Assessing Social Determinants of Health to Increase Cancer Screening

NCT06052449 | Completed Results

• 1 other identifier: Pro2023-0374
• Study Type: interventional
• Target: 101
• Locations: 1 country
• Sites: 1

Brief Summary

A multilevel lung screening intervention that pairs Social Determinants of Health (SDoH) screening and referral with a tailored health communication and decision support tool for lung screening has the potential to significantly impact lung screening uptake among at-risk individuals in the community, particularly among those who face barriers related to SDoH. In addition, findings will advance the understanding of effective strategies for improving lung screening and prevention efforts in non-traditional settings, with the ultimate goal of reducing the burden of lung cancer. As ways to support the realization of the public health benefit of lung cancer screening are considered, multiple strategies and venues to reach, and intervene, with screening-eligible is key. The goal of this study is to compare the effectiveness of a community-based lung screening educational tool paired with a social determinants of health (SDoH) screening assessment and referral process compared to a community-based lung cancer screening (LCS) educational tool alone as part of community outreach activities to improve (a) LCS rates (primary outcome); (b) intention to screen; and (c) individual-level potential drivers of LCS (health literacy, mistrust, stigma, fatalism, knowledge, health beliefs). It is hypothesized that providing SDoH screening and referral will result in higher levels of LCS, forward movement of intention to screen, and improved individual-level drivers of LCS.

Conditions

Lung Cancer

Keywords

screening; social determinants of health; lung cancer screening

Outcome Measures

Primary Outcomes (1)

• Lung Cancer Screening Uptake

  Number of participants in the two groups that get screened (have a computed tomography (CT or CAT) scan)

  1 months post intervention

Secondary Outcomes (14)

• Health Literacy

  Baseline

• Health Literacy

  1 months post intervention

• Medical Mistrust

  Baseline

• Medical Mistrust

  1 months post intervention

• Perceived Smoking-Related Stigma

  Baseline

Study Arms (2)

Social determinants of health screening

EXPERIMENTAL

Participants will receive a social determinants of health screening assessment and referral process in addition to the community-based lung cancer screening educational tool.

Behavioral: Social determinants of health screening assessment and referral process; Behavioral: Current practice - Community-based lunch cancer screening (LungTalk)

Community-based lung cancer screening

ACTIVE COMPARATOR

Participants will receive a community-based lung cancer screening educational tool.

Behavioral: Current practice - Community-based lunch cancer screening (LungTalk)

Interventions

Current practice - Community-based lunch cancer screening (LungTalk) BEHAVIORAL

The current practice during community events is to offer LungTalk. LungTalk is a novel theoretically grounded health educational tool that will be delivered via iPad and is an interactive computer-based program that includes audio, video and animation segments with scripts presented from a master content library in consideration of different ways people like to learn. Informed by our prior research, LungTalk tailors its content based on smoking status and perceived barriers.

Community-based lung cancer screening; Social determinants of health screening

Social determinants of health screening assessment and referral process BEHAVIORAL

Unite Us is an electronic SDoH screening and referral tool assessing: (1) financial resource strain; (2) housing stability; (3) transportation needs; and (4) food insecurity. Upon completion, the Unite Us platform identifies a list of geographically-tailored resources to connect the individual in need. A staff member will administer the SDoH screening and referral tool, review the results with the participant, and use the geographically-tailored resources to make SDoH-related referrals.

Social determinants of health screening

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 50 years to 80 years
• Currently smoke or quit smoking within the past 15 years
• pack-year smoking history
• Has never had lung cancer screening
• Able to provide informed consent
• Able to speak and understand English

You may not qualify if:

• Diagnosed with lung cancer
• Has a history of having a lung cancer screening scan
• Unable to speak and understand English

Sponsors & Collaborators

• Hackensack Meridian Health: lead
• Becton, Dickinson and Company: collaborator

Study Sites (1)

Hackensack Meridian Health - Center for Discovery and Innovation

Nutley, New Jersey, 07110, United States

Location

Related Publications (13)

• Cancer Facts & Figures 2023. American Cancer Society, Inc.; 2022. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2023-cancer-facts-figures.html

  BACKGROUND

• Pettit N, Ceppa D, Monahan P. Low Rates of Lung and Colorectal Cancer Screening Uptake Among a Safety-net Emergency Department Population. West J Emerg Med. 2022 Aug 11;23(5):739-745. doi: 10.5811/westjem.2022.5.55351.

