Education and Reminders for Lung Cancer Screening

Recruiting at 9 trial locations

Overseen By Richard Echeverria

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Irvine

Disqualifiers: Lung cancer, Chest CT, Alzheimer's, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

60 Participants Needed

Trial Summary

What is the purpose of this trial?

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.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on lung cancer screening and education, so it's unlikely that you would need to change your medications, but you should confirm with the trial coordinators.

What data supports the effectiveness of the treatment Empower Latinx for lung cancer screening?

The study on a cancer education-plus-navigation intervention showed that using community health workers to provide education and guidance significantly increased cancer screening rates among Latinos. This suggests that similar educational and navigational strategies, like those potentially used in Empower Latinx, could effectively improve lung cancer screening participation. ^{1 2 3 4 5}

Is the Education and Reminders for Lung Cancer Screening program safe for humans?

The research articles provided do not contain specific safety data for the Education and Reminders for Lung Cancer Screening program or its related names like Empower Latinx. They focus on awareness, barriers, and participation in lung cancer screening rather than safety information. ^{1 4 5 6 7}

How does the Empower Latinx treatment for lung cancer screening differ from other treatments?

The Empower Latinx treatment is unique because it focuses on culturally tailored education and reminders specifically for the Latinx community to increase awareness and participation in lung cancer screening, unlike standard treatments that may not address cultural and community-specific barriers. ^{4 5 8 9 10}

Research Team

Gelareh Sadigh, MD

Principal Investigator

University of California, Irvine

Eligibility Criteria

This trial is for Hispanic individuals aged 50-80 who are current or former smokers (quit within the last 15 years) with a history of heavy smoking. They must have an upcoming primary care appointment and be able to speak English or Spanish. It's focused on those in Orange County attending UCI Health clinics.

Inclusion Criteria

I can speak both English and Spanish.

Current smoker or a former smoker who has quit smoking within the last 15 years (based on survey self-report)

History of 20-pack year smoking history (based on survey self-report)

Exclusion Criteria

I had a chest CT scan in the last year.

I have had lung cancer before.

I have been diagnosed with Alzheimer's disease or dementia.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a multi-level intervention including PCP notifications, education, financial navigation resources, and reminders to discuss LCS during PCP visits

4 months

Follow-up

Participants are monitored for changes in knowledge, perceived benefits, barriers, self-efficacy, risk, and severity of lung cancer screening

4 months

Qualitative Assessment

Patient and provider experiences with the intervention are assessed through qualitative interviews

3-6 months after follow-up

Treatment Details

Interventions

• Empower Latinx

Trial Overview The study tests if reminders to patients and providers, patient education, and financial navigation aid can increase lung cancer screenings using low dose CT scans compared to enhanced usual care. The goal is early detection of lung cancer in the Hispanic community.

Participant Groups

Group I: Arm B: Empower Latinx Experimental Treatment 5 Interventions

* 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.

Group II: Arm A: Enhanced Usual Care Experimental Treatment 2 Interventions

Usual Care + Brief Educational Material

Who Is Running the Clinical Trial?

University of California, Irvine

Lead Sponsor

Trials

580

Recruited

4,943,000+

Radiological Society of North America

Collaborator

Trials

27

Recruited

1,000+

Findings from Research

A study of 438 individuals in Indiana revealed that sociodemographic factors such as race, geographic location, income, and health insurance significantly influence lung cancer screening behavior.

The research identified disparities in screening participation based on race and residence, highlighting the need for targeted outreach and educational programs to improve screening rates among underrepresented groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding lung cancer screening behavior: Racial, gender, and geographic differences among Indiana long-term smokers. Carter-Harris, L., Slaven, JE., Monahan, PO., et al.[2023]

A systematic review of 21 studies revealed significant disparities in lung cancer screening (LCS) outcomes for Black and socioeconomically disadvantaged individuals, highlighting that these groups often miss out on the benefits of LCS, which contributes to higher mortality rates from nonsmall cell lung cancer (NSCLC).

The study identified critical areas of inequity in the LCS pipeline, including eligibility criteria, utilization, and follow-up care, and recommends further research and targeted interventions to improve access and outcomes for marginalized populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review. Sosa, E., D'Souza, G., Akhtar, A., et al.[2022]

The community health worker (CHW) intervention successfully enrolled 3,045 Latino men and women, leading to a 71% cancer screening rate among participants, which is a significant increase compared to previous rates.

