DECIDE: Developing Tools for Lung Cancer Screening Discussion Improvement

Study Overview
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Brief Summary
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The purpose of this study is to learn about discussion between clinicians and their patients related to lung screening. Survey answers will be collected from both clinicians and their patients.

Official Title
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Using a Mixed Methods Approach to Understand Shared Decision-Making in Lung Cancer Screening

Conditions
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Smoking, Smoking, Tobacco, Smoking, Cigarette, Lung Cancer

Intervention / Treatment
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* Behavioral: Cataldo Lung Cancer Stigma Scale (Smoking-Related Subscale)
* Behavioral: Patient Trust in the Medical
* Behavioral: Decision Conflict Scale - Lung Cancer Screening
* Behavioral: Shared Decision Making Questionnaire - Patient
* Behavioral: Stage of Readiness for Smoking Cessation - Contemplation Ladder
* Behavioral: Primary Care Clinicians' Lung Cancer Screening Survey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CLINICIANS: Clinician (physician, nurse practitioner, or physician assistant) Practicing in a KPWA primary care clinic Having a patient panel with >/= 10 lung cancer screening eligible patients PATIENTS (Quantitative Phase): Age 55-80 years >/= 30 pack-year tobacco smoking history Current smoker or former smoker who has quit within the past 15 years Documented SDM lung cancer screening discussion during a recent clinic visit PATIENTS (Qualitative Phase) Age 55-80 years >/= 30 pack-year tobacco smoking history Current smoker or former smoker who has quit within the past 15 years Exclusion Criteria: PATIENTS: Significant comorbidities (Charlson Comorbidity Index >/=3) Lung cancer diagnosis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Clinicians<br>Primary care clinicians (general internists, family physicians, nurse practitioners, physician assistants) who treat lung cancer screening eligible patients | Behavioral: Primary Care Clinicians' Lung Cancer Screening Survey<br>* Includes items to assess attitudes, barriers, and knowledge of lung cancer screening guidelines.<br>|
| Smokers/Former Smokers<br>Current smoker or former smoker who has quit within the past 15 years | Behavioral: Cataldo Lung Cancer Stigma Scale (Smoking-Related Subscale)<br>* Perceived Smoking-Related Stigma will be measured using the 5-item Cataldo Lung Cancer Stigma Scale (Smoking-Related Subscale). The response scale is 1 = strongly disagree, to 4 = strongly agree, and scores range from 5 to 25 (high stigma). Cronbach's alphas were 0.75 to 0.89 in prior studies.<br>Behavioral: Patient Trust in the Medical<br>* Medical Mistrust will be measured using the 5-item Patient Trust in the Medical Profession Scale.80 The five-point Likert responses measure the extent to which patients perceive their clinician to be honest, caring more about convenience, thorough and careful, and trusted. The range of scores is 5 to 25 (higher mistrust). Reliability and validity have been well established with a Cronbachs alpha of 0.84.<br>Behavioral: Decision Conflict Scale - Lung Cancer Screening<br>* The DCS is a 16-item Likert-response item scale that has been modified for the lung cancer screening and smoking cessation contexts. The DCS was developed by OConnor,74-75 and validated in many health decisions including breast cancer screening with Cronbachs alphas ranging from 0.78 to 0.81. 74-75 Despite its name, the DCS measures more than decision conflict to encompass personal perceptions of perceived decision-making quality such as feeling the choice is informed, values based, and likely to be implemented as well as expressing satisfaction with the decision. 74-75 The DCS is comprised of items with response options ranging from 1 (strongly disagree) to 5 (strongly agree). The items are summed to total scale score with lower scores reflective of higher decision conflict and higher scores reflective of lower decision conflict.<br>* Other names: DCS;Behavioral: Shared Decision Making Questionnaire - Patient<br>* Shared Decision Making Process will be measured from the patient perspective using the 9-item Shared Decision Making Questionnaire (SDM-Q-9),77 which has been validated with a Cronbachs alpha of 0.94.<br>* Other names: SDM-Q-9;Behavioral: Stage of Readiness for Smoking Cessation - Contemplation Ladder<br>* Among current smokers<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Key components of Shared Decision Making process that predict patient-perceived lung cancer screening decision quality |  | up to 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Smoker, Memorial Sloan Kettering Cancer Center