Health Communication Tool + SDoH Screening for Lung Cancer

Overseen By Francis Valenzona

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Hackensack Meridian Health

Disqualifiers: Lung cancer, Prior screening, others

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

Compensation: Varies

Number of Visits: 2

100 Participants Needed

Trial Summary

What is the purpose of this trial?

A multilevel lung screening intervention that pairs Social Determinants of Health (SDoH) screening and referral with a tailored health communication and decision support tool for lung screening has the potential to significantly impact lung screening uptake among at-risk individuals in the community, particularly among those who face barriers related to SDoH. In addition, findings will advance the understanding of effective strategies for improving lung screening and prevention efforts in non-traditional settings, with the ultimate goal of reducing the burden of lung cancer. As ways to support the realization of the public health benefit of lung cancer screening are considered, multiple strategies and venues to reach, and intervene, with screening-eligible is key. The goal of this study is to compare the effectiveness of a community-based lung screening educational tool paired with a social determinants of health (SDoH) screening assessment and referral process compared to a community-based lung cancer screening (LCS) educational tool alone as part of community outreach activities to improve (a) LCS rates (primary outcome); (b) intention to screen; and (c) individual-level potential drivers of LCS (health literacy, mistrust, stigma, fatalism, knowledge, health beliefs). It is hypothesized that providing SDoH screening and referral will result in higher levels of LCS, forward movement of intention to screen, and improved individual-level drivers of LCS.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Health Communication Tool + SDoH Screening for Lung Cancer?

Research shows that community-based educational interventions, like the Lung AIR program, can effectively increase knowledge and intention to complete lung cancer screening, especially when delivered one-on-one. Additionally, understanding social factors like income and geographic location can help tailor interventions to improve screening rates. ^{1 2 3 4 5}

Is the Health Communication Tool + SDoH Screening for Lung Cancer safe for humans?

The research articles do not provide specific safety data for the Health Communication Tool + SDoH Screening for Lung Cancer, but they discuss the importance of informed decision-making and communication about risks and benefits in lung cancer screening. ^{5 6 7 8 9}

How does the Health Communication Tool + SDoH Screening for Lung Cancer treatment differ from other treatments for lung cancer?

This treatment is unique because it combines community-based lung cancer screening with a focus on social determinants of health (SDoH), which are factors like income and access to healthcare that can affect a person's health. It aims to improve lung cancer screening rates by addressing these broader social factors and using a health communication tool to engage patients. ^{2 3 7 10 11}

Research Team

Lisa Carter-Bawa, PhD

Principal Investigator

Hackensack Meridian Health

Eligibility Criteria

This trial is for individuals aged 50-80 who can consent, currently smoke or quit within the last 15 years, have a history of significant smoking (20 pack-years), and have never had lung cancer screening. They must speak and understand English. Those with previous lung screenings or diagnosed with lung cancer are excluded.

Inclusion Criteria

I am between 50 and 80 years old.

Able to provide informed consent

You currently smoke or quit smoking within the past 15 years.

Exclusion Criteria

You have previously had a lung cancer screening scan.

I have been diagnosed with lung cancer.

Unable to speak and understand English

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Intervention

Participants receive a community-based lung cancer screening educational tool, with or without a social determinants of health screening assessment and referral process

1 day

1 visit (in-person)

Follow-up

Participants are monitored for lung cancer screening uptake and changes in individual-level drivers of lung cancer screening

3 months

Treatment Details

Interventions

• Current practice - Community-based lung cancer screening (LungTalk)
• Social determinants of health screening assessment and referral process

Trial Overview The study tests if adding a Social Determinants of Health (SDoH) assessment and referral process to a community-based educational tool improves lung cancer screening rates compared to just the educational tool alone in at-risk communities.

Participant Groups

Group I: Social determinants of health screening Experimental Treatment 2 Interventions

Participants will receive a social determinants of health screening assessment and referral process in addition to the community-based lung cancer screening educational tool.

Group II: Community-based lung cancer screening Active Control 1 Intervention

Participants will receive a community-based lung cancer screening educational tool.

Who Is Running the Clinical Trial?

Hackensack Meridian Health

Lead Sponsor

Trials

141

Recruited

42,900+

Becton, Dickinson and Company

Industry Sponsor

Trials

80

Recruited

92,000+

Tom Polen

Becton, Dickinson and Company

Chief Executive Officer since 2020

Bachelor’s degree from Salisbury University, MBA from Johns Hopkins University

Meera Gopalakrishnan

Becton, Dickinson and Company

Chief Medical Officer

Ph.D. in Biomedical Engineering from the University of Memphis

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]

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]

Out of 2,797 patients with scheduled lung cancer screening appointments, 32.7% of appointments were missed, highlighting a significant issue with adherence to screening protocols.