The intervention not only improved cancer screening rates but also enhanced participants' knowledge of screening guidelines and their belief in the importance of early detection, demonstrating its effectiveness in addressing health disparities in underserved populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Cancer Education-Plus-Navigation Intervention Implemented Within a Federally Qualified Health Center and Community-Based Settings. Mojica, CM., Almatkyzy, G., Morales-Campos, D.[2021]

In a study conducted at an urban Native American clinic, two culturally targeted promotion strategies for lung cancer screening resulted in low scheduling rates for shared decision-making visits, with only 8.5% of eligible patients participating.

Despite ordering lung cancer screening CT exams, only about 50% of those exams were completed, highlighting a significant gap that suggests the need for more effective interventions to encourage follow-through on screenings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lung Cancer Screening Outreach Program in an Urban Native American Clinic. Robichaux, C., Anderson, M., Freese, R., et al.[2023]

52% of current and former smokers were aware of low-dose computed tomography (LDCT) lung cancer screening, indicating a significant gap in awareness that needs to be addressed.

Former smokers showed greater awareness of lung cancer screening compared to current smokers, and a high percentage (80.6%) of those who had never been screened expressed willingness to undergo screening if recommended by their doctor, highlighting the importance of physician encouragement for eligible patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Awareness and interest in lung cancer screening among current and former smokers: findings from the ITC United States Survey. Sharma, A., Kasza, K., Hyland, A., et al.[2019]

A randomized controlled trial involving 225 patients showed that telephone-based navigation significantly helped identify and address barriers to lung cancer screening, with personal and provider-related issues being the most common.

Provider-related barriers decreased by 80% during the screening process, indicating that patient navigation can effectively improve access to lung cancer screening, especially among minority and underserved populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing Barriers and Facilitators to Lung Cancer Screening: Initial Findings from a Patient Navigation Intervention. Lee, SJC., Lee, J., Zhu, H., et al.[2023]

The Native Cancer 101 Module 10 workshops significantly increased cancer screening knowledge among participants by 25.20%, with 97.1% expressing a willingness to recommend the workshop to others.

Following the workshops, 46.3% of participants reported completing at least one cancer screening test, demonstrating the workshops' effectiveness in encouraging cancer screening within the American Indian community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How can an Education Workshop Serve as an Intervention for American Indian Screening Participation. Burhansstipanov, L., Harjo, L., Kaur, JS.[2020]

In a survey of 460 older smokers, Latinos were more likely to believe that lung cancer could be prevented compared to non-Latinos (74.6% vs. 48.2%), indicating a more optimistic perception about lung cancer prevention.

When informed about lung screening, a significantly higher percentage of Latinos expressed interest in being screened (90.7% vs. 67% for non-Latinos), and they reported fewer barriers to accessing lung screening services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Barriers to and Interest in Lung Cancer Screening Among Latino and Non-Latino Current and Former Smokers. Percac-Lima, S., Ashburner, JM., Atlas, SJ., et al.[2021]

The Lung AIR intervention effectively increased knowledge and reduced fear about lung cancer screening among 292 participants, demonstrating its feasibility as a community-based educational program.

One-on-one phone sessions were particularly effective, leading to greater increases in participants' intention to complete screening compared to in-person group sessions, especially among those with lower income and higher smoking rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. Bouchard, EG., Saad-Harfouche, FG., Clark, N., et al.[2023]

The Cultivando la Salud (CLS) intervention, implemented by lay health workers, significantly increased breast and cervical cancer screening rates among low-income Hispanic women, with mammography rates rising to 40.8% compared to 29.9% in the control group, and Pap test rates increasing to 39.5% versus 23.6%.

The intervention improved participants' self-efficacy and perceptions related to cancer screening, indicating that enhancing confidence and awareness can positively influence screening behaviors, although it did not significantly change knowledge about Pap tests.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women. Fernández, ME., Gonzales, A., Tortolero-Luna, G., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Understanding lung cancer screening behavior: Racial, gender, and geographic differences among Indiana long-term smokers. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review. [2022]

3. England pubmed.ncbi.nlm.nih.gov

A Cancer Education-Plus-Navigation Intervention Implemented Within a Federally Qualified Health Center and Community-Based Settings. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Lung Cancer Screening Outreach Program in an Urban Native American Clinic. [2023]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Awareness and interest in lung cancer screening among current and former smokers: findings from the ITC United States Survey. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Assessing Barriers and Facilitators to Lung Cancer Screening: Initial Findings from a Patient Navigation Intervention. [2023]

7. England pubmed.ncbi.nlm.nih.gov

How can an Education Workshop Serve as an Intervention for American Indian Screening Participation. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Barriers to and Interest in Lung Cancer Screening Among Latino and Non-Latino Current and Former Smokers. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women. [2022]