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Multilevel Interventions to Increase Adherence to Lung Cancer Screening

Not Applicable
Conditions
Lung Cancer
Lung Cancer Screening
Interventions
Other: Patient Education
Other: Stepped Reminders
Registration Number
NCT05747443
Lead Sponsor
Kaiser Permanente
Brief Summary

Screening for lung cancer has the potential for a profound public health benefit. Repeat annual screening is necessary for early detection of lung cancer. The investigators will test two interventions which include patient education and reminders to improve adherence to lung cancer screening.

Detailed Description

Screening for lung cancer has the potential for a profound public health benefit.

Successful population-based screening requires continuous monitoring to adherence repeat screening in high risk adults to achieve similar results. Repeat annual screening is necessary for early detection of lung cancer. Baseline or first LDCT scans detect prevalent lung cancer, when subsequent screening detects new nodules. However, adherence to screening is low, ranging at 28-38% from centers nationally.

The investigators developed two novel, patient-centered interventions to address patient education and offering reminders for on-time screening. To address these goals, the specific aims are to: 1) Compare effectiveness of two multilevel interventions relative to usual care in improving (a) rates of adherence to lung cancer screening, (b) patient-centered outcomes; and (c) clinic outcomes; and 2) Determine the patient-, clinician-, and system-level factors that influence changes in adherence to inform lung cancer screening programs.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
1606
Inclusion Criteria
  • KPWA members
  • Aged 50-78 years
  • Have a negative screening LDCT scan
  • Speak English or Spanish
  • Meet US Preventive Services Task Force guidelines
Exclusion Criteria
  • Patients who were previously diagnosed with lung cancer,
  • Patients who have a positive scan,
  • Patients who have an indicator for interpreter services, except for Spanish

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Patient Video onlyPatient EducationAbout 3 weeks after the index LDCT, the study Medical Assistant (MA) will deliver a link to the Patient Voices Video, an educational video about lung cancer screening.
Patient Video and Stepped RemindersStepped RemindersSee above. Those assigned to the Patient Video and Stepped Reminders will receive both interventions, as described above.
Stepped Reminders onlyStepped RemindersPrior to patient's next LDCT scan is due, MA begins Stepped Reminders intervention: MA pends LDCT orders to PCP to sign. MA sends reminders to patient when order is placed and follows up by phone if patient has not scheduled LDCT.
Patient Video and Stepped RemindersPatient EducationSee above. Those assigned to the Patient Video and Stepped Reminders will receive both interventions, as described above.
Primary Outcome Measures
NameTimeMethod
Rate of repeat annual lung cancer screening9-15 months after index LDCT

Electronic health records will be searched for screening low dose CT (LDCT).

Secondary Outcome Measures
NameTimeMethod
Knowledge of lung cancer screening8 weeks after index LDCT

Knowledge of lung cancer screening eligibility, time to return and cost on patient reported outcomes survey.

Attitudes and beliefs8 weeks after index LDCT

The Lung Cancer Screening Health Belief Scale measures self-efficacy for lung cancer screening. The self-efficacy for lung cancer screening scale ranges from 9-36, with higher scores indicating lower self-efficacy.

Trial Locations

Locations (1)

Kaiser Permanente

🇺🇸

Seattle, Washington, United States

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