Empowering Hispanic Patients' Lung Cancer Screening Uptake (Empower Latinx)
- Conditions
- Lung Cancer
- Interventions
- Other: Usual CareBehavioral: Brief Patient EducationBehavioral: Patient educationBehavioral: Referral to financial navigation resourcesBehavioral: Patient RemindersBehavioral: Provider Reminders
- Registration Number
- NCT06225414
- Lead Sponsor
- University of California, Irvine
- Brief Summary
The Hispanic/Latinx community (hereafter Hispanic) is the country's second-largest racial/ethnic group, accounting for 19.1% of the total population. However, they remain one of the most underserved populations with suboptimal access to healthcare and screening services due to low income, lack of health insurance, perceived discrimination, language barriers, and limited health literacy. Lung cancer is the leading cause of cancer related mortality with 1.8 million annual deaths worldwide, with Hispanic patients known to have lower survival rates compared with non-Hispanic whites. Lung cancer screening (LCS) with low dose computed tomography (LDCT) decreases this mortality rate of lung cancer by 20%. Yet many Latinx patients who are eligible for lung cancer screening are still falling through the cracks which prevents patients the ability to detect lung cancer early. This study will test and compare the effect of a multi-level intervention on ordering LDCT within 4 months after patient enrollment to those in an Enhanced Usual Care. Our proposed intervention includes:
* Primary care provider notifications of patients' LCS eligibility;
* Patients' education;
* Patients' referral to financial navigation resources;
* Patients' reminder to discuss LCS during primary care provider (PCP) visit.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 60
- Aged 50- 80 years of age.
- Be able to speak English and Spanish
- Must have a scheduled appointment with their Primary Care Providers within next one to three months.
- The Scheduled PCP appointment is at any of the 4 University of California Irvine Health (UCI Health) primary care clinics in Orange County including two UCI federally qualified health centers
- History of 20-pack year smoking history ( based on survey self-report)
- Current smoker or a former smoker who has quit smoking within the last 15 years (based on survey self-report)
- Prior history of lung cancer
- Chest CT for any reason in the last 12 months based on self-report and UCI EMR
- History of Alzheimer's disease or dementia
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm A: Enhanced Usual Care Usual Care Usual Care + Brief Educational Material Arm A: Enhanced Usual Care Brief Patient Education Usual Care + Brief Educational Material Arm B: Empower Latinx Patient education * PCP notifications of patients' LCS eligibility (addressing provider time constraints and barrier in identifying eligible patients); * Patients' education (addressing knowledge barriers); * Patients' referral to financial navigation resources (addressing health-related social risks) * Patients' reminder to discuss LCS during PCP visit. Arm B: Empower Latinx Usual Care * PCP notifications of patients' LCS eligibility (addressing provider time constraints and barrier in identifying eligible patients); * Patients' education (addressing knowledge barriers); * Patients' referral to financial navigation resources (addressing health-related social risks) * Patients' reminder to discuss LCS during PCP visit. Arm B: Empower Latinx Referral to financial navigation resources * PCP notifications of patients' LCS eligibility (addressing provider time constraints and barrier in identifying eligible patients); * Patients' education (addressing knowledge barriers); * Patients' referral to financial navigation resources (addressing health-related social risks) * Patients' reminder to discuss LCS during PCP visit. Arm B: Empower Latinx Patient Reminders * PCP notifications of patients' LCS eligibility (addressing provider time constraints and barrier in identifying eligible patients); * Patients' education (addressing knowledge barriers); * Patients' referral to financial navigation resources (addressing health-related social risks) * Patients' reminder to discuss LCS during PCP visit. Arm B: Empower Latinx Provider Reminders * PCP notifications of patients' LCS eligibility (addressing provider time constraints and barrier in identifying eligible patients); * Patients' education (addressing knowledge barriers); * Patients' referral to financial navigation resources (addressing health-related social risks) * Patients' reminder to discuss LCS during PCP visit.
- Primary Outcome Measures
Name Time Method Number of participants with order of Low-dose CT (LDCT) for lung cancer screening (LCS) Within 4 months of randomization
- Secondary Outcome Measures
Name Time Method Number of Participants who received LDCT for LCS Within 4 months of randomization Patients' perceived severity of lung cancer Baseline and 4 months after randomization 5-items about the health consequences and severity of lung cancer will be used. The responses for each item will be based on a 5-point likert scale. A sum score will be calculated based on responses to all items. Score will range between 5-25. Higher score= higher perceived benefits.
Patients' self-efficacy of lung cancer screening Baseline and 4 months after randomization 10-item self-efficacy for lung cancer screening questionnaire will be used. 9 of these items were developed by Carter Harris et al (Cancer Nurs, 2018). The responses for each item will be based on a 5-point likert scale. A sum score will be calculated based on responses to all 9 validated item. Score will range between 9 and 45. Higher score= higher self-efficacy. An additional score including all 10 items will also be calculated.
Patients' knowledge about lung cancer screening Baseline and 4 months after randomization 9 questions adopted and modified from Volk R et al (PMID: 24518006) will be used. Responses will be based on true, false, unsure. Sum of correctly responded questions will be calculated. Higher score= higher knowledge.
Number of Participants with the documented discussion of lung cancer screening with their providers in the electronic medical record Within 4 months of randomization Patients' perceived barriers of lung cancer screening Baseline and 4 months after randomization 19-item perceived barriers of lung cancer questionnaire will be used. 17 of these items were developed by Carter Harris et al (Cancer Nurs, 2018). The responses for each item will be based on a 5-point likert scale. A sum score will be calculated based on responses to all 17 validated items. Score will range between 17 and 85. Higher score= higher perceived barriers. An additional score including all 19 items will also be calculated.
Patients' perceived risk of lung cancer Baseline and 4 months after randomization 3-item perceived risk of lung cancer questionnaire developed by Carter Harris et al (Cancer Nurs, 2018) will be used. The responses for each item will be based on a 5-point likert scale. A sum score will be calculated based on responses to all 3 item. Score will range between 3 and 15. Higher score= higher perceived risk.
Patients' perceived benefits of lung cancer screening Baseline and 4 months after randomization 6-item perceived benefit of lung cancer questionnaire developed by Carter Harris et al (Cancer Nurs, 2018) will be used. The responses for each item will be based on a 5-point likert scale. A sum score will be calculated based on responses to all items. Score will range between 6-30. Higher score= higher perceived benefits.
Trial Locations
- Locations (4)
UCI Health Family Health Center - Anaheim
🇺🇸Anaheim, California, United States
UCI Health SeniorHealth Center -Pavillion 4
🇺🇸Orange, California, United States
UCI Medical Center, Pavilion 3
🇺🇸Orange, California, United States
UCI Health Family Health Center - Santa Ana
🇺🇸Santa Ana, California, United States