one of the most underserved populations with suboptimal access to healthcare and screening services due to low income, lack of health insurance, perceived discrimination, language barriers, and limited health literacy. Lung cancer is the leading cause of cancer related mortality with 1.8 million annual deaths worldwide, with Hispanic patients known to have lower survival rates compared with non-Hispanic whites. Lung cancer screening (LCS) with low dose computed tomography (LDCT) decreases this mortality rate of lung cancer by 20%. Yet many Latinx patients who are eligible for lung cancer screening are still falling through the cracks which prevents patients the ability to detect lung cancer early. This study will test and compare the effect of a multi-level intervention on ordering LDCT within 4 months after patient enrollment to those in an Enhanced Usual Care. Our proposed intervention includes:
* Primary care provider notifications of patients' LCS eligibility;
* Patients' education;
* Patients' referral to financial navigation resources;
* Patients' reminder to discuss LCS during primary care provider (PCP) visit.
Do I need to stop my current medications for this trial?
The trial information does not specify whether you need to stop taking your current medications. It seems focused on lung cancer screening and education, so it's unlikely that you would need to change your medications, but you should confirm with the trial coordinators.
What data supports the effectiveness of the treatment Empower Latinx for lung cancer screening?
The study on a cancer education-plus-navigation intervention showed that using community health workers to provide education and guidance significantly increased cancer screening rates among Latinos. This suggests that similar educational and navigational strategies, like those potentially used in Empower Latinx, could effectively improve lung cancer screening participation.
12345Is the Education and Reminders for Lung Cancer Screening program safe for humans?
The research articles provided do not contain specific safety data for the Education and Reminders for Lung Cancer Screening program or its related names like Empower Latinx. They focus on awareness, barriers, and participation in lung cancer screening rather than safety information.
14567How does the Empower Latinx treatment for lung cancer screening differ from other treatments?
The Empower Latinx treatment is unique because it focuses on culturally tailored education and reminders specifically for the Latinx community to increase awareness and participation in lung cancer screening, unlike standard treatments that may not address cultural and community-specific barriers.
458910Eligibility Criteria
This trial is for Hispanic individuals aged 50-80 who are current or former smokers (quit within the last 15 years) with a history of heavy smoking. They must have an upcoming primary care appointment and be able to speak English or Spanish. It's focused on those in Orange County attending UCI Health clinics.Inclusion Criteria
I can speak both English and Spanish.
Current smoker or a former smoker who has quit smoking within the last 15 years (based on survey self-report)
History of 20-pack year smoking history (based on survey self-report)
+3 more
Exclusion Criteria
I had a chest CT scan in the last year.
I have had lung cancer before.
I have been diagnosed with Alzheimer's disease or dementia.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants receive a multi-level intervention including PCP notifications, education, financial navigation resources, and reminders to discuss LCS during PCP visits
4 months
Follow-up
Participants are monitored for changes in knowledge, perceived benefits, barriers, self-efficacy, risk, and severity of lung cancer screening
4 months
Qualitative Assessment
Patient and provider experiences with the intervention are assessed through qualitative interviews
3-6 months after follow-up
Participant Groups
The study tests if reminders to patients and providers, patient education, and financial navigation aid can increase lung cancer screenings using low dose CT scans compared to enhanced usual care. The goal is early detection of lung cancer in the Hispanic community.
2Treatment groups
Experimental Treatment
Group I: Arm B: Empower LatinxExperimental Treatment5 Interventions
* PCP notifications of patients' LCS eligibility (addressing provider time constraints and barrier in identifying eligible patients);
* Patients' education (addressing knowledge barriers);
* Patients' referral to financial navigation resources (addressing health-related social risks)
* Patients' reminder to discuss LCS during PCP visit.
Group II: Arm A: Enhanced Usual CareExperimental Treatment2 Interventions
Usual Care + Brief Educational Material
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
UCI Health Family Health Center - AnaheimAnaheim, CA
UCI Health SeniorHealth Center -Pavillion 4Orange, CA
UCI Health Family Health Center - Santa AnaSanta Ana, CA
UCI Medical Center, Pavilion 3Orange, CA
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Who Is Running the Clinical Trial?
