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

摘要 支持高危非裔美国男性参与肺癌的研究和决策 筛查是芝加哥化学研究中心的一项全面外展研究项目，旨在减少全国各地的肺癌不平等现象。 不同人群的高危吸烟者。少数族裔是肺癌的最大负担 发病率和死亡率，非洲裔美国人(AAM)的发病率和死亡率最高。 低剂量螺旋计算机断层扫描(LDCT)肺癌早期检测筛查建议 美国预防服务工作组(USPSTF-B建议)在55-80岁的成年人中，有 抽烟。然而，很少有研究涉及如何与高危AAM及其临床护理提供者接触 在LDCT中。我们提出了一个创新的外展干预研究项目，将AAM作为公民科学家 为了提高英里广场健康中心(MSHC)肺癌筛查的接受率，由13个联邦成员组成的小组 与伊利诺伊大学医院和UIC健康科学系统相关的合格健康中心。 公民科学家是指没有接受过正式的科学家培训，但接受过从事科学研究的非专业人员 响应社区需求的研究工作。事实证明，公民科学家在增加 社区对研究的知识和意识，建立对科学研究的信任，并向领域提供信息 研究设计和伦理。由于医疗保险和医疗补助服务中心需要一个共同的决定- 在LDCT筛查之前为Medicare和Medicaid接受者制定流程，我们专注于我们的公民科学家 本研究旨在利用他们的社交网络与AAM接洽，并支持和加强机构 对于医疗研究和质量(AHRQ)循证决策辅助(DA)，促进共享决策 进行和随后的肺癌筛查。我们提出了以下目标：1)招募和培训8名空管人员为 公民科学家；2)让公民科学家检查相关的知识、态度、障碍和促进者 在AAM吸烟者及其提供者中进行LDCT肺癌筛查；3)使用在AIM 2中获得的数据， 让公民科学家参与完善外展策略，让AAM参与MSHC的肺癌筛查 并调整AHRQ DA，共同为AAM患者和他们的患者创建具有文化针对性的肺癌筛查DA 提供者；以及4)让公民科学家参与一项试点RCT，比较文化目标的相对有效性 公民-科学家知情DA与标准护理AHRQ DA在知识、决策支持和肺癌方面的比较 在AAM中进行筛选。我们假设，与分配给标准护理DA的AAM相比，那些 收到公民-科学家通知的DA将显示出更大的筛查意图，更大的利用率 根据USPSTF指南进行LDCT筛查，以及更多的知识和感知的决策支持。引人入胜 AAM作为公民科学家预计将改善外联并响应社区的需求，这些社区可能 传统上在研究过程中不参与，至多为团队提供机会 增加肺癌的风险，AAM，直接推动循证筛查的接受。

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.