Health Communication Tool + SDoH Screening for Lung Cancer
Recruiting in Palo Alto (17 mi)
Overseen byLisa Carter-Bawa, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Hackensack Meridian Health
Disqualifiers: Lung cancer, Prior screening, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
A multilevel lung screening intervention that pairs Social Determinants of Health (SDoH) screening and referral with a tailored health communication and decision support tool for lung screening has the potential to significantly impact lung screening uptake among at-risk individuals in the community, particularly among those who face barriers related to SDoH. In addition, findings will advance the understanding of effective strategies for improving lung screening and prevention efforts in non-traditional settings, with the ultimate goal of reducing the burden of lung cancer. As ways to support the realization of the public health benefit of lung cancer screening are considered, multiple strategies and venues to reach, and intervene, with screening-eligible is key. The goal of this study is to compare the effectiveness of a community-based lung screening educational tool paired with a social determinants of health (SDoH) screening assessment and referral process compared to a community-based lung cancer screening (LCS) educational tool alone as part of community outreach activities to improve (a) LCS rates (primary outcome); (b) intention to screen; and (c) individual-level potential drivers of LCS (health literacy, mistrust, stigma, fatalism, knowledge, health beliefs). It is hypothesized that providing SDoH screening and referral will result in higher levels of LCS, forward movement of intention to screen, and improved individual-level drivers of LCS.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Health Communication Tool + SDoH Screening for Lung Cancer?
Research shows that community-based educational interventions, like the Lung AIR program, can effectively increase knowledge and intention to complete lung cancer screening, especially when delivered one-on-one. Additionally, understanding social factors like income and geographic location can help tailor interventions to improve screening rates.12345
Is the Health Communication Tool + SDoH Screening for Lung Cancer safe for humans?
How does the Health Communication Tool + SDoH Screening for Lung Cancer treatment differ from other treatments for lung cancer?
This treatment is unique because it combines community-based lung cancer screening with a focus on social determinants of health (SDoH), which are factors like income and access to healthcare that can affect a person's health. It aims to improve lung cancer screening rates by addressing these broader social factors and using a health communication tool to engage patients.2371011
Eligibility Criteria
This trial is for individuals aged 50-80 who can consent, currently smoke or quit within the last 15 years, have a history of significant smoking (20 pack-years), and have never had lung cancer screening. They must speak and understand English. Those with previous lung screenings or diagnosed with lung cancer are excluded.Inclusion Criteria
I am between 50 and 80 years old.
Able to provide informed consent
You currently smoke or quit smoking within the past 15 years.
See 3 more
Exclusion Criteria
You have previously had a lung cancer screening scan.
I have been diagnosed with lung cancer.
Unable to speak and understand English
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
1 visit (in-person)
Intervention
Participants receive a community-based lung cancer screening educational tool, with or without a social determinants of health screening assessment and referral process
1 day
1 visit (in-person)
Follow-up
Participants are monitored for lung cancer screening uptake and changes in individual-level drivers of lung cancer screening
3 months
Treatment Details
Interventions
- Current practice - Community-based lung cancer screening (LungTalk) (Behavioral Intervention)
- Social determinants of health screening assessment and referral process (Behavioral Intervention)
Trial OverviewThe study tests if adding a Social Determinants of Health (SDoH) assessment and referral process to a community-based educational tool improves lung cancer screening rates compared to just the educational tool alone in at-risk communities.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Social determinants of health screeningExperimental Treatment2 Interventions
Participants will receive a social determinants of health screening assessment and referral process in addition to the community-based lung cancer screening educational tool.
Group II: Community-based lung cancer screeningActive Control1 Intervention
Participants will receive a community-based lung cancer screening educational tool.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Hackensack Meridian Health - Center for Discovery and InnovationNutley, NJ
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Who Is Running the Clinical Trial?
Hackensack Meridian HealthLead Sponsor
Becton, Dickinson and CompanyIndustry Sponsor
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.
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.
The Impact of Social Determinants of Health on Lung Cancer Screening Utilization. [2023]The purpose of this study was to understand how social determinants of health might influence lung cancer screening (LCS) adherence.
