Developing a Trustworthy Multilevel Intervention to Improve Lung Cancer Screening

Lung cancer screening using low-dose computed tomography significantly reduces lung cancer mortality, the leading cause of cancer mortality in the United States. Despite its life-saving potential, lung cancer screening uptake remains extremely low among eligible populations. Multilevel barriers to lung cancer screening exist at the patient, provider, and health system levels. However, prior research assessing these barriers is limited by inadequate involvement of many communities affected by lung cancer (e.g., populations with lower access to health care) and by the exclusion of key health care staff (e.g., nurses) who often champion screening programs. Many health care interventions also lack trustworthiness, partly because they are often designed without community input. Little is known about how screening barriers can be addressed through implementation strategies that have an explicit goal to earn patient trust and improve lung cancer outcomes for all populations. Through three specific aims, this study will address these knowledge gaps. These aims are to: 1) identify multilevel barriers and facilitators to the implementation of lung cancer screening, 2) engage with community advisors and key stakeholders to identify multilevel implementation strategies to promote lung cancer screening, and 3) pilot test the feasibility of multilevel implementation strategies designed to improve lung cancer screening uptake (one at the patient level and one at the provider/system level). Overall, this innovative study will be among the first to respond to the need to increase lung cancer screening receipt for all populations. It will also lay the groundwork for a R01 application to evaluate the intervention pilot tested in this study.