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Optimizing adherence to lung cancer screening: Applying theory and implementation science to participant engagement

优化肺癌筛查的依从性：将理论和实施科学应用于参与者的参与

基本信息

批准号：
10818665
负责人：
Erin Hirsch
金额：
$ 9.3万
依托单位：
HACKENSACK UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10818665
关键词：
Address Adherence Affect Algorithms Benefits and Risks Breast Cancer Detection Cancer Etiology Cervical Cancer Screening Cessation of life Characteristics Clinical Clinical Trials Cognitive Computerized Medical Record Consumption Counseling Data Dedications Development Diagnosis Effectiveness Effectiveness of Interventions Eligibility Determination Exposure to Goals Guideline Adherence Guidelines Health Health Benefit Health behavior Human Resources Hybrids Image Individual Intervention Intervention Studies Interview Malignant Neoplasms Malignant neoplasm of lung Measures Medical Mentors Methods Outcome Outcome Measure Parents Participant Patients Phase Postdoctoral Fellow Process Provider Recommendation Reminder Systems Reporting Research Research Design Research Methodology Research Personnel Research Training Scanning Scientist Screening for cancer Smoker Smoking Specialist Surveys System Testing Time Training Training Programs Visit acceptability and feasibility cancer diagnosis career clinically significant colorectal cancer screening computed tomography screening cost design dissemination science effective intervention effectiveness evaluation effectiveness outcome effectiveness/implementation study effectiveness/implementation trial evidence base experience former smoker health application high risk high risk population implementation outcomes implementation research implementation science improved informant information processing innovation intervention program low dose computed tomography lung cancer screening mortality patient engagement person centered population based population health pragmatic study primary care provider programs protective behavior risk perception routine screening screening screening guidelines screening program shared decision making skills social social health determinants social stigma theories therapy development tool user centered design

项目摘要

PROJECT SUMMARY Lung cancer is the leading cause of cancer death in the US, with most lung cancer diagnosed at advanced stages. Low-dose CT screening of high-risk individuals is the only evidence-based tool available to diagnose lung cancer at an early stage when curable treatment options exist. The promising mortality reduction benefit of lung cancer screening (LCS) is presently overwhelmingly unfulfilled due to suboptimal population-based adherence to annual screening guidelines. Outside of research settings, adherence to annual LCS is less than half of the rates observed in the practice-changing, landmark clinical trials. There is an urgent need for effective and feasible interventions to improve LCS adherence and achieve optimal individual and population health benefits. Research during the F99 phase will leverage an innovative, multi-phase, mixed methods design to describe how LCS patients process health information regarding health protective behavior and utilize this information to develop and evaluate reminder messages with individuals eligible for LCS. Using a four-step process, data collected in a survey of LCS program participants (step 1) will inform the development of a pool of candidate reminder messages (step 2). In the final two steps, the reminder messages will be evaluated by LCS experts (step 3) and further evaluated and refined with LCS program participants (step 4) using mixed methods, including surveys and interviews. Differences between health information processing constructs by demographic or clinical characteristics found to be significant from step 1 will be the focus for message targeting (group level) and/or tailoring (individual level). At the conclusion of the F99 phase, I will have a formalized set of clear, engaging, and efficient messages to support LCS annual adherence, ready to be evaluated in a clinical setting. Research proposed in the K00 phase will focus on gaining real-world experience with hybrid effectiveness implementation study designs and pragmatic outcome measures to simultaneously assess effectiveness and implementation outcomes. Specifically, I propose a mentored pre-post type 1 hybrid effectiveness- implementation trial, within a parent trial, that will allow concurrent assessment of effectiveness and implementation outcomes of the F99 reminder strategy in real-world LCS programs. Effectiveness will be tested using a pre-post design, comparing percent screening participants adherent to annual screening guidelines before and after implementation of the reminder strategy. Secondary implementation outcomes (i.e., acceptability and feasibility) will be assessed with surveys and key informant interviews of personnel involved in the reminder system implementation (e.g., LCS program directors, navigators, coordinators). This body of research will prepare me for a career as an independent cancer-focused intervention scientist with expertise in the development and implementation of effective, low-burden interventions aimed at improving LCS adherence, maximizing screening benefit, and reducing lung cancer mortality.

项目总结