Improving Lung Cancer Screening Adherence by Overcoming Barriers for Vulnerable Populations

Completed

• Conditions: Lung Carcinoma
• Interventions: Other: Survey Administration; Other: Electronic Health Record Review

• Registration Number: NCT04969341
• Lead Sponsor: Thomas Jefferson University

Brief Summary

This study investigates multi-level barriers to lung cancer screening uptake and adherence to lung cancer screening. Identifying cost- and convenience-related barriers to lung cancer screening may help researchers develop targeted strategies to facilitate screening adherence specifically among vulnerable populations.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-05-05
• Study First Submitted: 2021-07-06
• Study First Submitted QC: 2021-07-19
• Study First Posted: 2021-07-20
• Primary Completion: 2023-05-30
• Study Completion: 2023-05-30
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-15
• Last Update Posted: 2025-05-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 947

Inclusion Criteria

• All patients referred to the Jefferson LCSP and eligible for lung cancer screening by our standard criteria (United States Preventive Services Task Force, Center for Medicaid and Medicare Services, and/or National Comprehensive Cancer Network group II guidelines) will be eligible for inclusion in the study
• Additionally, individuals must provide a signed and dated informed consent form to participate in the survey portion of this study

Exclusion Criteria

• Non-English-speaking individuals
• Individuals who lack consent capacity

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Screening (survey, medical record review)	Electronic Health Record Review	Patients complete survey over 20 minutes consisting of validated and piloted items related to cost and convenience barriers in lung cancer screening, personal financial and lung cancer risk perception questions, and the Telehealth Satisfaction and Usefulness questionnaire. Patients also have their medical records reviewed retrospectively.
Screening (survey, medical record review)	Survey Administration	Patients complete survey over 20 minutes consisting of validated and piloted items related to cost and convenience barriers in lung cancer screening, personal financial and lung cancer risk perception questions, and the Telehealth Satisfaction and Usefulness questionnaire. Patients also have their medical records reviewed retrospectively.

Primary Outcome Measures

Name	Time	Method
Associations between health insurance availability and financial burdens as factors in lung cancer screening adherence	Up to study completion; 15 months	Individual-level insurance status will be analyzed for association with lung cancer screening adherence. Descriptive analyses of neighborhood factors will be conducted to characterize residential computed tomography (CT)s. Multilevel logistic regression models examining the relationship between screening adherence and each neighborhood factor (i.e., one per model for each CT) and will be adjusted for important individual-level covariates, such as patient age, sex, and smoking status. To address the dependence of the neighborhood factors on race in predicting screening adherence, the modeling results will be focused on interaction terms to examine interactions between race and neighborhood factors.
Individual-level cost-related factors associated with screening adherence	Up to study completion; 15 months	Will use generalized linear mixed effects logistic regression to model the longitudinal adherence to lung cancer screening as a function of cost-related variables, race, and their interactions. The model will be used to estimate odds ratios representing how adherence associated with financial variables depends on race at each follow-up CT scan.
Convenience-related factors that impact lung cancer screening adherence	Up to study completion; 15 months	Will assess convenience-related factors that may affect lung cancer screening uptake and adherence. Survey items will address technology and internet accessibility; preferred methods for patient communication; effectiveness of patient navigation; and identification of logistical barriers along each step of the screening workflow including referral, eligibility assessment, scheduling, shared decision-making (SDM) visit, low dose CT (LDCT), results review, and follow-up instructions.

Trial Locations

Locations (1)

Thomas Jefferson University Hospital; 🇺🇸 Philadelphia, Pennsylvania, United States