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Using Implementation Science to Disseminate a Lung Cancer Screening Education Intervention Through Community Health Workers

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Abstract

National lung cancer screening with low dose computed tomography (LDCT) uptake is suboptimal. One factor contributing to slow uptake is lack of awareness. Trained Community Health Workers (CHWs) may be effective in increasing lung cancer screening awareness among disparate populations, however little is known about the processes necessary to scale an intervention for implementation by CHWs in a new area. We examined implementation processes with the RE-AIM framework and pilot tested a CHW-delivered lung cancer education intervention based on the Health Belief Model. We measured pre-post participant knowledge, attitudes and beliefs regarding cancer screening, lung cancer stigma, and intent to obtain LDCT screening. We used community-engaged strategies to collaborate with a local health system, to identify CHWs. CHWs were trained to recruit participants and deliver the one-session lung cancer education intervention. Seven CHWs and eight community sites participated. Participants (n = 77) were female (53%) primarily low income (62.9%); tobacco use was high (36.9%). Post intervention changes in lung cancer screening knowledge (p =  < .0001), attitudes regarding lung cancer screening benefit (p = .034) and lung cancer stigma. (p = .024) We learned important lessons that will be useful in subsequent scaling. Collaborating with a local health system is a promising method to disseminate a lung cancer screening education intervention.

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Acknowledgements

This research was supported by funding provided by the University of Kentucky Markey Cancer Center’s Cancer Center Support Grant National Cancer Institute #P30 CA177558. Support from the CCSG also enabled services from the Biostatistics and Community Based Research Shared Resource Facilities, whose services were used in the conduct of this research. All authors acknowledge that they have no conflicts of interest.

Funding

This study was funded by: University of Kentucky Markey Cancer Center’s Cancer Center Support Grant National Cancer Institute #P30 CA177558.

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Authors and Affiliations

  1. College of Nursing, University of Kentucky, 751 Rose St. 531 College of Nursing Building, Lexington, KY, 40536-0232, USA

    Lovoria B. Williams, Maria L. Gomez & Yazan D. Al-Mrayat

  2. College of Medicine, Cancer Biostatistics within the Division of Medical Oncology, University of Kentucky, Lexington, KY, USA

    Brent J. Shelton

  3. Department of Behavioral Science, University of Kentucky, College of Medicine, Lexington, KY, USA

    Jamie L. Studts

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  1. Lovoria B. Williams
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  2. Brent J. Shelton
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  3. Maria L. Gomez
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  4. Yazan D. Al-Mrayat
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  5. Jamie L. Studts
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Contributions

Conceptualization: [LW]; Methodology: [LW; JS; Formal analysis and investigation: [BS; YA]; Writing—original draft preparation: [LW]; Writing—review and editing: [All authors]; Funding acquisition: [LW]. All authors read and approved the final manuscript.

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Correspondence to Lovoria B. Williams.

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Williams, L.B., Shelton, B.J., Gomez, M.L. et al. Using Implementation Science to Disseminate a Lung Cancer Screening Education Intervention Through Community Health Workers. J Community Health 46, 165–173 (2021). https://doi.org/10.1007/s10900-020-00864-2

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  • DOI: https://doi.org/10.1007/s10900-020-00864-2

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