Lung Cancer Screening Outreach Program in an Urban Native American Clinic

Abstract

Objectives: To evaluate uptake of lung cancer screening in an urban Native American clinic using 2 culturally targeted promotion strategies. Methods: Patients eligible for lung cancer screening from July 2019 to July 2021 were randomized to receive either a single culturally-targeted mailer from the clinic regarding possible eligibility for screening, or the same mailer plus a follow-up text message and additional mailing. Results: Overall, there were low rates of shared decision-making visit scheduling (8.5%) with no difference between promotion strategy groups (9.4% in control group vs 7.7% in culturally-targeted outreach group). Only about 50% of the lung cancer screening CT exams ordered were completed and returned to the clinic. Conclusions: While there was no difference between arms in this intervention, 8.5% of the sample did complete a shared decision-making visit after these low-cost interventions. The gap between the number of screening CTs ordered and number who completed the CT represents an area where further interventions should focus.

Understanding determinants of lung cancer preventive care in at-risk urban American Indians and Alaska Natives: A mixed-methods study

“…A few studies have specifically explored navigation among AI/AN participants in the context of cancer-related care, and though the navigation processes are not fully described, there appear to be improvements in engagement and satisfaction in care using these models ( Menon et al, 2022 , Grimes et al, 2017 , Petereit et al, 2008 ). Participants endorsed outreach and screening delivery outside the clinical setting, affirming that patient navigation may need to be combined with interventions impacting other levels, such as community-targeted outreach, to improve uptake of LCS ( Dignan et al, 2024 , Robichaux et al, 2023 ).…”

Inadequate Uptake of USPSTF-Recommended Low Dose CT Lung Cancer Screening

“…Also, investigators have recognized that barriers to SDM and LCS might differ in different populations. For example, Robichaux et al 44 assessed uptake of LCS in an urban Native American clinic by providing individuals either a single culturally-targeted mailer or the same mailer plus a follow-up text message and additional mailing. The investigators proposed that SDM discussions need to be personalized according to their patients notions about not just the harms, but the perceived benefits of tobacco.…”