[R01] Increasing Lung Cancer Screening Uptake Among High-Risk Emergency Department Patients
Ente: National Cancer Institute
Scadenza: 2031-05-31
Importo max: 345.413 EUR
Paese: US
Descrizione
PROJECT SUMMARY/ABSTRACT
Lung cancer is the leading cause of cancer death in the US. Although lung cancer screening (LCS), using low-
dose CT scan, decreases lung cancer mortality through early disease identification, fewer than 1 in 6 eligible
individuals get screened, with significant differences based on demographic and socio-economic factors. LCS
is a process, not just a test. The critical first steps in this process are (1) identification of high-risk individuals
who are eligible for LCS, and (2) recruitment of these individuals into an LCS program. The Emergency
Department (ED) setting is optimal for an intervention to promote LCS by accomplishing these steps.
Individuals at high risk for lung cancer are over-represented in the ED population, including: individuals that
smoke, non-White individuals, patients with lower education levels, and the under-insured. In fact, over 2.3
million high-risk people pass through EDs every year who are eligible for LCS but have never been screened.
The investigators’ long-term goal is to develop a low-cost, scalable intervention that increases LCS uptake
among ED patients and is deployable in any ED with a regionally referrable LCS program. The objective of the
proposed randomized clinical trial is to test the efficacies of text messaging and a facilitated referral strategy to
promote uptake of LCS in order to achieve this goal. Step 1 of the approach is to identify participants that are
eligible for LCS. Step 2 is to randomize eligible participants, using a 2x2 design, among four study arms: (1)
basic referral for LCS (i.e. verbal referral with written materials; comprising an enhanced control arm), (2) basic
referral plus a subsequent series of text messages, grounded in behavioral change theory, aimed at generating
intention and motivation to get screened, (3) facilitated referral for LCS (i.e. submission of a requisition to LCS
program by staff), and (4) facilitated referral plus text messages. The investigators’ pilot work demonstrated the
feasibility and efficacy of the proposed approach. A total of 1036 individuals eligible for LCS will be recruited
from a high-volume urban ED and a low-volume rural ED, randomized among study arms, and followed-up at
120 days to assess interval LCS uptake. The Specific Aims of the proposed project are, (1) Compare LCS
program uptake among study arms that receive text messages to study arms that do not, (2) Compare LCS
program uptake among study arms with basic referral to study arms with facilitated referral, (3) Investigate the
interaction between receipt of text messages (yes/no) and referral type (basic/facilitated), and (4) Evaluate
participant feedback on (a) differential barriers to LCS across sub-groups and (b) acceptability and
appropriateness of ED-based promotion of LCS. The study team is at the forefront of developing ED-based
interventions to promote cancer screening. This project leverages the universal access setting of the ED to
identify individuals a
Istituzione: UNIVERSITY OF ROCHESTER
PI: DAVID H ADLER
Progetto: 1R01CA310937-01
Settori: National Cancer Institute
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