Multilevel Interventions to Increase Adherence to Lung Cancer Screening (Larch)

Kaiser Permanente

Status: Active, not recruiting

Conditions: Lung Cancer Screening; Lung Cancer

Treatments: Other: Patient Education; Other: Stepped Reminders

Study type: Interventional

Funder types: Other

Identifiers

NCT05747443

220-115.001

Details and patient eligibility

About

Screening for lung cancer has the potential for a profound public health benefit. Repeat annual screening is necessary for early detection of lung cancer. The investigators will test two interventions which include patient education and reminders to improve adherence to lung cancer screening.

Full description

Screening for lung cancer has the potential for a profound public health benefit.

Successful population-based screening requires continuous monitoring to adherence repeat screening in high risk adults to achieve similar results. Repeat annual screening is necessary for early detection of lung cancer. Baseline or first LDCT scans detect prevalent lung cancer, when subsequent screening detects new nodules. However, adherence to screening is low, ranging at 28-38% from centers nationally.

The investigators developed two novel, patient-centered interventions to address patient education and offering reminders for on-time screening. To address these goals, the specific aims are to: 1) Compare effectiveness of two multilevel interventions relative to usual care in improving (a) rates of adherence to lung cancer screening, (b) patient-centered outcomes; and (c) clinic outcomes; and 2) Determine the patient-, clinician-, and system-level factors that influence changes in adherence to inform lung cancer screening programs.

Enrollment: 1,837 patients

Sex: All

Ages: 50 to 78 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• KPWA members
• Aged 50-78 years
• Have a negative screening LDCT scan
• Speak English or Spanish
• Meet US Preventive Services Task Force guidelines

Exclusion criteria

• Patients who were previously diagnosed with lung cancer,
• Patients who have a positive scan,
• Patients who have an indicator for interpreter services, except for Spanish

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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1,837 participants in 4 patient groups

Patient Video only

Experimental group

Description:

About 3 weeks after the index LDCT, the study Medical Assistant (MA) will deliver a link to the Patient Voices Video, an educational video about lung cancer screening.

Treatment:

Other: Patient Education

Stepped Reminders only

Experimental group

Description:

Prior to patient's next LDCT scan is due, MA begins Stepped Reminders intervention: MA pends LDCT orders to PCP to sign. MA sends reminders to patient when order is placed and follows up by phone if patient has not scheduled LDCT.

Treatment:

Other: Stepped Reminders

Patient Video and Stepped Reminders

Experimental group

Description:

See above. Those assigned to the Patient Video and Stepped Reminders will receive both interventions, as described above.

Treatment:

Other: Stepped Reminders

Other: Patient Education

Usual Care

No Intervention group

Description:

Those assigned to the the Usual Care arm will continue to receive usual lung cancer screening care.