This clinical trial tests how well providing education improves screening for lung cancer in patients with a history of smoking. Screenings may help doctors find lung cancer sooner when it may be easier to treat. Education and counseling may be an effective method to help providers and patients learn about lung cancer screening. Providing education and decision counseling to providers and patients may increase lung cancer screening.
PRIMARY OBJECTIVES: I. Assess intervention impact on lung cancer screening (LCS). II. Assess intervention impact on shared decision making (SDM). SECONDARY OBJECTIVES: I. Identify mediators and moderators of LCS. II. Assess intervention implementation barriers and facilitators. EXPLORATORY OBJECTIVES: I. Assess intervention impact on: Ia. LCS referral; Ib. Tobacco treatment services referral; Ic. Repeat annual LCS among participants with a normal initial screening result; Id. Follow-up diagnostic evaluation for participants with an abnormal screening result. OUTLINE: In accordance with the 2X2 cluster randomized design, primary care practices along with providers initially are randomized to 1 of 2 groups. Then, patients within the practices are randomized to 1 of 2 groups. PROVIDERS: GROUP A: PROVIDER SUPPORT GROUP: Providers complete baseline and endpoint surveys once on study. Providers also undergo online educational activity on study. Participants undergo distance learning on study. GROUP B: PROVIDER CONTROL GROUP: Participants complete baseline and endpoint surveys once on study. PATIENTS: GROUP A: PROVIDER SUPPORT + PATIENT OUTREACH GROUP: Providers receive support once on study. Patients undergo educational activity and SDM counseling once on study and complete baseline and endpoint surveys. GROUP B: PROVIDER SUPPORT + PATIENT CONTROL GROUP: Providers receive support once on study. Patients receive usual care once on study and complete baseline and endpoint telephone surveys. GROUP C: PROVIDER CONTROL + PATIENT OUTREACH GROUP: Providers receive usual care once on study. Patients undergo educational activity and SDM counseling once on study and complete baseline and endpoint surveys. Group D: PROVIDER CONTROL + PATIENT CONTROL GROUP: Providers receive usual care once on study. Patients receive usual care once on study and complete baseline and endpoint telephone surveys.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
Complete survey
Undergo online shared decision making training and distance learning
Complete survey
Sidney Kimmel Cancer Center at Thomas Jefferson University
Philadelphia, Pennsylvania, United States
RECRUITINGCompletion of initial lung cancer screening (LCS)
LCS will be assessed through an endpoint electronic medical records (EMR) search, supplemented with a question on the participant endpoint survey to capture any LCS performed outside the health system and/or not captured in the EMR.
Time frame: Within 4 months of randomization
Referral for LCS
Referrals for lung cancer screenings will be found by reviewing electronic medical records.
Time frame: Up to 5 years
Tobacco cessation services
Referrals for tobacco treatment services will be found by reviewing medical records.
Time frame: Up to 5 years
Repeat annual lung cancer screenings within 11-16 months of original screening
Number of repeat screenings will be found by reviewing electronic medical records.
Time frame: within 11-16 months of original screening
Diagnostic follow up after initial lung cancer screening
Number of patients that had follow up within 4 months of initial lung cancer screening will be found by reviewing electronic medical records.
Time frame: Up to 4 months of screening
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SCREENING
Masking
QUADRUPLE
Enrollment
822
Undergo electronic health record review
Undergo online shared decision making training and distance learning
Undergo shared decision making counseling
Complete survey
Undergo electronic health record review