DECIDE: Developing Tools for Lung Cancer Screening Discussion Improvement

Hackensack Meridian Health654 enrolled

Overview

The purpose of this study is to learn about discussion between clinicians and their patients related to lung screening. Survey answers will be collected from both clinicians and their patients.

Study Type

OBSERVATIONAL

Enrollment

654

Conditions

Smoking Smoking, Tobacco Smoking, Cigarette Lung Cancer

Interventions

Cataldo Lung Cancer Stigma Scale (Smoking-Related Subscale)BEHAVIORAL

Perceived Smoking-Related Stigma will be measured using the 5-item Cataldo Lung Cancer Stigma Scale (Smoking-Related Subscale). The response scale is 1 = strongly disagree, to 4 = strongly agree, and scores range from 5 to 25 (high stigma). Cronbach's alphas were 0.75 to 0.89 in prior studies.

Patient Trust in the MedicalBEHAVIORAL

Medical Mistrust will be measured using the 5-item Patient Trust in the Medical Profession Scale.80 The five-point Likert responses measure the extent to which patients perceive their clinician to be honest, caring more about convenience, thorough and careful, and trusted. The range of scores is 5 to 25 (higher mistrust). Reliability and validity have been well established with a Cronbach"s alpha of 0.84.

Decision Conflict Scale (DCS) - Lung Cancer Screening

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: CLINICIANS: * Clinician (physician, nurse practitioner, or physician assistant) * Practicing in a KPWA primary care clinic * Having a patient panel with \>/= 10 lung cancer screening eligible patients PATIENTS (Quantitative Phase): * Age 55-80 years * \>/= 30 pack-year tobacco smoking history * Current smoker or former smoker who has quit within the past 15 years * Documented SDM lung cancer screening discussion during a recent clinic visit Exclusion Criteria: PATIENTS: * Significant comorbidities (Charlson Comorbidity Index \>/=3) * Lung cancer diagnosis

Locations (1)

Kaiser Permanente Washington Health Research Institute

Seattle, Washington, United States

Outcomes

Primary Outcomes

Key Components of Shared Decision Making Process That Predict Patient-perceived Lung Cancer Screening Decision Quality

Decisional Quality was measured using the multidimensional Decisional Conflict Scale, a 16-item Likert-response scale that was modified by the investigators for the lung cancer screening context. The total score ranging from 0 to 64. This total score is commonly transformed into a standardized score that falls within a 0 to 100 range. Decisional quality measured on this numeric scale from which lower scores represent lower decisional conflict and, therefore, higher decisional quality. Scores below 25 have been associated with low decisional conflict.

Time frame: at baseline (study enrollment)

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

The DCS is a 16-item Likert-response item scale that has been modified for the lung cancer screening and smoking cessation contexts. The DCS was developed by O"Connor,74-75 and validated in many health decisions including breast cancer screening with Cronbach"s alphas ranging from 0.78 to 0.81. 74-75 Despite its name, the DCS measures more than decision conflict to encompass personal perceptions of perceived decision-making quality such as feeling the choice is informed, values based, and likely to be implemented as well as expressing satisfaction with the decision. 74-75 The DCS is comprised of items with response options ranging from 1 (strongly disagree) to 5 (strongly agree). The items are summed to total scale score with lower scores reflective of higher decision conflict and higher scores reflective of lower decision conflict.