Grants and Contracts Details
Description
Statewide Capacity Building and Quality Implementation of
Lung Cancer Screening Utilizing the QUILSTM System
Although lung cancer screening (LCS) using low-dose computed tomography (LDCT) has been shown to
be an effective strategy to reduce lung cancer mortality and is widely supported by most private and public
health insurance providers, uptake of screening has remained suboptimal, impeding anticipated potential
individual and population health benefits. Further, inequitable implementation patterns are emerging and
could exacerbate current lung cancer-related health disparities. Implementation of LCS has also varied
widely across states. Nevada and Mississippi evince inferior uptake and experience persistent health
inequity that could be addressed by leveraging a state-based initiative to facilitate equitable and high-
quality LCS implementation and support efforts to reduce lung cancer mortality. The Kentucky LEADS
Collaborative developed a state-based strategy using a multilevel approach to help Kentucky reach the top
tier of LCS implementation. Kentucky is currently the second leading state regarding LCS implementation,
and analyses of the implementation data suggest increased rates of screening in regions that were
affiliated with the Kentucky LEADS Collaborative implementation sites. Additionally, analyses of Kentucky
Cancer Registry data have demonstrated a statewide reduction in late stage diagnosis of lung cancer on
the order of 10% but that the reduction in the Central Appalachian region of Kentucky demonstrated a
nearly 20% reduction in late stage lung cancer diagnosis. To achieve these outcomes, the Kentucky
LEADS Collaborative approach included three essential elements to facilitating LCS implementation: (1)
state-based collaborative efforts; (2) primary care clinician engagement, and (3) a focus on quality
implementation using the QUILSTM System among LCS programs. The proposed project will work with
collaborating partners in Nevada and Mississippi to implement two statewide initiatives to facilitate LCS
implementation by adapting and replicating the Kentucky LEADS Collaborative. The overarching project
goal involves facilitating equitable and high-quality implementation of lung cancer screening utilizing novel
and impactful state-based efforts and the QUILSTM System 2.0.
Project Aim 1 will launch a statewide LCS initiative to stimulate LCS implementation using two
approaches. First, to establish a social norm of LCS implementation through awareness and engagement,
Dr. Knight at the University of Kentucky Markey Cancer Center (UKMCC), will lead state-based
collaborative efforts in conjunction with each state cancer coalition and lung cancer task forces to identify
policy opportunities as well as awareness and engagement campaigns needed to support LCS
implementation. By engaging state residents to raise LCS awareness and engagement, this effort will work
to normalize LCS participation and reduce the stigma and nihilism that serve as prominent barriers to
effective early detection and treatment efforts. Second, Dr. Studts at the University of Colorado Cancer
Center (UCCC) will facilitate primary care clinician engagement with LCS using updated academic detailing
and outreach efforts across each state by working with the network of primary care clinicians, primary care
clinics, and other LCS referral sources across both states to help clinicians integrate workflows and
routines to identify LCS candidates, conduct informed and shared decision making, make appropriate
referrals, and sustain engagement with LCS participants.
Project Aim 2 will be led by Dr. Mullett at UKMCC and will employ the QUILSTM System among 5-6 lung
cancer screening programs in each state to facilitate equitable and high-quality LCS implementation. This
component works directly and intensively with specific LCS programs in each to optimize LCS delivery and
outcomes using the QUILSTM Index to evaluate quality, the QUILSTM Audit and Feedback System to help
identify opportunities for program improvement, the QUILSTM Resource Portal to facilitate staff training and
implementation resource access, and QUILSTM Coaching and Technical Assistance to help LCS programs
implement and manage program optimizing changes.
To assess the impact of the interventions on relevant lung cancer screening quality, uptake, and outcomes,
Dr. Studts will lead project evaluation efforts in conjunction with the Population Health Shared Resource at
UCCC. In addition to evaluating immediate outcomes related to program delivery and participant evaluation
feedback, population health evaluation efforts will leverage multiple data sources including state surveys,
federal and state public databases, and registry data (screening and cancer registries) to evaluate the
impact of the state-based initiative in both states.
Status | Active |
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Effective start/end date | 9/1/24 → 8/31/28 |
Funding
- Bristol Myers Squibb Foundation Incorporated: $1,541,870.00
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