Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

Carter‐Harris, Lisa; Davis, Lorie L.; Rawl, Susan M.

doi:10.1891/1541-6577.30.4.333

Cited by 37 publications

(44 citation statements)

References 59 publications

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“…[5][6][7][8][9] We developed a conceptual model to explain lung cancer screening behaviour from the perspective of the individual making the decision to screen or not (Figure 1). 10 The Conceptual Model for Lung Cancer Screening Participation is based on: (i) empirically supported theoretical linkages from a comprehensive literature review;…”

Section: Introductionmentioning

confidence: 99%

“…(ii) screening-eligible individuals' perspectives of key Health Belief Model (HBM) constructs; and (iii) our preliminary focus group findings. 5,10 Our proposed framework depicts psychological variables as key factors in lung cancer screening behaviour, and links these and other factors to traditional HBM constructs that have predicted participation in screening for other cancers. 10 Linking the uniquely important psychological variables with traditional HBM constructs has the potential to offer new foundational knowledge needed to tailor future interventions for this high-risk population.…”

Section: Introductionmentioning

confidence: 99%

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Understanding lung cancer screening behaviour using path analysis

et al. 2019

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Objective Understanding lung cancer screening behaviour is crucial to identifying potentially modifiable factors for future intervention. Qualititative work has explored attitudes and beliefs about lung cancer screening from the perspective of the participant, but the theoretically grounded factors that influence screening-eligible individuals to screen are unknown. We tested an explanatory framework for lung cancer screening participation from the individual’s perspective. Methods Data were collected as part of a sequential explanatory mixed methods study, the quantitative component of which is reported here. A national purposive sample of 515 screening-eligible participants in the United States was recruited using Facebook-targeted advertisement. Participants completed surveys assessing constructs of the Conceptual Model for Lung Cancer Screening Participation. Path analysis was used to assess the relationships between variables. Results Path analyses revealed that a clinician recommendation to screen, higher self-efficacy scores, and lower mistrust scores were directly associated with screening participation (p < 0.05). However, the link between screening behaviour and self-efficacy appeared to be fully mediated by fatalism, lung cancer fear, lung cancer family history, knowledge of lung cancer risk and screening, income, clinician recommendation, and social influence (p < 0.05). Conclusions This study found that medical mistrust, self-efficacy, and clinician recommendation were significant in the decision of whether to screen for lung cancer. These findings offer insight into potentially modifiable targets most appropriate on which to intervene. This understanding is critical to design meaningful clinician- and patient-focused interventions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding lung cancer screening behaviour using path analysis

et al. 2019

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“…Guided by the Conceptual Model on Lung Cancer Screening Participation ( Carter-Harris et al, 2016 ), data were collected using a compilation of items and scales to assess lung cancer screening behavior, sociodemographic and health status characteristics (age, gender, race, geographic area of residence, income, education, insurance status, smoking status, and family history of lung cancer), and knowledge of lung cancer and screening. Geographic area of residence was categorized using address and zip code data to classify participants as residing in urban, suburban, or rural areas.…”

Section: Methodsmentioning

confidence: 99%

Understanding lung cancer screening behavior: Racial, gender, and geographic differences among Indiana long-term smokers

Carter‐Harris

Slaven

Monahan

et al. 2018

Preventive Medicine Reports

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Lung cancer screening is a relatively new screening option. Inequalities related to screening behavior have been documented in other types of cancer screening. Because stage at presentation drives mortality in lung cancer, it is critical to understand factors that influence screening behavior in lung cancer screening in order to intervene. However, we must first understand where disparities exist in lung cancer screening participation in order to effectively guide intervention efforts. Therefore, the purpose of this study was to determine the association of sociodemographic (including key disparity-related variables) and knowledge with lung cancer screening behavior. This cross-sectional, descriptive study used survey methodology to collect data from 438 screening-eligible individuals in the state of Indiana between January and February 2017 and measured sociodemographic variables and knowledge about lung cancer and screening. Key sociodemographic and health status characteristics associated with screening behavior included race, geographic area of residence, income, health insurance, and family history of lung cancer. Of the variables generally reflective of disparities, key differences were noted by race and geographic area of residence with total knowledge scores as well as screening behavior, respectively. Results indicate key differences in race and geographic area of residence that may perpetuate screening behavior disparities. We have a unique opportunity at this early implementation stage in lung cancer screening to learn what variables influence screening behavior from our target patient population. This knowledge can be used to design equitable patient outreach programs, meaningful, tailored patient engagement materials, and effective patient-clinician decision support tools.

