Full Project 2: Supporting High Risk African American Men in Research, Engagement & Decision Making (SHARED)

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ABSTRACT Supporting High Risk African American Men in Research & Engagement in Decision Making for Lung Cancer Screening is a ChicagoCHEC outreach research full project that aims to reduce lung cancer inequities across diverse populations of high-risk smokers. Racial/ethnic minorities carry the greatest burden of lung cancer morbidity and mortality, with African American men (AAM) carrying the greatest incidence and mortality rates. Low dose helical computed tomography (LDCT) lung cancer early detection screening is recommended by the US Preventive Services Task Force (USPSTF - B recommendation) among adults aged 55-80, with a history of smoking. However, few studies have addressed how to engage high risk AAM and their clinical care providers in LDCT. We propose an innovative outreach intervention research project engaging AAM as Citizen Scientists to improve uptake of lung cancer screening at Mile Square Health Centers (MSHC), a group of 13 Federally Qualified Health Centers associated with the University of Illinois Hospital and Health Sciences System at UIC. Citizen Scientists refer to lay persons who are not formally trained as scientists but who are trained to engage in research efforts responsive to community needs. Citizen Scientists have proven valuable in increasing communities’ knowledge and awareness of research, building trust in scientific research, and informing areas of research design and ethics. As the Centers for Medicare and Medicaid Services requires a shared decision- making process for Medicare and Medicaid recipients prior to LDCT screening, we focus our Citizen Scientists efforts in this study on leveraging their social networks to engage AAM and supporting and enhancing an Agency for Healthcare Research and Quality (AHRQ) evidence-based Decision Aid (DA) that promotes shared decision making and subsequent lung cancer screening. We propose the following aims 1): recruit and train 8 AAM as Citizen Scientists; 2) engage Citizen Scientists to examine knowledge, attitudes, barriers and facilitators related to LDCT lung cancer screening among AAM smokers and their providers; 3) using data obtained in Aim 2, engage Citizen Scientists to refine outreach strategies for engaging AAM in lung cancer screening with MSHC and adapt the AHRQ DA to co-create a culturally targeted lung cancer screening DA for AAM patients and their providers; and 4) engage Citizen Scientists in a pilot RCT comparing the relative efficacy of the culturally targeted Citizen-Scientist informed DA vs the standard care AHRQ DA on knowledge, decisional support, and lung cancer screening among AAM. We hypothesize that compared with AAM assigned to the standard care DA, those receiving the Citizen-Scientist informed DA will demonstrate greater intention to screen, greater utilization of LDCT screening per USPSTF guidelines, and greater knowledge and perceived decisional support. Engaging AAM as Citizen Scientists is expected to improve outreach and respond to the needs communities that may traditionally be “unengaged” in the research process and provides an opportunity for the group at the most increased risk for lung cancer, AAM, to directly drive uptake of evidence based screening.