A Community Health Intervention to Improve Lung Cancer Screening Uptake in Community Health Centers

Feasibility: Number of participants at each stage of the recruitment and retention cascade

Counts abstracted from the study screening and enrollment log at each of the following stages: approached, screened eligible, consented, randomized, completed baseline data collection, and completed post-intervention follow-up assessment.

Feasibility: Percentage of participants at each stage of the recruitment and retention cascade

Percentages calculated from the study screening and enrollment log. Eligibility rate = number screened eligible divided by number approached. Consent rate = number consented divided by number screened eligible. Randomization rate = number randomized divided by number consented. Baseline completion rate = number completing baseline data collection divided by number randomized. Retention rate = number completing post-intervention follow-up divided by number randomized.

Fidelity: Duration in minutes of shared decision making (SDM) counseling per encounter

Time in minutes spent on SDM, recorded by community health workers (CHWs) and lay navigators in the encounter/call tracking log.

Fidelity: Duration in minutes of smoking cessation counseling per encounter

Time in minutes spent on smoking cessation counseling,recorded by community health workers (CHWs) and lay navigators in the encounter/call tracking log.

Percentage of participants with a lung cancer screening (LCS) referral order

Proportion of participants with an order placed in the electronic health record referring them to the LCS program, abstracted from EHR order data. Reported overall and by ordering source (community health worker vs. primary care provider).

Percentage of participants completing low-dose CT lung cancer screening (LCS uptake)

Proportion of participants with a completed low-dose CT scan documented in the electronic health record, ascertained by EHR chart abstraction

Percentage of participants initiating tobacco treatment, by treatment type

Proportion of participants initiating any tobacco treatment, and proportion by type (telephone quitline, in-person counseling, nicotine replacement therapy, prescription pharmacotherapy), ascertained by EHR chart abstraction and participant self-report at follow-up.

Duration in weeks of tobacco treatment

Number of weeks of continuous tobacco treatment received, calculated from EHR pharmacy fill and counseling encounter data supplemented by participant self-report.

Mean score on the LCS-12 lung cancer screening knowledge instrument

The Lung Cancer Screening Knowledge Measure (published as "a brief measure of smokers' knowledge of lung cancer screening with low-dose computed tomography") is a 12-item instrument assessing knowledge of lung cancer screening eligibility, benefits, and harms. One point is awarded per correct response. Total score ranges from 0 (minimum) to 12 (maximum). Higher scores indicate greater knowledge and are a better outcome.

Mean score on the Perceived Risk of Lung Cancer subscale of the Lung Cancer Screening Health Belief Scales

The Lung Cancer Screening Health Belief Scales are a 35-item instrument based on the Expanded Health Belief Model. The Perceived Risk of Lung Cancer subscale comprises 3 items rated on a 4-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). The subscale score is the mean of the item responses and ranges from 1 (minimum) to 4 (maximum). Higher scores indicate greater perceived personal risk of lung cancer. This construct is not inherently better or worse; higher perceived risk is hypothesized to be associated with greater screening uptake.

Mean score on the Perceived Benefits of Lung Cancer Screening subscale of the Lung Cancer Screening Health Belief Scales

The Perceived Benefits subscale comprises 6 items rated on a 4-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). The subscale score is the mean of the item responses and ranges from 1 (minimum) to 4 (maximum). Higher scores indicate greater perceived benefit of lung cancer screening and are a better outcome.

Mean score on the Perceived Barriers to Lung Cancer Screening subscale of the Lung Cancer Screening Health Belief Scales

The Perceived Barriers subscale comprises 17 items rated on a 4-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). The subscale score is the mean of the item responses and ranges from 1 (minimum) to 4 (maximum). Higher scores indicate greater perceived barriers to lung cancer screening and are a worse outcome.