Empowering Patients' Lung Cancer Screening Uptake

Study Overview
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Brief Summary
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Lung cancer is the leading cause of cancer related mortality. Lung cancer screening (LCS) with low dose computed tomography (LDCT) decreases mortality rate of lung cancer by 20%. Yet many patients who are eligible for lung cancer screening are still falling through the cracks which prevents patients the ability to detect lung cancer early. This study will test the effect of a a multi-level intervention on ordering LDCT within 6 months after patient enrollment. Our proposed intervention includes (1) Primary care provider notifications of patients' LCS eligibility; (2) patients' education ; (3) patients' referral to financial navigation resources; and (4) patients' reminder to discuss LCS during PCP visit.

Official Title
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Empowering Patients' Lung Cancer Screening Uptake (Empower LCS)

Conditions
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Lung Cancer

Intervention / Treatment
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* Behavioral: Patient education
* Behavioral: Referral to financial navigation resources
* Behavioral: Patient Reminders
* Behavioral: Provider Reminers


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 50- 80 years of age. Be able to Speak English, Spanish, or Vietnamese Must have a scheduled appointment with their Primary Care Providers within next one to three months. The Scheduled PCP appointment is at any of the UCI Health primary care clinics in Orange County including two UCI federally qualified health centers History of 20 pack year smoking history ( based on survey self report) Current smoker or a former smoker who has quit smoking within the last 15 years (based on survey self report) Exclusion Criteria: 1 No prior history of lung cancer 2, No chest CT for any reason in the last 12 months based on self-report and UCI EMR 3,No history of Alzheimer's disease or dementia

Ages Eligible for Study
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Minimum Age: 50 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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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Empower LCS<br>Patient will be given education material(addressing knowledge barriers); patients' referral to financial navigation resources (addressing health-related social risks); and patients' reminder to discuss LCS during PCP visit. Providers will also be notified of eligibility of their patients to receive LCS. | Behavioral: Patient education<br>* Patients will be sent information (in preferred language) on lung cancer risk, lung cancer screening (LCS) benefits, harms, false positive rates, recommendations of follow-up for positive results, and exam insurance coverage.<br>Behavioral: Referral to financial navigation resources<br>* Patients who self-report needing help with health-related social risks at baseline will be sent a brochure (in preferred language) from patient advocate foundation (PAF), a national non-profit financial navigation organization, where patients can self-refer.<br>Behavioral: Patient Reminders<br>* Within 2 weeks prior to primary care appointment, patients will receive a text message or a phone call (if not having a phone that receives text messaging) encouraging patients to discuss the LCS with their provider.<br>Behavioral: Provider Reminers<br>* Within 2 weeks prior to primary care appointment, providers will be notified of their patient's eligibility for LCS.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Order of LDCT | Primary end point is order of LDCT within 6 months after enrollment assessed with self-reported surveys and EMR data extraction. | within 6 months of enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived Risk of lung cancer | self reported in survey | at baseline and 6 month post enrollment | 
| Perceived Severity of lung cancer | self reported in survey | at baseline and 6 month post enrollment | 
| Perceived Benefit of lung cancer screening | self reported in survey | at baseline and 6 month post enrollment | 
| Perceived barriers lung cancer screening | self reported in survey | at baseline and 6 month post enrollment | 
| Self-efficacy for lung cancer screening | self reported in survey | at baseline and 6 month post enrollment | 
| Knowledge about lung cancer and screening | self reported in survey | at baseline and 6 month post enrollment | 
| LCS discussion | Patient and Primary Care Provider discussing lung cancer screening | within 6 months after enrollment | 
| Receipt of LDCT | A receipt of LDCT for LCS will be checked either through self reported or EMR | Within 6 months of enrollment | 
| Providers' Perceived barriers | Provider will be asked about perceived barriers and knowledge of Lung cancer screening though a survey | within 3 month after last patient enrolled |