A stepped-wedge randomized trial protocol of a community intervention for increasing lung screening through engaging primary care providers (I-STEP)

Salazar, Ana S.; Sekhon, Subhjit; Rohatgi, Karthik W.; Nuako, Akua; Liu, Jingxia; Harriss, Courtney; Brennan, Ellen; LaBeau, Dareld; Abdalla, Ibrahim; Schulze, Christopher; Muenks, Jackie; Overlot, Dave; Higgins, Jeri Ann; Jones, Linda; Swick, Colleen; Goings, Stacia; Badiu, Jennifer; Walker, Justin; Colditz, Graham A.; James, Aimee S.

doi:10.1016/j.cct.2020.105991

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…New evidence-based lung cancer screening guidelines have refined our ability to identify high-risk individuals who would optimally benefit from lung cancer screening with low-dose computed tomography (LDCT). However, few eligible high-risk patients receive lung cancer screening due to limited or lack of awareness of lung cancer screening among patients [1,23]. Community outreach and education is particularly important for reducing disparities in lung cancer screening.…”

Section: Discussionmentioning

confidence: 99%

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery

et al. 2022

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Few eligible patients receive lung cancer screening. We developed the Lung AIR (awareness, information, and resources) intervention to increase community education regarding lung cancer screening. The intervention was designed as an inperson group intervention; however, the COVID-19 pandemic necessitated adapting the mode of delivery. In this study we examined intervention feasibility and efficacy overall and by mode of delivery (in-person group vs. one-on-one phone) to understand the impact of adapting community outreach and engagement strategies. Feasibility was examined through participant demographics. Efficacy was measured through pre/post knowledge, attitudes, and beliefs about lung cancer screening, and intention to complete screening. We reached N = 292 participants. Forty percent had a household income below $35,000, 58% had a high school degree or less, 40% were Hispanic, 57% were Black, and 84% reported current or past smoking. One-on-one phone sessions reached participants who were older, had lower incomes, more current smoking, smoked for more years, more cigarettes per day, lower pre-intervention lung cancer screening knowledge, and higher pre-intervention fear and worry. Overall pre/post test scores show significant increases in knowledge, salience, and coherence, and reduced fear and worry. Participants in the one-on-one phone sessions had significantly higher increases in salience and coherence and intention to complete screening compared to participants in the in-person group sessions. The Lung AIR intervention is a feasible and effective community-based educational intervention for lung cancer screening. Findings point to differences in reach and efficacy of the community-based intervention by mode of delivery.

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Section: Discussionmentioning

confidence: 99%

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery

et al. 2022

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“…This multilevel model for coordinated care leverages the clinical expertise of oncologists at both the academic and partner institutions managing patients with MBC, the numerous clinical trials available at SCC, and the unique NCI Community Oncology Research Program (NCORP) resources at the community partner centers. Employing the single institutional review board (IRB) structure through the WUSM, Project ADAPT extends existing SCC partnerships in the St. Louis region to develop a sustainable collaborative care model [ 26 ]. To achieve this goal, we have the following specific objectives: (1) assess patients’ satisfaction and acceptability of the academic and community collaborative care model for their MBC care; (2) evaluate providers’ (academic oncologists and referring oncology providers) satisfaction and acceptability of the collaborative care model with the referral and management processes of MBC patients; and (3) evaluate the implementation of the adapted EMBRACE program using fidelity and adoption measures.…”

Section: Methodsmentioning

confidence: 99%

“…Due to the various characteristics of our 3 partner sites, these sites are in different stages in the administrative and registration processes to obtain single IRB approval through the WUSM IRB. Utilizing the single IRB approval process strengthens the existing executive partnerships to create a sustainable research collaboration [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

Adapting and Developing an Academic and Community Practice Collaborative Care Model for Metastatic Breast Cancer Care (Project ADAPT): Protocol for an Implementation Science–Based Study

