Project ACTS (Adherence to CT Screening): Development and Usability of Patient Engagement Tools to Support Lung Cancer Screening Adherence

Project ACTS is a multi-year, multi-phase project to be conducted over two phases to inform and develop an intervention package to facilitate adherence to lung cancer screening. All phases will be co-led by Dr. Upal Basu Roy (LUNGevity Foundation) and Dr. Jamie L. Studts (University of Kentucky Markey Cancer Center) in collaboration with Dr. Margaret Byrne (Moffitt Cancer Center) and with consultants, Dr. Pierre Massion (Vanderbilt University), and Dr. Peter Mazzone (Cleveland Clinic). Phase I, the Needs Assessment Phase will employ a mixed methods approach, including a brief survey and in-depth key informant interviews with screening center participants visiting the University of Kentucky Lung Cancer Screening Program and the Lung Cancer Screening Program at the Moffitt Cancer Center. Eligible participants, defined as high-risk individuals who present with lung nodules on the initial scan but do not return for follow-up scans,” as well as individuals who fail to return for annual screening after a negative/clear baseline scan result will be identified through electronic health records, and interviewed/surveyed to understand barriers (e.g., stress, stigma) to screening adherence in the participants own voice and identify potential strategies to mitigate these barriers. Additionally, key informant interviews will be conducted with lung cancer screening program clinicians/directors (defined as individuals who are involved in implementing screening programs) to understand how best to serve different populations and address concerns regarding participant adherence. These interviews will identify the clinician/program experience with regard to adherence, review program efforts to support adherence, and explore responses to novel approaches to supporting program engagement and adherence. Data collected through the needs assessment interviews will be triangulated to develop preliminary engagement tools that will undergo preliminary testing in Phase II (Usability Testing Phase). During Phase II, the study team will conduct usability testing on the overall approach and proposed tools that will likely incorporate a combination of targeted and tailored materials designed to increase patient engagement with screening and support screening adherence. Importantly, another goal for these tools will involve implementation readiness, meaning that they could be easily adopted and readily deployed by a screening program. Developing approaches and tools of this nature will require significant guidance and feedback from the target population of users to increase the relevance, usability, and impact of the intervention. Realizing the varied needs of different screening center participants, the team will test the feasibility and acceptability of at least 2-3 different approaches and tools to create a toolkit that could be implemented by screening programs.