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| ID | Type | Description | Link |
|---|---|---|---|
| UCI 23-219 | Other Identifier | CFCCC |
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| Name | Class |
|---|---|
| Radiological Society of North America | OTHER |
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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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A: Enhanced Usual Care | Experimental | Usual Care + Brief Educational Material |
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| Arm B: Empower Latinx | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Usual Care | Other | The usual care includes a provider flag in electronic medical record (EMR) on patients' eligibility for LCS if their smoking history is complete. |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with order of Low-dose CT (LDCT) for lung cancer screening (LCS) | Within 4 months of randomization |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants who received LDCT for LCS | Within 4 months of randomization | |
| Number of Participants with the documented discussion of lung cancer screening with their providers in the electronic medical record | Within 4 months of randomization |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gelareh Sadigh, MD | University of California, Irvine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCI Health Family Health Center - Anaheim | Anaheim | California | 92801 | United States | ||
| UCI Health-Costa Mesa |
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| Brief Patient Education | Behavioral | Brief one-page education material on lung cancer screening benefits and risk |
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| Patient education | Behavioral | Patients will be sent information (in preferred language) on lung cancer risk, lung cancer screening (LCS) benefits, harms, false positive rates, recommendations of follow-up for positive results, and exam insurance coverage. |
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| Referral to financial navigation resources | Behavioral | Patients who self-report needing help with health-related social risks at baseline will be sent a brochure (in preferred language) from patient advocate foundation (PAF), a national non-profit financial navigation organization, where patients can self-refer. |
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| Patient Reminders | Behavioral | within 2 weeks prior to appointment, patients will receive a text message or a phone call (if not having a phone that receives text messaging) encouraging patients to discuss lung cancer screening with their provider. |
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| Provider Reminders | Behavioral | Within 2 weeks prior to primary care appointment, providers will be notified of their patient's eligibility for lung cancer screening and their reported barriers. |
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| Patients' perceived risk of lung cancer | 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. | Baseline and 4 months after randomization |
| Patients' perceived severity of lung cancer | 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. | Baseline and 4 months after randomization |
| Patients' perceived benefits of lung cancer screening | 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. | Baseline and 4 months after randomization |
| Patients' perceived barriers of lung cancer screening | 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. | Baseline and 4 months after randomization |
| Patients' self-efficacy of lung cancer screening | 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. | Baseline and 4 months after randomization |
| Patients' knowledge about lung cancer screening | 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. | Baseline and 4 months after randomization |
| Costa Mesa |
| California |
| 92627 |
| United States |
| UCI Health-Irvine | Irvine | California | 92612 | United States |
| UCI Health-Laguna hilla | Laguna Hills | California | 92653 | United States |
| UCI Health-Newport | Newport Beach | California | 92660 | United States |
| UCI Health SeniorHealth Center -Pavillion 4 | Orange | California | 92868 | United States |
| UCI Medical Center, Pavilion 3 | Orange | California | 92868 | United States |
| UCI Health Family Health Center - Santa Ana | Santa Ana | California | 92701 | United States |
| UCI-Health Tustin | Tustin | California | 92780 | United States |
| UCI Health-Yorba Linda | Yorba Linda | California | 92886 | United States |
| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D010353 | Patient Education as Topic |
| ID | Term |
|---|---|
| D006266 | Health Education |
| D011314 | Preventive Health Services |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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