Increasing Lung Cancer Screening Uptake Among Emergency Department Patients

Conditions

• Lung Cancer
• Lung Cancer (Diagnosis)
• Lung Cancer Diagnosis
• Screening Compliance

Eligibility Criteria

Sex

ALL

Age

50 Years - 80 Years

Healthy Volunteers

Accepted

Interventions

• Facilitated referral and text messaging — BEHAVIORAL
  Participants randomized to the experimental arm will be instructed that the LCS program will reach out to them to discuss LCS and, if decided upon, schedule screening. An LCS Program Navigator will call the participant by phone, conduct a shared decision-making discussion, and schedule the screening CT scan (assuming eligibility is confirmed and the discussion results in the participant's decision to schedule screening). In addition, participants in Arm 2 will receive a series of text messages, grounded in the TPB, SDT, and HBM aimed at generating intention and motivation to get LCS.
• Basic Referral (enhanced control arm) — BEHAVIORAL
  They will also be provided with written materials that include telephone contact information for the LCS Program Navigator. If contacted, the LCS Program Navigator will conduct a shared decision-making (SDM) discussion, schedule the screening CT scan at one of the 8 regional American College of Radiology-designated LCS centers and arrange follow-up as needed. Since determination of LCS needs is not routine during an ED visit, this "control arm" reflects an enhancement over usual care. It would not be ethical to identify a patient with screening needs without providing a referral.

Study Details

The objective of the proposed clinical trial is to determine if we can increase LCS among ED patients using a combination of facilitated referral to an LCS program plus text message reminders to get screened. Step 1 of the approach is to identify participants that are eligible for LCS. Step 2 is to randomize eligible study participants between two study arms: (1) basic referral for LCS (i.e. verbal referral with written materials), and (2) facilitated referral for LCS (i.e. submission of a requisition to LCS program by staff) plus a subsequent series of text messages aimed at generating intention and motivation to get screened. The investigators' preliminary work showed this approach was feasible in the ED setting. The proposed study will build on this preliminary work with the goal of having a significant positive impact on LCS uptake. A total of 300 individuals eligible for LCS will be recruited from a high-volume urban ED, randomized between study arms, and followed-up at 120 days to assess interval LCS uptake. The Specific Aims of the proposed project are, (1) Compare LCS uptake between the two study arms, (2) Identify predictors of individuals that are not up-to-date with LCS at the time of enrollment, and (3) Evaluate study participant feedback on (a) barriers and facilitators to getting screened and (b) acceptability and appropriateness of ED-based promotion of LCS. The study team is at the forefront of developing ED-based interventions to promote cancer screening. This project leverages the universal access setting of the ED to identify individuals at greatest risk for lung cancer and get them screened. A scalable ED-based intervention that increases LCS uptake would save lives.

Key Dates

Start date

Mar 18, 2026

Status verified

Apr 2026

Primary completion

Mar 31, 2028

Completion

Nov 30, 2028

Study Design

Enrollment

349 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

SCREENING

Arms

• Active Comparator: Basic Referral (enhanced control arm)
  Participants assigned to Arm 1 will be referred to the UR Medicine LCS Program and their primary care provider (if they have one) to discuss LCS. They will also be provided with written materials that include telephone contact information for the LCS Program Navigator.
• Experimental: Facilitated Referral + Text Messaging
  For participants assigned to Arm 2, an LCS requisition form will be submitted to the UR Medicine LCS Program on behalf of the participant during their ED visit. The participant's primary care provider (if they have one) will be CC'd on the requisition. Participants will be instructed that the LCS program will reach out to them to discuss LCS and, if decided upon, schedule screening. An LCS Program Navigator will call the participant by phone, conduct a shared decision-making discussion, and schedule the screening CT scan (assuming eligibility is confirmed and the discussion results in the participant's decision to schedule screening). In addition, participants in Arm 2 will receive a series of text messages, grounded in the TPB, SDT, and HBM aimed at generating intention and motivation to get LCS.

Primary Outcome Measure

Assessment for LCS Uptake and Downstream Care [ Time Frame: From enrollment through participation with first assessment at ~ 120 days of participation. ]

Central Contacts

• Peter MacDowell
  585-274-1509
  [email protected]

Locations (1)

Find similar trials in Rochester, NY

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