University of California, IrvineLead Sponsor
Radiological Society of North AmericaCollaborator
References
Understanding lung cancer screening behavior: Racial, gender, and geographic differences among Indiana long-term smokers. [2023]Lung cancer screening is a relatively new screening option. Inequalities related to screening behavior have been documented in other types of cancer screening. Because stage at presentation drives mortality in lung cancer, it is critical to understand factors that influence screening behavior in lung cancer screening in order to intervene. However, we must first understand where disparities exist in lung cancer screening participation in order to effectively guide intervention efforts. Therefore, the purpose of this study was to determine the association of sociodemographic (including key disparity-related variables) and knowledge with lung cancer screening behavior. This cross-sectional, descriptive study used survey methodology to collect data from 438 screening-eligible individuals in the state of Indiana between January and February 2017 and measured sociodemographic variables and knowledge about lung cancer and screening. Key sociodemographic and health status characteristics associated with screening behavior included race, geographic area of residence, income, health insurance, and family history of lung cancer. Of the variables generally reflective of disparities, key differences were noted by race and geographic area of residence with total knowledge scores as well as screening behavior, respectively. Results indicate key differences in race and geographic area of residence that may perpetuate screening behavior disparities. We have a unique opportunity at this early implementation stage in lung cancer screening to learn what variables influence screening behavior from our target patient population. This knowledge can be used to design equitable patient outreach programs, meaningful, tailored patient engagement materials, and effective patient-clinician decision support tools.
Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review. [2022]Nonsmall cell lung cancer (NSCLC) is the leading cause of cancer deaths. Lung cancer screening (LCS) reduces NSCLC mortality; however, a lack of diversity in LCS studies may limit the generalizability of the results to marginalized groups who face higher risk for and worse outcomes from NSCLC. Identifying sources of inequity in the LCS pipeline is essential to reduce disparities in NSCLC outcomes. The authors searched 3 major databases for studies published from January 1, 2010 to February 27, 2020 that met the following criteria: 1) included screenees between ages 45 and 80 years who were current or former smokers, 2) written in English, 3) conducted in the United States, and 4) discussed socioeconomic and race-based LCS outcomes. Eligible studies were assessed for risk of bias. Of 3721 studies screened, 21 were eligible. Eligible studies were evaluated, and their findings were categorized into 3 themes related to LCS disparities faced by Black and socioeconomically disadvantaged individuals: 1) eligibility; 2) utilization, perception, and utility; and 3) postscreening behavior and care. Disparities in LCS exist along racial and socioeconomic lines. There are several steps along the LCS pipeline in which Black and socioeconomically disadvantaged individuals miss the potential benefits of LCS, resulting in increased mortality. This study identified potential sources of inequity that require further investigation. The authors recommend the implementation of prospective trials that evaluate eligibility criteria for underserved groups and the creation of interventions focused on improving utilization and follow-up care to decrease LCS disparities.
A Cancer Education-Plus-Navigation Intervention Implemented Within a Federally Qualified Health Center and Community-Based Settings. [2021]Despite the availability of effective cancer screening tests, Latinos are screened at lower rates than non-Hispanic Whites. We implemented and evaluated the effectiveness of an evidence-based community health worker (CHW) cancer education-plus-navigation intervention designed to increase cancer screening, knowledge of screening guidelines, and the benefit of early detection. The project included a community and clinic component and served a primarily Latino population. In collaboration with a federally qualified health center (FQHC) and three community-based organizations, bilingual/bicultural CHWs recruited men and women (not up-to-date with the cancer screening guidelines) from a FQHC and the community. Participants received education plus navigation and no-cost cancer screening tests. Together with the FQHC, we outlined eligibility criteria, project protocols, project implementation, and evaluation activities. With the community organizations, we outlined recruitment protocols-when to recruit, how to recruit, and connections with other organizations. CHWs enrolled 3045 men and women into the education-plus-navigation intervention. Overall, 71% received at least one cancer screening. Stratifying by gender, 72% of women received at least one cancer screening test whereas 63% of enrolled men received a test for colorectal cancer. Knowledge of screening guidelines and the belief in early detection also increased from baseline to follow-up. Our evidence-based education-plus-navigation intervention successfully reached large numbers of underserved men and women and yielded positive changes in cancer screening and knowledge of screening guidelines and the belief in early detection. The inclusion of a clinic and community component ensured success of the project.
Lung Cancer Screening Outreach Program in an Urban Native American Clinic. [2023]To evaluate uptake of lung cancer screening in an urban Native American clinic using 2 culturally targeted promotion strategies.
Awareness and interest in lung cancer screening among current and former smokers: findings from the ITC United States Survey. [2019]To examine the awareness of low-dose computed tomography (LDCT) lung cancer screening among a population of current and former smokers using a nationally representative sample from the United States.
