Lung Cancer Screening Eligibility Assessment

Study Overview
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Brief Summary
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The primary purpose of this study evaluate if different messaging impacts response rates to a brief survey (i.e., the simplified eligibility tool) that is designed to estimate pack-year eligibility for lung cancer screening (LCS). This will help inform the best way to increase response rates to the tool in future intervention studies designed to increase LCS, and expand upon survey methodology in general.

Detailed Description
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Despite growing evidence that lung cancer screening (LCS) reduces lung cancer-specific mortality, LCS across the United States is remarkably low. This is due in part to challenges with identifying adults who meet eligibility criteria for lifetime smoking intensity (i.e., 20 pack-years or greater), which is often missing from the electronic medical record. We have developed a simplified eligibility tool that has shown accuracy in estimating pack-years. But given the potential for low response rates, there is a great need to identify effective strategies to increasing response rates equitably prior to using it in practice or in future studies. The primary purpose of this study evaluate if different messaging impacts response rates to a brief survey (i.e., the simplified eligibility tool) that is designed to estimate pack-year eligibility for lung cancer screening (LCS). This will help to identify the best way to increase response rates to the tool in future intervention studies designed to increase LCS, and expand upon survey methodology in general.

Official Title
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Using a Simplified Tool to Predict Lung Cancer Screening (LCS) Eligibility: Experiment to Test Effects of Messaging on Response Rates

Conditions
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Lung Cancer

Intervention / Treatment
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* Behavioral: Framed Introductory Message A
* Behavioral: Framed Introductory Message B
* Behavioral: Framed Introductory Message C
* Behavioral: Framed Tobacco Use Message A
* Behavioral: Framed Tobacco Use Message B
* Behavioral: Financial Incentive


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: meet age eligibility (50-80 years old) for LCS based on 2021 USPSTF guidelines; and have completed at least one primary care visit at Penn Medicine in 2020-2025 Exclusion Criteria: have a documented history of lung cancer; have a documented history of completing LCS at Penn Medicine; are listed as not wanting to be contacted or solicited for research; or do not otherwise meet inclusion criteria.

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: We will use a randomized factorial design to test the effects of different types of messaging with or without incentives on response rates to an eligibility survey.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm 1 (Introductory Message A + Tobacco Use Message A + Incentive)<br>Participants will receive two framed messages (AA) plus an incentive | Behavioral: Framed Introductory Message A<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).<br>Behavioral: Framed Tobacco Use Message A<br>* Randomly assign patients to receive norming message related to tobacco use (version A).<br>Behavioral: Financial Incentive<br>* Randomly assigned patients to be entered into a drawing to receive a $100 gift card.<br>|
| Experimental: Arm 2 (Introductory Message A + Tobacco Use Message A)<br>Participants will receive two framed messages (AA) | Behavioral: Framed Introductory Message A<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).<br>Behavioral: Framed Tobacco Use Message A<br>* Randomly assign patients to receive norming message related to tobacco use (version A).<br>|
| Experimental: Arm 3 (Introductory Message A + Tobacco Use Message B + Incentive)<br>Participants will receive two framed messages (AB) plus an incentive | Behavioral: Framed Introductory Message A<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).<br>Behavioral: Framed Tobacco Use Message B<br>* Randomly assign patients to receive norming message related to tobacco use (version B).<br>Behavioral: Financial Incentive<br>* Randomly assigned patients to be entered into a drawing to receive a $100 gift card.<br>|
| Experimental: Arm 4 (Introductory Message A + Tobacco Use Message B)<br>Participants will receive two framed messages (AB) | Behavioral: Framed Introductory Message A<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).<br>Behavioral: Framed Tobacco Use Message B<br>* Randomly assign patients to receive norming message related to tobacco use (version B).<br>|
| Experimental: Arm 5 (Introductory Message B + Tobacco Use Message A + Incentive)<br>Participants will receive two framed messages (BA) plus an incentive | Behavioral: Framed Introductory Message B<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).<br>Behavioral: Framed Tobacco Use Message A<br>* Randomly assign patients to receive norming message related to tobacco use (version A).<br>Behavioral: Financial Incentive<br>* Randomly assigned patients to be entered into a drawing to receive a $100 gift card.<br>|
| Experimental: Arm 6 (Introductory Message B + Tobacco Use Message A)<br>Participants will receive two framed messages (BA) | Behavioral: Framed Introductory Message B<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).<br>Behavioral: Framed Tobacco Use Message A<br>* Randomly assign patients to receive norming message related to tobacco use (version A).<br>|
| Experimental: Arm 7 (Introductory Message B + Tobacco Use Message B + Incentive)<br>Participants will receive two framed messages (BB) plus an incentive | Behavioral: Framed Introductory Message B<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).<br>Behavioral: Framed Tobacco Use Message B<br>* Randomly assign patients to receive norming message related to tobacco use (version B).<br>Behavioral: Financial Incentive<br>* Randomly assigned patients to be entered into a drawing to receive a $100 gift card.<br>|
| Experimental: Arm 8 (Introductory Message B + Tobacco Use Message B)<br>Participants will receive two framed messages (BB) | Behavioral: Framed Introductory Message B<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).<br>Behavioral: Framed Tobacco Use Message B<br>* Randomly assign patients to receive norming message related to tobacco use (version B).<br>|
| Experimental: Arm 9 (Introductory Message C + Tobacco Use Message A + Incentive)<br>Participants will receive two framed messages (CA) plus an incentive | Behavioral: Framed Introductory Message C<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).<br>Behavioral: Framed Tobacco Use Message A<br>* Randomly assign patients to receive norming message related to tobacco use (version A).<br>Behavioral: Financial Incentive<br>* Randomly assigned patients to be entered into a drawing to receive a $100 gift card.<br>|
| Experimental: Arm 10 (Introductory Message C + Tobacco Use Message A)<br>Participants will receive two framed message (CA) | Behavioral: Framed Introductory Message C<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).<br>Behavioral: Framed Tobacco Use Message A<br>* Randomly assign patients to receive norming message related to tobacco use (version A).<br>|
| Experimental: Arm 11 (Introductory Message C + Tobacco Use Message B + Incentive)<br>Participants will receive two framed messages (CB) plus an incentive | Behavioral: Framed Introductory Message C<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).<br>Behavioral: Framed Tobacco Use Message B<br>* Randomly assign patients to receive norming message related to tobacco use (version B).<br>Behavioral: Financial Incentive<br>* Randomly assigned patients to be entered into a drawing to receive a $100 gift card.<br>|
| Experimental: Arm 12 (Introductory Message C + Tobacco Use Message B)<br>Participants will receive two framed messages (CB) | Behavioral: Framed Introductory Message C<br>* Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).<br>Behavioral: Framed Tobacco Use Message B<br>* Randomly assign patients to receive norming message related to tobacco use (version B).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Full Survey Completion | The proportion of participants that answers all three survey questions via text message among all those randomized. | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Partial Survey Completion | The proportion of participants that answer at least one of three survey questions via text message among all those randomized. | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lung Cancer Screening