This study is a three-arm, randomized controlled pilot of a lung cancer screening intervention. The investigators will recruit participants ages 50-80 who are likely to meet lung cancer screening guidelines. After eligibility screening, participants will be randomized to one of three educational interventions regarding lung cancer. Lung cancer screening outcomes will be assessed.
Smoking is associated with a dramatically increased risk of lung cancer, with rates 10-40 times higher among those who smoke than among those who do not smoke, with smoking accounting for about 85-90% of all lung cancer cases. Screening for lung cancer with low-dose computed tomography (LDCT) has been shown to significantly reduce lung cancer mortality in high-risk populations. Lung cancer screening with annual LDCT is therefore recommended by the US Preventive Services Task Force (USPSTF) for all adults aged 50 to 80 years with a 20 pack-year history of smoking who currently smoke or have quit within the past 15 years. However, in a nationwide study of individuals eligible for lung cancer screening in 2022, only 18% were up-to-date with the recommended screening. The investigators propose a three-arm, randomized controlled pilot of a lung cancer screening intervention. Recruitment will be carried out primarily through the electronic health record, with invitations sent to patients aged 50-80 who have a documented history of smoking but no chest CT on file within the past 18 months. The investigators will also partner with community organizations such as senior centers and churches to distribute information about the study. Potential participants will be screened for eligibility for lung cancer screening. If eligible, the participants will undergo a consent process, complete baseline surveys (demographics, etc.), and be randomized to one of the following three study conditions: 1. Notification of eligibility for lung cancer screening with a recommendation to discuss with the participant's health care provider 2. Animated video on shared decision-making for LDCT with accompanying guide, offered as a downloadable PDF or mailed hard copy, per individual preference 3. Video and guide as in (b), plus a one-on-one call with a community health worker (CHW), 1-2 weeks after viewing the materials Three months after receiving the intervention, follow-up surveys will be sent to assess attitudes toward and completion of lung cancer screening.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
300
Brief animated video that covers the basics of lung cancer screening and shows shared decision-making. An accompanying brochure uses images and information from the video to reinforce concepts (delivered via PDF or mail, per participant preference).
Brief animated video that covers the basics of lung cancer screening and shows shared decision-making. An accompanying brochure uses images and information from the video to reinforce concepts (delivered via PDF or mail, per participant preference). A follow-up call with a community outreach specialist/community health worker is made 1-2 weeks after the initial intervention to check in on participant plans regarding lung cancer screening and to assist with any barriers.
Number of Participants with Completion of Lung Cancer Screening
Self-reported completion of low dose chest CT for lung cancer screening during the study follow-up period
Time frame: 3 months
Number of Participants with Clinician Discussion on Lung Cancer Screening
Self-reported conversation with clinician about lung cancer screening during the study follow-up period
Time frame: 3 months
Number of Participants with Change in Intent to obtain lung cancer screening
Change in intent to obtain lung cancer screening
Time frame: 3 months
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