Assessing Barriers and Facilitators to Lung Cancer Screening: Initial Findings from a Patient Navigation Intervention. [2023]Low-dose computed tomography-based lung cancer screening represents a complex clinical undertaking that could require multiple referrals, appointments, and time-intensive procedures. These steps may pose difficulties and raise concerns among patients, particularly minority, under-, and uninsured populations. The authors implemented patient navigation to identify and address these challenges. They conducted a pragmatic randomized controlled trial of telephone-based navigation for lung cancer screening in an integrated, urban safety-net health care system. Following standardized protocols, bilingual (Spanish and English) navigators educated, motivated, and empowered patients to traverse the health system. Navigators made systematic contact with patients, recording standardized call characteristics in a study-specific database. Call type, duration, and content were recorded. Univariable and multivariable multinomial logistic regression was performed to investigate associations between call characteristics and reported barriers. Among 225 patients (mean age 63 years, 46% female, 70% racial/ethnic minority) assigned navigation, a total of 559 barriers to screening were identified during 806 telephone calls. The most common barrier categories were personal (46%), provider (30%), and practical (17%). System (6%) and psychosocial (1%) barriers were described by English-speaking patients, but not by Spanish-speaking patients. Over the course of the lung cancer screening process, provider-related barriers decreased 80% (P = 0.008). The authors conclude that patients undergoing lung cancer screening frequently report personal and health care provider-related barriers to successful participation. Barrier types may differ among patient populations and over the course of the screening process. Further understanding of these concerns may increase screening uptake and adherence. Clinical Trial Registration number: (NCT02758054).
How can an Education Workshop Serve as an Intervention for American Indian Screening Participation. [2020]American Indians (AIs) continue to have elevated cancer incidence and mortality, and most have issues accessing cancer screening services. During 2013-2014, Mayo and its partners created Native Cancer 101 Module 10 "Prevention and Early Cancer Detection" education workshop. A community-based AI organization implemented nine of these workshops during 2014-2015 via diverse venues. Nearly all participants eligible for at least one type of cancer screening participated in a workshop and consented to follow-up within 3 to 6 months to determine if screenings had been completed or scheduled. Native Cancer 101 Module 10 workshops were conducted with 150 community members of whom 6 had recently completed cancer screening (n = 144). The workshops had a 25.20% increase in knowledge, and 97.1% of subjects responded that they would recommend the workshop to their friends and family. Most (136 of 144) submitted a consent form to be contacted 3 to 6 months following the workshop. Patient navigators reached 86 (63.2%) of the consented participants in the follow-up calls after the workshop, and 63 (46.3%) self-reported that they had completed at least one cancer screening test for which they were eligible. The single implementation of the workshop influenced community participants' completion of cancer screening.
Barriers to and Interest in Lung Cancer Screening Among Latino and Non-Latino Current and Former Smokers. [2021]Lung cancer is a leading cause of cancer death in Latinos. In a telephone survey, we assessed perceptions about lung cancer and awareness of, interest in, and barriers to lung screening among older current and former smokers. We compared Latino and non-Latino responses adjusting for age, sex, education, and smoking status using logistic regression models. Of the 460 patients who completed the survey (51.5% response rate), 58.0% were women, 49.3% former smokers, 15.7% Latino, with mean age 63.6 years. More Latinos believed that lung cancer could be prevented compared to non-Latinos (74.6% vs. 48.2%, OR 3.07, CI 1.89-5.01), and less worried about developing lung cancer (34.8% vs. 50.3%, OR 0.44, CI 0.27-0.72). Most participants were not aware of lung screening (44.1% Latinos vs. 34.3% Non-Latinos, OR 1.24, CI 0.79-1.94), but when informed, more Latinos wanted to be screened (90.7% vs. 67%, OR 4.58, CI 2.31-9.05). Latinos reported fewer barriers to lung screening.
Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. [2023]Few eligible patients receive lung cancer screening. We developed the Lung AIR (awareness, information, and resources) intervention to increase community education regarding lung cancer screening. The intervention was designed as an in-person group intervention; however, the COVID-19 pandemic necessitated adapting the mode of delivery. In this study we examined intervention feasibility and efficacy overall and by mode of delivery (in-person group vs. one-on-one phone) to understand the impact of adapting community outreach and engagement strategies. Feasibility was examined through participant demographics. Efficacy was measured through pre/post knowledge, attitudes, and beliefs about lung cancer screening, and intention to complete screening. We reached N = 292 participants. Forty percent had a household income below $35,000, 58% had a high school degree or less, 40% were Hispanic, 57% were Black, and 84% reported current or past smoking. One-on-one phone sessions reached participants who were older, had lower incomes, more current smoking, smoked for more years, more cigarettes per day, lower pre-intervention lung cancer screening knowledge, and higher pre-intervention fear and worry. Overall pre/post test scores show significant increases in knowledge, salience, and coherence, and reduced fear and worry. Participants in the one-on-one phone sessions had significantly higher increases in salience and coherence and intention to complete screening compared to participants in the in-person group sessions. The Lung AIR intervention is a feasible and effective community-based educational intervention for lung cancer screening. Findings point to differences in reach and efficacy of the community-based intervention by mode of delivery.
Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women. [2022]We tested the effectiveness of a lay health worker intervention to increase breast and cervical cancer screening among low-income Hispanic women.