Educating QUitline Callers About Lung Cancer Screening
Condition: Population at Risk
MeSH terms: Lung Neoplasms
Study type: Interventional
Phase: Phase 3

Summary: 
      The specific aims are:

        1. To evaluate the potential barriers of providing educational lung screening interventions
           to quitline users, the investigators will seek input from 10-20 stakeholders on the
           newly adapted print version of the Should I Screen website, and on our proposed Aim 2
           recruitment and retention procedures.

        2. To conduct a randomized intervention, comparing: 1) ShouldIScreen.com website, (WEB;
           N=150); vs. 2) the Should I Screen print version (PRINT; N=150). H2.1. At 1- and
           4-months post-randomization, the WEB arm will have significantly higher lung screening
           knowledge and intention to undergo lung screening, compared to PRINT. Randomization will
           be stratified by age and pack-years in order to incorporate those who are recently
           eligible for screening, ages 50-54 and with 20-29 pack years. H2.2 The investigators
           will explore several potential moderators (age and e-health literacy). For example, the
           investigators will explore whether older vs younger participants have differential
           knowledge outcomes when using the PRINT vs WEB interventions. H2.3 We will explore
           whether mediators (prior lung screening, current primary care provider, lung cancer
           perceived risk) positively affects knowledge and screening intentions.

        3. To evaluate reach (% of quitline users enrolled) and engagement (% who read the
           intervention materials) by study arm and subgroup (e.g., method of quitline access, age,
           e-health literacy).
    

Detailed description: 
      Aim 1: The 30-45 minute qualitative interviews will obtain: 1) feedback on the print
      adaptation of the Should I Screen website (the investigators will send it in advance of the
      interview), 2) recommendations for effective recruitment and retention procedures in Aim 2,
      3) feedback on methods to increase the likelihood that participants will enroll and engage
      with the interventions (e.g., whether to present the study information immediately following
      initial contact with the quitline or later), 4) ideas to increase the likelihood that
      participants will contact their providers for an appointment to discuss lung screening, and
      5) feedback on the Aim 2 measures regarding feasibility and acceptability.

      Aim 2: H2.1. At 1- and 4-months post-randomization, the WEB arm will have significantly
      higher lung screening knowledge and intentions to undergo lung screening, compared to PRINT.
      H2.2 Moderators include, age, e-health literacy. For example, the investigators expect that
      younger participants will have significantly increased knowledge in the WEB (vs PRINT) arm,
      whereas intervention arm will have less of an impact among the older participants. H2.3
      Mediators (e.g., prior lung screening, current primary care provider, lung cancer perceived
      risk) will positively affect knowledge and screening intentions. Aim 3. To evaluate reach (%
      of quitline users enrolled) and engagement (% who read the intervention materials) by study
      arm and subgroup (e.g., age, e-health literacy). The investigators will assess the
      feasibility for widespread implementation of both interventions
    

Intervention name(s): Should I Screen website; Should I Screen print booklet
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Should I Screen educational website, developed by our consultant, Rafael Meza, PhD, is available at no cost, is written at an 8th grade reading level, requires 15 minutes to use, and undergoes regular updates (https://shouldiscreen.com). The goal is to increase lung screening awareness and to encourage a shared decision making visit with a provider. Sections of the website include the benefits (the reduced likelihood of dying from lung cancer) and harms (false alarms, overdiagnosis, more testing, and invasive procedures) of screening, causes of lung cancer, methods to reduce lung cancer risk, and the lung cancer risk calculator. Improvements in knowledge have been demonstrated with individuals eligible for screening.; The Should I Screen print-based education will be developed in Aim 1 and compared to the Should I Screen website in Aim 2. It will also be at the 8th grade level and will require 15 minutes to read. Although it will contain the same topics as the website, there is one inherent difference - it is not possible to include the interactive risk calculator in the print version. The print-based version will list all of the risk criteria that are included in the algorithm so that participants can see which ones apply to them. However, the risk calculator requires the computer algorithm to calculate a person's 6-year risk of developing lung cancer.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Screening
Keywords: lung cancer; lung cancer screening