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“…LungTalk is a computer-tailored decision support tool that is theoretically grounded in the conceptual model on lung cancer screening participation [ 21 ]. This model links the health belief model to the precaution adoption process model and includes key psychological variables (eg, stigma, mistrust, fatalism, fear, and worry) as factors that may influence an individual’s decision to screen, or not, for lung cancer [ 21 ]. The LungTalk prototype is an interactive program that includes audio, video, and animation segments with tailoring algorithms for scripts presented from the master content library.…”

Section: Methodsmentioning

confidence: 99%

Development and Usability Testing of a Computer-Tailored Decision Support Tool for Lung Cancer Screening: Study Protocol

Carter‐Harris¹,

Comer²,

Goyal³

et al. 2017

JMIR Res Protoc

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BackgroundAwareness of lung cancer screening remains low in the screening-eligible population, and when patients visit their clinician never having heard of lung cancer screening, engaging in shared decision making to arrive at an informed decision can be a challenge. Therefore, methods to effectively support both patients and clinicians to engage in these important discussions are essential. To facilitate shared decision making about lung cancer screening, effective methods to prepare patients to have these important discussions with their clinician are needed.ObjectiveOur objective is to develop a computer-tailored decision support tool that meets the certification criteria of the International Patient Decision Aid Standards instrument version 4.0 that will support shared decision making in lung cancer screening decisions.MethodsUsing a 3-phase process, we will develop and test a prototype of a computer-tailored decision support tool in a sample of lung cancer screening-eligible individuals. In phase I, we assembled a community advisory board comprising 10 screening-eligible individuals to develop the prototype. In phase II, we recruited a sample of 13 screening-eligible individuals to test the prototype for usability, acceptability, and satisfaction. In phase III, we are conducting a pilot randomized controlled trial (RCT) with 60 screening-eligible participants who have never been screened for lung cancer. Outcomes tested include lung cancer and screening knowledge, lung cancer screening health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy), perception of being prepared to engage in a patient-clinician discussion about lung cancer screening, occurrence of a patient-clinician discussion about lung cancer screening, and stage of adoption for lung cancer screening.ResultsPhases I and II are complete. Phase III is underway. As of July 15, 2017, 60 participants have been enrolled into the study, and have completed the baseline survey, intervention, and first follow-up survey. We expect to have results by December 31, 2017 and to have data analysis completed by March 1, 2018.ConclusionsResults from usability testing indicate that the computer-tailored decision support tool is easy to use, is helpful, and provides a satisfactory experience for the user. At the conclusion of phase III (pilot RCT), we will have preliminary effect sizes to inform a future fully powered RCT on changes in (1) knowledge about lung cancer and screening, (2) perceived risk of lung cancer, (3) perceived benefits of lung cancer screening, (4) perceived barriers to lung cancer screening, (5) self-efficacy for lung cancer screening, and (6) perceptions of being adequately prepared to engage in a discussion with their clinician about lung cancer screening.

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Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

Cited by 37 publications

References 59 publications

Understanding lung cancer screening behaviour using path analysis

Understanding lung cancer screening behaviour using path analysis

Understanding lung cancer screening behavior: Racial, gender, and geographic differences among Indiana long-term smokers

Development and Usability Testing of a Computer-Tailored Decision Support Tool for Lung Cancer Screening: Study Protocol

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