Developing and testing a brief clinic‐based lung cancer screening decision aid for primary care settings

McDonnell, Karen Kane; Strayer, Scott M.; Sercy, Erica; Campbell, Callie; Friedman, Daniela B.; Cartmell, Kathleen B.; Eberth, Jan M.

doi:10.1111/hex.12675

Cited by 24 publications

(23 citation statements)

References 28 publications

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“…A study that included rural providers in New Mexico suggested that the development of decision-making tools, in conjunction with continuing medical education, would be the most effective way to ensure that providers are able to effectively educate their patients about LDCT screening. Decision aids have been tested in urban populations and have been found to be a helpful and effective tool to educate patients about LDCT screening [32,38,39]. However, when analyzed outside the intervention (eg, randomized trial) context, the quality and length of such screening discussions between patients and their providers is suboptimal, with virtually no mention of potential LDCT screening harms [40].…”

Section: Provider-patient Communicationmentioning

confidence: 99%

Challenges and Opportunities for Lung Cancer Screening in Rural America

Odahowski

Zahnd

Eberth

2019

Journal of the American College of Radiology

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Rural populations have higher rates of smoking and both lung cancer incidence and mortality compared with their urban peers. As such, it is imperative that high-risk, rural populations have access to recommended low-dose CT (LDCT) screening, which can detect lung cancer at an earlier, more treatable stage. Data from the 2015 National Health Interview Survey, a nationally representative survey, were analyzed to assess nonmetropolitan-metropolitan and geographic differences in LDCT utilization among screening-eligible individuals. Screening uptake did not differ by nonmetropolitan vs. metropolitan status (3.72% and 3.83%, respectively). Regional uptake varied from 1.58% in the West to 10.11% in the Northeast. Additionally, nonmetropolitan populations represent a disproportionately high 23% of the screening-eligible population despite accounting for only 15% of the US population. There are two key challenges to highquality LDCT screening experienced by rural populations: (1) geographic access to LDCT screening programs and (2) provider-patient communication. Despite the increased availability of LDCT screening centers since 2015, which is when most insurance plans began to cover the costs of screening, centers are geographically maldistributed relative to the rural-urban and regional need. Although decision aids can facilitate discussion between providers and patients regarding the risks and benefits of LDCT screening, research on the uptake and utility of these tools in rural areas is very limited. Analyses of population-based surveys and administrative and clinical data are needed to continue to surveil screening utilization, elucidate predictors of screening use, and inform shared decision-making tools and interventions for at-risk rural populations.

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Section: Provider-patient Communicationmentioning

confidence: 99%

Challenges and Opportunities for Lung Cancer Screening in Rural America

Odahowski

Zahnd

Eberth

2019

Journal of the American College of Radiology

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“…Figure 1 depicts the SHARED Project’s three key areas of innovation: (a) intentionally targeting black men as the population with the highest risk of lung cancer disparities, (b) engaging black male citizen scientists as an emerging community engagement model, and (c) integrating multiple theoretical frameworks. Citizen scientists will use the Integrated Model of Stages in the Cultural Adaption of Evidence-Based Intervention to adapt the Agency for Healthcare Research and Quality LDCT decision aid to the informational, language, and cultural needs of black men at an elevated risk of lung cancer (Carter-Harris & Gould, 2017; McDonnell et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

The SHARED Project: A Novel Approach to Engaging African American Men to Address Lung Cancer Disparities

et al. 2020

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Black men are disproportionately impacted by lung cancer morbidity and mortality. Low-dose helical computed tomography (LDCT) lung cancer screening has demonstrated benefits for reducing lung cancer deaths by identifying cancers at earlier, more treatable stages. Despite the known benefits, LDCT screening is underutilized in black men. Studies in racially heterogeneous populations have found correlations between screening behaviors and factors such as physician trust, physician referral, and a desire to reduce the uncertainty of not knowing if they had lung cancer; yet little is known about the factors that specifically contribute to screening behaviors in black men. Community engagement strategies are beneficial for understanding barriers to health-care engagement. One community engagement approach is the citizen scientist model. Citizen scientists are lay people who are trained in research methods; they have proven valuable in increasing communities’ knowledge of the importance of healthy behaviors such as screening, awareness of research, building trust in research, and improving study design and ethics. This paper proposes an intervention, grounded in community-based participatory research approaches and social network theory, to engage black men as citizen scientists in an effort to increase lung cancer screening in black men. This mixed-methods intervention will examine the attitudes, behaviors, and beliefs of black men related to uptake of evidence-based lung cancer screening.

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“…In the United States, joint discussions between patients and health care providers have been mandated by Medicare in the lung screening process to support informed decision making . Supporting informed and equitable lung screening uptake is an anticipated challenge in the UK . Decisions about screening uptake require weighing up complicated information and a high degree of “health literacy”, the comprehension of health information in order to make a well‐founded choice.…”

Section: Discussionmentioning

confidence: 99%

“…Poor levels of health literacy found have also been found in older UK smokers, the key target group for lung screening. In the United States, some decision aids have been developed and tested with promising results for supporting decision making; however, the readability of online aids has been challenged and further testing is needed . In the UK, there are currently no guidelines for developing quality assured lung screening patient literature or established decision‐making tools.…”

Section: Discussionmentioning

confidence: 99%

“To know or not to know…?” Push and pull in ever smokers lung screening uptake decision‐making intentions

Tonge

Atack

Barber

et al. 2018

Health Expectations

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Background In the United States, lung cancer screening aims to detect cancer early in nonsymptomatic current and former smokers. A lung screening pilot service in an area of high lung cancer incidence in the United Kingdom has been designed based on United States trial evidence. However, our understanding of acceptability and reasons for lung screening uptake or decline in a United Kingdom nontrial context are currently limited. Objective To explore with ever smokers the acceptability of targeted lung screening and uptake decision‐making intentions. Design Qualitative study using semistructured focus groups and inductive thematic analysis to explore acceptability and uptake decision‐making intentions with people of similar characteristics to lung screening eligible individuals. Setting and participants Thirty‐three participants (22 ex‐smokers; 11 smokers) men and women, smokers and ex‐smokers, aged 50‐80 were recruited purposively from community and health settings in Manchester, England. Results Lung screening was widely acceptable to participants. It was seen as offering reassurance about lung health or opportunity for early detection and treatment. Participant's desire to know about their lung health via screening was impacted by perceived benefits; emotions such as worry about a diagnosis and screening tests; practicalities such as accessibility; and smoking‐related issues including perceptions of individual risk and smoking stigma. Discussion Decision making was multifaceted with indications that current smokers faced higher participation barriers than ex‐smokers. Reducing participation barriers through careful service design and provision of decision support information will be important in lung screening programmes to support informed consent and equitable uptake.

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Developing and testing a brief clinic‐based lung cancer screening decision aid for primary care settings

Cited by 24 publications

References 28 publications

Challenges and Opportunities for Lung Cancer Screening in Rural America

Challenges and Opportunities for Lung Cancer Screening in Rural America

The SHARED Project: A Novel Approach to Engaging African American Men to Address Lung Cancer Disparities

“To know or not to know…?” Push and pull in ever smokers lung screening uptake decision‐making intentions

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