Lung Cancer Screening: A Multilevel Intervention
Condition: Lung Cancer
MeSH terms: Lung Neoplasms
Study type: Interventional

Summary: 
      The study will develop and test the feasibility of the Lung Cancer Assessment of Risk and
      Education (LungCARE) intervention to increase discussions about lung cancer screening between
      patients and physicians. This intervention will be designed to reach primary care patients
      and will be implemented at three levels of the healthcare structure: patient, physician, and
      system. The patient component includes a short lung cancer screening video and questions
      regarding screening preferences. Patients will receive immediate feedback in a report
      (patient report) that summarizes their lung cancer screening preferences and a handout
      summarizing the educational video. At the physician level, primary care physicians (PCPs)
      will receive a similar report (physician report), which will be delivered to them prior to
      the patient visit. The report contains additional information about documenting discussion
      related to risk, screening, and referrals in the electronic health record (EHR) system
      (system component). The investigators will develop the LungCARE intervention and have a
      comparison group that will receive usual care. Preliminary testing of LungCARE will occur via
      a randomized controlled trial (RCT) at the University of California, San Francisco, General
      Internal Medicine and Women's Health Primary Care clinics. The RCT will evaluate LungCARE
      among 50 PCPs and 120 high-risk current and former smoker patients. The investigators will
      determine whether the intervention is accepted by patients and physicians and whether
      patients who received LungCARE are more likely to discuss lung cancer screening with their
      physicians when compared to patients and physicians in the comparison group. The
      investigators will also determine whether the intervention affects knowledge of lung cancer
      and low-dose computed tomography (LDCT) screening, perception of risk, and worry about lung
      cancer in patients when compared to patients in the comparison group. The investigators
      expect their research to provide specific recommendations that will facilitate
      patient-physician discussions about LDCT screening and promote shared decision-making among
      patients and physicians.
    


Intervention name(s): LungCARE
Intervention type(s): Behavioral
Intervention description(s): The LungCARE intervention involves patient and PCP components. The patient component consists of watching a short, educational video, answering questions about lung cancer screening preferences, and receiving a patient report and handout.
The PCP component consists of receiving a similar report (physician report) prior to the patient visit. This report is based on the patient's risk factors and lung cancer screening preferences. It contains additional information about documenting discussions related to risk, screening, and referrals in the electronic medical record system.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The intervention will involve a randomized control trial (RCT) with an intervention group that receives LungCARE and a comparison group that does not receive LungCARE.
Masking: None (Open Label)
Primary purpose: Screening
Keywords: randomized control trial; lung cancer risk assessment; shared decision making