TELEhealth Shared Decision-making COaching for Lung Cancer Screening in Primary Care (TELESCOPE) for Hispanics

Summary

Aim 1: Culturally adapt the TELESCOPE intervention for Hispanics. Using iterative qualitative feedback from a study-specific Community Advisory Board, focus groups, and interviews with community members, the investigators will culturally adapt the TELESCOPE intervention for Hispanics at high risk for lung cancer. Aim 2: Assess the feasibility, acceptability, and implementation potential of the culturally adapted TELESCOPE intervention delivered by bilingual patient navigators for Hispanics. Hypothesis 1: The investigators expect a recruitment rate of ≥60%, ≥90% of Hispanic participants will complete the 1-week follow-up assessments, ≥80% of the key intervention components will be delivered with 80% fidelity by the patient navigators, and ≥90% of participants and clinicians will agree or completely agree that the intervention was feasible and acceptable. Aim 3: Explore the impact of a culturally adapted TELESCOPE intervention delivered by bilingual patient navigators vs enhanced usual care (EUC) on the initial uptake of low-dose computed tomography (LDCT) and quality of the shared decision-making (SDM) process. Hypothesis 2: The investigators expect that an adapted TELESCOPE intervention will result in higher uptake of LDCT and higher SDM quality for lung cancer screening (LCS) compared to EUC.

Eligibility

Inclusion Criteria:

Aim 1 (Cultural Adaptation):

To be eligible, patients must:

1. Identify as Hispanic and/or Latino(a)
2. Able to read and speak in English or Spanish
3. Be 50 to 77 years of age
4. Be a current or former smoker
5. Have at least a 20-pack-year smoking history

Aims 2-3 (Pilot Randomized Controlled Trial)

To be eligible, patients must:

* Identify as Hispanic or Latino(a)
* Able to speak and read in English or Spanish
* Be 50 to 77 years of age
* Be a current or former smoker having quit within the past 15 years
* Have at least a 20 pack-year smoking history
* Be scheduled for a non-acute care visit at one of the study sites.
* Not coughing up blood in the last two weeks

Interviews

Providers completing the semi-structured interviews will be:

* A practicing primary care clinician or a clinic director (n=20), nursing director, or clinic practice administrator at one of the participating sites, or a TELESCOPE study patient navigator and nurse navigator
* Age 18 or older
* Fluent in English

Online surveys

Providers completing online PRISM construct surveys will be:

* A practicing primary care provider at one of the participating sites or a TELESCOPE study navigator
* Age 18 or older
* Fluent in English

Exclusion Criteria:

For the cluster randomized trial, excluded will be patients who:

* Do not speak English
* Are not Hispanic or Latino(a)
* Have a history of lung cancer
* Had a CT scan in the past 12 months
* Has been coughing up blood in the last two weeks
* Have health conditions that make them poor candidates for curative treatment as determined by the primary care provider,
* Are unable to provide informed consent Interviews

Providers/administrators will be excluded if they:

* Are unable to provide informed consent Online surveys
* Are unable to provide informed consent
* Women who are pregnant.

Conditions3

Locations1 site

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