Abstract PO-064: Health literacy as a tool to drive equitable action for lung cancer screening in high-risk communities
Authors: Regnante Jeanne M. , Roy Upal Basu , O'Leary Catina , Fleisher Linda M. , Webb Diane W. , Wenger Linda , Ferris Andrea , Winn Robert 
Published: January 2022

Abstract
In the United States, communities at risk of developing lung cancer include rural populations, low socioeconomic status (SES) and the under-insured, immigrants, aged populations, racial and ethnic minority groups, and LGBTQIA communities. Many of these high-risk communities are diagnosed at much later stages than high SES whites. When lung cancer is detected early, survival rates are higher due to the possibility of curative surgery. Lung cancer screening (LCS) using low-density computed tomography (LDCT) has been recommended by the USPSTF since 2013. Guidelines for those who meet the USPSTF LCS criteria were expanded in 2021. A major barrier to accessing screening by vulnerable populations is the lack of health literate LCS education materials that can be used to engage and empower these groups and motivate them to seek screening. Research Question: How do we develop health literate (HL), culturally sensitive, and linguistically appropriate health information about LCS to high-risk communities and make them available through trusted community partners? Methods: A multi-phased approach that included material creation, testing, and dissemination was conceptualized by LUNGevity Foundation in partnership with Health Literacy Media (HLM) and a leading expert in accessible patient education. Using an IRB-approved protocol, the study team identified a representative population of persons (N=40 in 15 states) with online recruitment facilitated by NCI community cancer center outreach leaders in high-risk geographies. The participants gave extensive quantitative and qualitative feedback via virtual focus groups or in-depth interviews to obtain opinions and insights into how easily LUNGevity Foundation's Screening and Early Detection Booklet was understood. Revised materials were created using HL best practices, and re-tested with new community members to ensure acceptability, accessibility, and HL. Then, additional materials with relevant health topics were developed consistent with HL principles for extensive testing with communities. An additional 24 people in 11 states took part in 1 of 4, 1 ½ hour focus groups for final review. New HL lung cancer screening materials were made available to NCI community outreach leaders via LUNGevity Foundation's trusted national community engagement network. Results: The participants raised important insights about eligibility for and accessibility to screening. Based on their insights and recommendations, HLM transformed one large booklet into 4 fact sheets and 6 mini booklets. Final materials were disseminated to vulnerable populations via LUNGevity Foundation's trusted community engagement network. Conclusions: The feasibility of creating patient-centered health literate materials that also incorporate community engagement is established. Using LCS as an example, we were able to successfully create materials that were acceptable to high-risk communities. We recommend offering understandable and accessible information to all communities regardless of their literacy or education levels.
Citation Format: Jeanne M. Regnante, Upal Basu Roy, Catina O'Leary, Linda M. Fleisher, Diane W. Webb, Linda Wenger, Andrea Ferris, Robert Winn. Health literacy as a tool to drive equitable action for lung cancer screening in high-risk communities [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-064.