Health Promotion Research Center

项目摘要 虽然国家肺部筛查试验观察到肺癌死亡率下降了20%，与 在吸烟者中进行年度胸部CT检查，许多问题仍然存在，这对现实世界的影响 在临床实践中实施CT筛查。一个关键的问题是，早期检测到的信息 通过CT筛查肺癌可以挽救生命将被视为戒烟和 可能会在不经意间导致戒烟动力降低。 我们建议进行一个形成性的定性研究项目，该项目嵌套在VHA的肺部筛查中 临床示范工程。该示范项目正在检验实施CT的可行性 在美国8个州的一小部分初级保健团队中进行筛查。我们建议 受试者在他们的初级保健提供者提供参与电话筛查后不久 在CT筛查的背景下，访谈他们对戒烟的看法和态度。 选择筛查的受试者也将在收到筛查测试结果后重新联系 进一步探讨戒烟观念和态度的任何转变。我们预计会进行 约40次访谈，以涵盖来自8个地理区域的不同主题 参与示范项目，确保少数民族主体和农村主体的代表性 和低收入地区。采访的成绩单将通过解释现象学进行评估 分析视角。这种定性研究方法侧重于检查患者的经验。 当他们接受CT筛查时，以及提供筛查和接收结果的过程是如何 CT筛查影响戒烟态度。该项目将吸引各国领导人参与 VHA和致力于实施肺癌筛查的社区。我们的长期目标是 将简短的干预信息纳入决策支持材料，供提供者在初级保健中使用 整合患者经历筛查的感受。随着筛选工作的开始 在临床讨论中，我们意识到，对于如何最好地及早讨论，我们的指导非常有限。 检测肺癌，并将CT检查纳入戒烟背景。这个项目是一个 为填补这一关键差距迈出的第一步。

Project Summary While the National Lung Screening Trial observed a 20% reduction in lung cancer mortality associated with annual chest CT screening among smokers, many questions remain about the real-world implications of implementing CT screening in clinical practice. One critical concern is that the message that early detection of lung cancer through CT screening can saves lives will be perceived as an alternative to smoking cessation and may inadvertently lead to lower motivation to quit. We propose to conduct a formative qualitative research project that is nested within the VHA's lung screening clinical demonstration project. This demonstration project is examining the feasibility of implementing CT screening within a small set of primary care teams in 8 states across the U.S. We propose to approach subjects shortly after being offered screening by their primary care provider to participate in telephone interviews about their perceptions and attitudes towards smoking cessation in the context of CT screening. Subjects who opt for screening will also be re-contacted after they receive the result of their screening test to further explore any shift in perceptions and attitudes about smoking cessation. We anticipate conducting approximately 40 interviews in order to include a diverse mix of subjects from across the 8 geographic areas involved in the demonstration project, and ensure representation of minority subjects and subjects from rural and low-income areas. Transcripts from the interviews will be assessed from an Interpretive Phenomenological Analysis perspective. This qualitative research approach focuses on examining the experience of the patient as they undergo CT screening and how the process of being offered screening and receiving the results of the CT screening test influences attitudes towards smoking cessation. The project will engage national leaders in VHA and in the community working on implementing lung cancer screening. Our long-term objective is to incorporate brief intervention messages into decision support materials for providers to use in primary care that integrate what it is like for patients to go through the experience of screening. As screening begins to be discussed in the clinic, we are realizing that we have very limited guidance about how best to discuss early detection of lung cancer, and integrate CT screening into the context of smoking cessation. This project is an initial step towards filling this critical gap.