et al. 2022

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Background Metastatic breast cancer (MBC) remains incurable despite significant treatment advances. Coordinating care for patients with MBC can be challenging given the various treatment options, available clinical trials, and frequent need for ancillary services. To optimize MBC care, we designed a project for adapting and developing an academic and community practice collaborative care model for MBC care (Project ADAPT), based on the Ending Metastatic Breast Cancer for Everyone (EMBRACE) program developed at Dana Farber Cancer Institute. Objective We aim to describe the implementation science–based study design and innovative components of Project ADAPT. Methods Project ADAPT uses the Dynamic Adaptation Process informed by the Exploration, Preparation, Implementation, Sustainment framework. Washington University School of Medicine (WUSM) partnered with 3 community hospitals in the St. Louis region covering rural and urban settings. The exploration and preparation phases provide patient and provider feedback on current referral practices to finalize the approach for the implementation phase. At the implementation phase, we will enroll patients with MBC at these 3 community sites to evaluate potential collaborative care at WUSM and assess the impact of this collaborative care model on referral satisfaction and acceptability for patients with MBC and their providers. Patients may then return to their community site for care or continue to receive part of their care at WUSM. We are incorporating virtual and digital health strategies to improve MBC care coordination in order to minimize patient burden. Results The exploration phase is ongoing. As of August 2021, we have recruited 21 patient and provider participants to complete surveys of the current collaborative care process at WUSM. Using a 2-tailed paired t test, 44 patients (including 10 patients from the exploration phase) and 32 oncologists are required to detect an effect size of 0.5 with 80% power at a level of significance of .05. Throughout this phase and in preparation for the implementation phase, we have iteratively updated and refined our surveys for the implementation phase based on testing of our data collection instruments. Our partner sites are in various stages of the single institutional review board (IRB) approval process. We have ongoing engagement with all partner sites, which has helped solidify our participant recruitment strategies and design patient-friendly recruitment materials. In addition, we have included a patient advocate on the research team. Members of the research team have launched a single IRB Support Network at WUSM to create a repository of the single IRB procedures in order to streamline the partner site onboarding process and facilitate enhanced collaboration across institutions. Conclusions With this robust model, we expect that patients with MBC will receive optimal care regardless of geographical location and the model will improve patient and provider experiences when navigating the health system. International Registered Report Identifier (IRRID) DERR1-10.2196/35736

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Section: Project Adaptmentioning

confidence: 99%

Adapting and Developing an Academic and Community Practice Collaborative Care Model for Metastatic Breast Cancer Care (Project ADAPT): Protocol for an Implementation Science–Based Study (Preprint)

Housten¹,

Okere²,

Colditz³

et al. 2021

Preprint

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BACKGROUND Metastatic breast cancer (MBC) remains incurable despite significant treatment advances. Coordinating care for patients with MBC can be challenging given the various treatment options, available clinical trials, and frequent need for ancillary services. To optimize the care of those with MBC, we designed an academic and community practice collaborative care model based on the Ending Metastatic Breast Cancer for Everyone (EMBRACE) program developed at the Dana Farber Cancer Institute entitled Project ADAPT. OBJECTIVE To describe the implementation science-based study design and innovative components of Project ADAPT. METHODS Project ADAPT utilizes the Dynamic Adaptation Process informed by the Exploration, Preparation, Implementation, and Sustainment framework. Washington University School of Medicine (WUSM) partnered with three community hospitals in the St. Louis region covering rural and urban settings. The Exploration and Preparation phases provide patient and provider feedback on current referral practices to finalize the approach for the Implementation phase. At the Implementation phase, we will enroll patients with MBC at these three community sites to evaluate potential collaborative care at WUSM and assess the impact of this collaborative care model on referral satisfaction and acceptability for patients with MBC and their providers. Patients may then return to their community site for care or continue to receive part of their care at WUSM. We are incorporating virtual and digital health strategies in our approach to improving MBC care coordination to minimize the patient burden. RESULTS The Exploration phase is ongoing. As of August 2021, we have recruited 21 patient and provider participants to complete surveys of the current collaborative care process at WUSM. Throughout this phase and in preparation for the Implementation phase, we have iteratively updated and refined our surveys for the Implementation phase based on testing of our data collection instruments. Our partner sites are in various stages of the single Institutional Review Board (IRB) approval process, which involves a signed reliance agreement between the institutions as well as a site registration and study application process. We have ongoing engagement with all partner sites, which helped solidify our participant recruitment strategies and design patient-friendly recruitment materials. In addition, we have included a patient advocate on the research team. Members of the research team have launched a single IRB Support Network at WUSM to create a repository of the single IRB procedures to streamline partner sites’ onboarding process and facilitate enhanced collaboration across institutions. CONCLUSIONS With this robust model, we expect that patients with MBC will receive optimal care regardless of geographical location and will improve the patient and provider experiences when navigating the health systems

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A stepped-wedge randomized trial protocol of a community intervention for increasing lung screening through engaging primary care providers (I-STEP)

Cited by 7 publications

References 33 publications

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery

Adapting Community Educational Programs During the COVID-19 Pandemic: Comparing the Feasibility and Efficacy of a Lung Cancer Screening Educational Intervention by Mode of Delivery

Adapting and Developing an Academic and Community Practice Collaborative Care Model for Metastatic Breast Cancer Care (Project ADAPT): Protocol for an Implementation Science–Based Study

Adapting and Developing an Academic and Community Practice Collaborative Care Model for Metastatic Breast Cancer Care (Project ADAPT): Protocol for an Implementation Science–Based Study (Preprint)

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