  PMID: 36205665 BACKGROUND

• Carter-Harris L, Ceppa DP, Hanna N, Rawl SM. Lung cancer screening: what do long-term smokers know and believe? Health Expect. 2017 Feb;20(1):59-68. doi: 10.1111/hex.12433. Epub 2015 Dec 23.

  PMID: 26701339 BACKGROUND

• Carter-Harris L, Brandzel S, Wernli KJ, Roth JA, Buist DSM. A qualitative study exploring why individuals opt out of lung cancer screening. Fam Pract. 2017 Apr 1;34(2):239-244. doi: 10.1093/fampra/cmw146.

  PMID: 28122849 BACKGROUND

• Carter-Harris L, Slaven JE 2nd, Monahan PO, Draucker CB, Vode E, Rawl SM. Understanding lung cancer screening behaviour using path analysis. J Med Screen. 2020 Jun;27(2):105-112. doi: 10.1177/0969141319876961. Epub 2019 Sep 24.

  PMID: 31550991 BACKGROUND

• Mohan G, Chattopadhyay S. Cost-effectiveness of Leveraging Social Determinants of Health to Improve Breast, Cervical, and Colorectal Cancer Screening: A Systematic Review. JAMA Oncol. 2020 Sep 1;6(9):1434-1444. doi: 10.1001/jamaoncol.2020.1460.

  PMID: 32556187 BACKGROUND

• Weinstein D. The Precaution Adoption Process Model. In: Health Behavior and Health Education: Theory, Researchm and Practice. 4th Ed. Jossey-Bass; 2008:123-147.

  BACKGROUND

• Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004 Sep;36(8):588-94.

  PMID: 15343421 BACKGROUND

• Thompson HS, Valdimarsdottir HB, Winkel G, Jandorf L, Redd W. The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004 Feb;38(2):209-18. doi: 10.1016/j.ypmed.2003.09.041.

  PMID: 14715214 BACKGROUND

• Cataldo JK, Slaughter R, Jahan TM, Pongquan VL, Hwang WJ. Measuring stigma in people with lung cancer: psychometric testing of the cataldo lung cancer stigma scale. Oncol Nurs Forum. 2011 Jan;38(1):E46-54. doi: 10.1188/11.ONF.E46-E54.

  PMID: 21186151 BACKGROUND

• Mayo RM, Ureda JR, Parker VG. Importance of fatalism in understanding mammography screening in rural elderly women. J Women Aging. 2001;13(1):57-72. doi: 10.1300/J074v13n01_05.

  PMID: 11217186 BACKGROUND

• Carter-Harris L, Slaven JE 2nd, Monohan P, Rawl SM. Development and Psychometric Evaluation of the Lung Cancer Screening Health Belief Scales. Cancer Nurs. 2017 May/Jun;40(3):237-244. doi: 10.1097/NCC.0000000000000386.

  PMID: 27244666 BACKGROUND

• Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J, Duda SN; REDCap Consortium. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019 Jul;95:103208. doi: 10.1016/j.jbi.2019.103208. Epub 2019 May 9.

  PMID: 31078660 BACKGROUND

MeSH Terms

Conditions

Lung Neoplasms

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Results Point of Contact

• Title: Dr. Ana Guadalupe Vielma
• Organization: Hackensack Meridian Health - Center for Discovery and Innovation

ana.vielma@hmh-cdi.org

2018803100

Study Officials

• Lisa Carter-Bawa, PhD

  Hackensack Meridian Health

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 19, 2023
• First Posted: September 25, 2023
• Study Start: September 30, 2023
• Primary Completion: August 19, 2025
• Study Completion: August 19, 2025
• Last Updated: March 11, 2026
• Results First Posted: March 11, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)