Introduction Lung cancer screening with low-dose computed tomography (LDCT) scan is now covered by Centers for Medicare & Medicaid Services following an evidence-based recommendation, but a shared decision making process should inform patients of risks and limitations. An awareness campaign promoting LDCT screenings is an opportunity to elicit patient engagement with health providers about the risks and benefits. Focus groups representing three regions of Appalachian Kentucky known for high lung cancer rates discussed development of a lung cancer screening campaign. Recommendations included messaging content, appeals or design, campaign implementation, and trusted information or communication sources. Methods Community health workers (CHWs) from three Eastern Kentucky regions recruited individuals from their local communities using established client files. CHWs hosted six total focus groups (7–11 participants each) using questions guided by the Communication-Persuasion Matrix framework. All sessions were recorded and transcribed for independent content analysis. Results A total of fifty-four individuals (61.1% female; >55 pack year history) participated. Prior to discussion, most participants had not heard of lung cancer screening. Cited needs for content of a campaign included benefits of early detection and payment information. Messages considered most persuasive were those that include: personal testimony, messages of hope, prolonged life, and an emphasis on family and the ambition to survive. Having information come from one’s family doctor or specialty provider was considered important to message communication. Conclusions Messages about survivorship, family, and prolonged life should be considered in lung cancer screening awareness campaigns. Our results provide community input about messages regarding screening options.

For low dose CT lung cancer screening to be effective in curbing disease mortality, efforts are needed to overcome barriers to awareness and facilitate uptake of the current evidence-based screening guidelines. A sequential mixed-methods approach was employed to design a screening campaign utilizing messages developed from community focus groups, followed by implementation of the outreach campaign intervention in two high-risk Kentucky regions. This study reports on rates of awareness and screening in intervention regions, as compared to a control region.

Background Increased prevalence of overweight and obesity among Appalachian residents may contribute to increased cancer rates in this region. This manuscript describes the design, components, and participant baseline characteristics of a faith-based study to decrease overweight and obesity among Appalachian residents. Methods A group randomized study design was used to assign 13 churches to an intervention to reduce overweight and obesity (Walk by Faith) and 15 churches to a cancer screening intervention (Ribbons of Faith). Church members with a body mass index (BMI) ≥25 were recruited from these churches in Appalachian counties in five states to participate in the study. A standard protocol was used to measure participant characteristics at baseline. The same protocol will be followed to obtain measurements after completion of the active intervention phase (12 months) and the sustainability phase (24 months). Primary outcome is change in BMI from baseline to 12 months. Secondary outcomes include changes in blood pressure, waist-to-hip ratio, and fruit and vegetable consumption, as well as intervention sustainability. Results Church members (n = 664) from 28 churches enrolled in the study. At baseline 64.3% of the participants were obese (BMI ≥30), less than half (41.6%) reported regular exercise, and 85.5% reported consuming less than 5 servings of fruits and vegetables per day. Conclusions Church members recruited to participate in a faith-based study across the Appalachian region reported high rates of unhealthy behaviors. We have demonstrated the feasibility of developing and recruiting participants to a faith-based intervention aimed at improving diet and increasing exercise among underserved populations.

O besity in both sexes and all age groups has become a prominent problem in the United States. The city of Durham in North Carolina, like many cities in this country, has many individuals who are obese. The Durham County 2011 Community Health Assessment notes that 65% of adults in the county are overweight or obese [1]. Obesity is more prevalent among blacks and Hispanics than among whites throughout the United States [2], and in the city of Durham, 41% of the population is black and 14.2% is Hispanic [3]. Obesity is becoming more prevalent in children as well as adults. Nationally, 16.9% of children are obese [4], and in Durham County, 20% of children are [1].The scope of the problem in Durham has stimulated a team of researchers, clinicians, and community members to develop a proposal for reducing obesity, starting with elementary school children. The project, called Achieving Health for a Lifetime (AHL), will then expand to include older and younger children in schools and eventually parents and older adults in the communities surrounding the schools.Recommendations regarding diet, physical activity, and other behaviors have been widely disseminated for decades. Some experts in the United States now believe that in order to better manage the problem of overweight and obesity, national policy changes are needed that might have an effect on citizens' dietary and physical activity habits [5]. Multidimensional approaches that include policy change and combine the resources of public, private, and philanthropic organizations to ensure a coordinated and sustainable long-term effort can also be effective when initiated locally, as evidenced by recent research [6][7][8][9][10][11][12][13]. However, such an approach is likely to be successful only after a proper community assessment is carried out in partnership with the community in which one hopes to initiate change. Following the examples of the city of Somerville, Massachusetts, the city of Chicago, the state of Delaware, and others [6-10], AHL used community meetings, interviews, focus groups, and advisory councils to assess existing local services and gaps in those services, and to solicit input, support, and assistance from a range of sources.Community engagement is defined as the process of working collaboratively with groups of people who are affiliated by geographic proximity, special interests, or simi-

Case summaryBronchial stents may be useful to relieve clinical signs of extraluminal compression. Herein we describe a case which, to our knowledge, is the first cat where bilateral bronchial stents have been used clinically. Respiratory signs of principal bronchial compression were alleviated after the stent procedure. Minor complications occurred, specifically: severe hypoxia during stent deployment; a transient, self-limiting postoperative pneumothorax possibly associated with ventilation-induced lung injury; bronchopneumonia (possibly pre-existing); and transient worsening of cough postoperatively. Stents were well- tolerated long- term. The cat was euthanased at 44 weeks post-stent procedure, owing to clinical signs of regurgitation, seemingly related to oesophageal dysfunction associated with tumour invasion.Relevance and novel informationIn this case, it appeared that bronchial stents were feasible and the procedure was associated with long-term improvement in respiratory signs related to extraluminal bronchial compression.