Social determinants of health, such as being self-reported Black or having Medicaid insurance, were linked to higher odds of missing appointments, indicating that targeted interventions are needed to address these disparities and improve access to lung cancer screening.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Social Determinants of Health on Lung Cancer Screening Utilization. Shin, D., Fishman, MDC., Ngo, M., et al.[2023]

Education delivered by community health advisors significantly improved lung cancer screening knowledge among high-risk individuals in Alabama, with knowledge scores increasing from an average of 4.64 to 7.61 after the intervention.

Despite the increase in knowledge, only 23 out of 100 participants underwent lung cancer screening, highlighting that structural barriers, such as lack of access to primary care and reluctance from providers, still limit effective utilization of lung cancer screening programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Community Health Advisors to Increase Lung Cancer Screening Awareness in the Black Belt: a Pilot Study. Niranjan, SJ., Opoku-Agyeman, W., Hardy, CM., et al.[2023]

In New York state, nearly half (48.3%) of lung cancer patients were diagnosed with late-stage disease, highlighting the need for improved access to lung cancer screening resources, especially in rural areas.

The study found that rural counties had fewer lung cancer screening centers and higher lung cancer mortality rates, indicating that geographic disparities in healthcare resources significantly impact patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Multilevel Approach to Investigate Relationships Between Healthcare Resources and Lung Cancer. Somayaji, D., Seo, YS., Wilding, GE., et al.[2023]

Lung cancer screening using low-dose computed tomography can significantly improve survival rates, yet it remains underutilized, especially among rural populations in the United States.

This scoping review aims to identify the barriers and facilitators affecting the uptake and adherence to lung cancer screening in rural areas, focusing on studies published since 2013 that meet specific inclusion criteria.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Barriers and facilitators for low-dose computed tomography lung cancer screening in rural populations in the United States: a scoping review protocol. Palokas, M., Hinton, E., Duhe, R., et al.[2023]

A focus group study involving 54 participants from Appalachian Kentucky revealed that most individuals were previously unaware of lung cancer screening with low-dose computed tomography (LDCT), highlighting the need for effective awareness campaigns.

Participants emphasized the importance of messaging that includes personal testimonies, hope, and the benefits of early detection, suggesting that communication from trusted healthcare providers is crucial for promoting lung cancer screening.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying Community Perspectives for a Lung Cancer Screening Awareness Campaign in Appalachia Kentucky: The Terminate Lung Cancer (TLC) Study. Cardarelli, R., Roper, KL., Cardarelli, K., et al.[2018]

A mobile lung cancer screening program in New York City successfully screened 216 patients, reaching a younger and more diverse demographic compared to traditional hospital-based screenings, which may help increase early detection of lung cancer.

The program identified lung cancer in 2 patients and significant non-lung cancer findings in 28.2% of participants, demonstrating the effectiveness of mobile screening in detecting serious health issues and the need for targeted outreach to high-risk populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Results from Lung Cancer Screening Outreach Utilizing a Mobile CT Scanner in an Urban Area. Pua, BB., O'Neill, BC., Ortiz, AK., et al.[2023]

The NHS England leaflet for the Targeted Lung Health Check (TLHC) program was generally well-received by 40 current and former smokers aged 55-73, helping them understand the screening process and fostering positive intentions towards participation.

Participants expressed anxiety about potential screening results but felt reassured by the involvement of healthcare professionals; however, they struggled with understanding certain risks and eligibility criteria, indicating a need for clearer communication to support informed decision-making.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability of a standalone written leaflet for the National Health Service for England Targeted Lung Health Check Programme: A concurrent, think-aloud study. Jallow, M., Black, G., van Os, S., et al.[2022]

A study involving 18 high-risk patients in Toronto revealed that socioeconomic factors significantly influence the decision to participate in lung cancer screening, highlighting the need for tailored interventions.

The research identified key themes such as the impact of social disadvantages on health-seeking behavior and the importance of creating non-judgmental healthcare environments to improve access to lung cancer screening for underserved populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. Sayani, A., Vahabi, M., O'Brien, MA., et al.[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]

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. 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]

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

The Impact of Social Determinants of Health on Lung Cancer Screening Utilization. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Using Community Health Advisors to Increase Lung Cancer Screening Awareness in the Black Belt: a Pilot Study. [2023]

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

A Multilevel Approach to Investigate Relationships Between Healthcare Resources and Lung Cancer. [2023]

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

Barriers and facilitators for low-dose computed tomography lung cancer screening in rural populations in the United States: a scoping review protocol. [2023]

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

Identifying Community Perspectives for a Lung Cancer Screening Awareness Campaign in Appalachia Kentucky: The Terminate Lung Cancer (TLC) Study. [2018]

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

Results from Lung Cancer Screening Outreach Utilizing a Mobile CT Scanner in an Urban Area. [2023]

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

Acceptability of a standalone written leaflet for the National Health Service for England Targeted Lung Health Check Programme: A concurrent, think-aloud study. [2022]

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

Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. [2021]

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

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