Digital Outreach Intervention for Lung Cancer Screening

A Pragmatic Randomized-Controlled Trial of a Digital Outreach Intervention for Lung Cancer Screening: mPATH-Lung (Mobile Patient Technology for Health-Lung)

mPATH-Lung (mobile Patient Technology for Health - Lung) is an innovative digital outreach program that identifies patients who qualify for lung cancer screening and helps them get screened. The study will: 1) Determine the effect of mPATH-Lung on receipt of lung cancer screening in a pragmatic randomized-controlled trial conducted with primary care patients in two large health networks, 2) Elucidate the drivers of patients' screening decisions and screening behavior; and 3) Explore implementation outcomes that will impact the sustainability and dissemination of mPATH-Lung using program data, surveys, and interviews.

This project will determine how mPATH-Lung affects patients' screening decisions and their completion of screening.

Primary Objective: Determine the effectiveness of mPATH-Lung on receipt of LCS in a randomized pragmatic clinical trial of 1318 patients recruited from two large health networks, Wake Forest Baptist Health and the University of North Carolina at Chapel Hill.

Secondary Objectives:

• Elucidate the drivers of patients' decisions to receive or forgo LCS through a values clarification exercise embedded within mPATH-Lung and supplemental semi-structured interviews of at least 50 patients.
• Assess several critical implementation outcomes (reach, acceptability, and appropriateness) to inform the sustainability and scalability of mPATH-Lung across diverse primary care settings

Inclusion Criteria:

• Meet the Medicare criteria for lung cancer screening, as updated in February 2022:

  • Age 50 - 77 years
  • Smoked at least 20 pack years
  • Current smoker or quit smoking within the past 15 years

• Be scheduled to see a primary care provider within the health network in the next 3-4 weeks

• Have a patient portal account or cellphone number listed in the electronic health record

Exclusion Criteria:

• Patients flagged as needing a language interpreter in the electronic health record (electronic messages and intervention is delivered in English only).

• Those for whom lung cancer screening would be inappropriate:

  • Prior history of lung cancer
  • Chest CT within the last 12 months
  • Those with medical conditions predicting shorter life expectancy
  • Patients whose home address is not within the state of North Carolina. (Due to telehealth guidelines)