Accepted for/Published in: JMIR Research Protocols
Date Submitted: Feb 20, 2023
Date Accepted: Feb 24, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Utilizing user-centered design to facilitate adherence to annual lung cancer screening: a mixed methods study protocol for intervention development
ABSTRACT
Background:
Lung cancer is the leading cause of cancer death in the US, with the majority of lung cancer diagnosed after the disease has already metastasized. Lung cancer screening (LCS) with low-dose CT can diagnose early-stage disease, especially when eligible individuals participate on a yearly basis. Unfortunately, annual adherence has emerged as a challenge for academic and community screening programs, endangering the individual and population health benefits of LCS. Reminder messages have effectively increased adherence rates in breast, colorectal, and cervical cancer screenings, but have not been tested with LCS participants who experience unique barriers to screening associated with the stigma of smoking and social determinants of health.
Objective:
The goal of this research is to use a theory-informed, multiphase, mixed-methods approach with LCS experts and participants to develop a set of clear and engaging reminder messages to support LCS annual adherence.
Methods:
In aim 1, survey data informed by the Cognitive Social Health Information Processing Model will be collected to assess how LCS participants process health information aimed at health protective behavior to develop content for the reminder messages and pinpoint options for message targeting and/or tailoring. Aim 2 focuses on identifying themes are message imagery through a modified photovoice activity that asks participants to identify three images that represent LCS to them and then participate in an interview about the selection, likes, and dislikes of each photo. A pool of candidate messages for multiple delivery platforms will be developed in aim 3 utilizing results from aim 1 for message content and aim 2 for imagery selection. Refinement of message content and imagery combinations will be completed through iterative feedback from LCS experts and participants.
Results:
Institutional Review Board approval was obtained by the Colorado Multiple Institutional Review Board in July 2021 (COMIRB 21-3881). Data collection started in July 2022 and will be complete by May 2023. Final reminder message candidates are expected to be complete by June 2023.
Conclusions:
This project proposes a novel approach to facilitate adherence to annual lung cancer screening through development of reminder messages that embrace content and imagery representative of the target population directly into the design process. Developing effective strategies to increase LCS adherence is instrumental in achieving optimal LCS outcomes at the individual and population health levels. Clinical Trial: Trial registration is not applicable.
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