DOI: 10.3886/e242009v1
title: Feasibility and Adaptation of an Evidence-Based Multilevel Intervention for Improving Timeliness of Lung Cancer Treatment

description: Delayed time to treatment is a key determinant of poor survival among patients with lung cancer. Factors that
affect timeliness of lung cancer treatment are multilevel in nature. However, most interventions target only one
level of influence. Existing evidence-based interventions (EBIs) that work in one setting may also fail to work in
a different setting due to poor fit in the new setting or deviations from the original intervention. The goals of this
proposed R03 study are to: 1) evaluate the feasibility of adopting, within West Virginia University Cancer
Institute (WVUCI) Network, an evidence-based Veterans Health Administration (VHA) multilevel lung cancer
care coordination intervention aimed at improving timeliness of lung cancer treatment and; 2) adapt the
intervention, guided by the Planned Adaptation framework, to improve fit. WVUCI is a regional network of
cancer centers affiliated with WVU Medicine Health, with facilities in West Virginia, Pennsylvania, and
Maryland. Five sites are credentialed for clinical trials with the National Cancer Institute. Our specific aims are
to: 1) conduct a survey of providers and leadership on acceptability, appropriateness, feasibility, and attitudes
towards the EBI (Aim 1) which will inform questions posed in subsequent interviews to further probe on
appropriateness, inner and outer contextual issues affecting fit and feasibility, and proposed adaptations to the
EBI (Aim 2). This study employs a sequential explanatory mixed methods methodology with integration at the
data collection (interview questions informed by survey results) and interpretation stages (weaving the
narrative from the interview into survey results). The main innovation of the proposed project is the redesign
of an evidence-based intervention (EBI) to adapt it to a new setting by applying the concept of fidelity to core
function. The study is significant because more than half of patients diagnosed with lung cancer in West
Virginia either do not receive any treatment or receive delayed treatment (&gt;35 days after diagnosis). The
WVUCI Network is the single largest network of cancer care centers that provides treatment to patients with
lung cancer in West Virginia. Over 800 patients with lung cancer receive care across the network annually,
accounting for nearly half of 2000 cases diagnosed with lung cancer every year across WV. A well-adapted
evidence-based multilevel intervention has the potential to improve timeliness of lung cancer treatment for a
significant number of patients in West Virginia.<br>
description: Response Rates: 70-100%
description: Presence of Common Scales: 1) Implementation Climate Scale (ICS); 2) Implementation Leadership
Scale (ILS); 3) Acceptability of Intervention Measure (AIM); 4) Intervention
Appropriateness Measure (IAM); 5) Feasibility of Intervention Measure (FIM). <br>
description: <b></b>An electronic survey was
distributed to individual providers with provider teams via REDCap where all
providers involved in the diagnosis and care of patients with cancer were
invited to participate in the study. <br>
description: Providers who provide care to patients with lung cancer across the West VIrginia University Cancer Institute network. Smallest Geographic Unit: Single state
description: web-based survey;