Using Community Health Advisors to Increase Lung Cancer Screening Awareness in the Black Belt: a Pilot Study. [2023]Disease stage at the time of diagnosis is the most important determinant of prognosis for lung cancer. Despite demonstrated effectiveness of lung cancer screening (LCS) in reducing lung cancer mortality, early detection continues to elude populations with the highest risk for lung cancer death. Consistent with the national rate, current screening rate in Alabama is dismal at 4.2%. While public awareness of LCS may be a likely cause, there are no studies that have thoroughly evaluated current knowledge of LCS within the Deep South. Therefore, we measured LCS knowledge before and after receiving education delivered by community health advisors (CHAs) among high-risk individuals living in medically underserved communities of Alabama and to determine impact of psychological, demographic, health status, and cognitive factors on rate of lung cancer screening participation. Participants were recruited from one urban county and six rural Black Belt counties (characterized by poverty, rurality, unemployment, low educational attainment, and disproportionate lack of access to health services). One hundred individuals (i) aged between 55 and 80 years; (ii) currently smoke or have quit within the past 15 years; and (iii) have at least a total of 30-pack-year smoking history were recruited. Knowledge scores to assess lung cancer knowledge were calculated. Paired t-test was used to assess pre- and post-knowledge score improvement. Screening for lung cancer was modeled as a function of predisposed factors (age, gender, insurance, education, fatalism, smoking status, and history of family lung cancer). Average age was 62.94 (SD = 6.28), mostly female (54%); mostly current smokers (53%). Most participants (80.85%) reported no family history of cancer. Fatalism was low, with a majority of the participants disagreeing that a cancer diagnosis is pre-destined (67.7%) and that there are no treatments for lung cancer (88.66%). Overall, lung cancer knowledge increased significantly from baseline of 4.64 (SD = 2.37) to 7.61 (SD = 2.26). Of the 100 participants, 23 underwent screening due to lack of access to primary care providers and reluctance of PCPs to provide referral to LCS. Sixty-five percent of those who were screened reported no family history of lung cancer. Regression analysis revealed no significant association between risk factors and the decision to get screened by participants. Our study demonstrates that while CHA delivered education initiatives increases lung cancer screening knowledge, there are significant structural barriers that prohibit effective utilization of LCS which needs to be addressed.
A Multilevel Approach to Investigate Relationships Between Healthcare Resources and Lung Cancer. [2023]Screening for lung cancer is an evidence-based but underutilized measure to reduce the burden of lung cancer mortality. Lack of adequate data on geographic availability of lung cancer screening inhibits the ability of healthcare providers to help patients with decision-making and impedes equity-focused implementation of screening-supportive services.
Barriers and facilitators for low-dose computed tomography lung cancer screening in rural populations in the United States: a scoping review protocol. [2023]The objective of this scoping review is to identify barriers and facilitators for low-dose computed tomography lung cancer screening uptake and adherence among rural populations in the United States.
Identifying Community Perspectives for a Lung Cancer Screening Awareness Campaign in Appalachia Kentucky: The Terminate Lung Cancer (TLC) Study. [2018]Lung cancer screening with low-dose computed tomography (LDCT) scan is now covered by Centers for Medicare & Medicaid Services following an evidence-based recommendation, but a shared decision making process should inform patients of risks and limitations. An awareness campaign promoting LDCT screenings is an opportunity to elicit patient engagement with health providers about the risks and benefits. Focus groups representing three regions of Appalachian Kentucky known for high lung cancer rates discussed development of a lung cancer screening campaign. Recommendations included messaging content, appeals or design, campaign implementation, and trusted information or communication sources. Community health workers (CHWs) from three Eastern Kentucky regions recruited individuals from their local communities using established client files. CHWs hosted six total focus groups (7-11 participants each) using questions guided by the Communication-Persuasion Matrix framework. All sessions were recorded and transcribed for independent content analysis. A total of 54 individuals (61.1 % female; >55 pack year history) were participated. Prior to discussion, most participants had not heard of lung cancer screening. Cited needs for content of a campaign included benefits of early detection and payment information. Messages considered most persuasive were those that include personal testimony, messages of hope, prolonged life, and an emphasis on family and the ambition to survive. Having information come from one's family doctor or specialty provider was considered important to message communication. Messages about survivorship, family, and prolonged life should be considered in lung cancer screening awareness campaigns. Our results provide community input about messages regarding screening options.
Results from Lung Cancer Screening Outreach Utilizing a Mobile CT Scanner in an Urban Area. [2023]Lung cancer screening (LCS) using low-dose computed tomography (LDCT) reduces lung cancer-specific and all-cause mortality in high-risk individuals, although there remain significant barriers to screening. We assessed the outreach of a mobile LCS program to increase screening accessibility and early detection of lung cancer.
Acceptability of a standalone written leaflet for the National Health Service for England Targeted Lung Health Check Programme: A concurrent, think-aloud study. [2022]Many countries are introducing low-dose computed tomography screening programmes for people at high risk of lung cancer. Effective communication strategies that convey risks and benefits, including unfamiliar concepts and outcome probabilities based on population risk, are critical to achieving informed choice and mitigating inequalities in uptake.
Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. [2021]Individuals living with low income are more likely to smoke, have a higher risk of lung cancer, and are less likely to participate in preventative healthcare (i.e., low-dose computed tomography (LDCT) for lung cancer screening), leading to equity concerns. To inform the delivery of an organized pilot lung cancer screening program in Ontario, we sought to contextualize the lived experiences of poverty and the choice to participate in lung cancer screening.
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.