JMIR Publications

ABSTRACT

Background:

Lung cancer remains the leading cause of cancer deaths in the United States, yet uptake of lung cancer screening (LCS) with low dose computed tomography (LDCT) among eligible individuals remains low. Evidence suggests that limited knowledge, stigma, and false health beliefs contribute to underutilization of the LDCT screening.

Objective:

This pilot study examined an online educational intervention aimed at improving knowledge, attitudes, health beliefs, and behavioral intentions, perceived importance, and confidence related to LCS among high-risk individuals.

Methods:

A single-group pre–post intervention design was used. High-risk individuals who smoke, defined according to the U.S. Preventive Services Task Force (USPSTF) criteria, completed baseline questionnaires followed by five self-directed online educational modules delivered through REDCap. Post-intervention questionnaires assessed changes in lung cancer and screening knowledge, lung cancer stigma, health beliefs based on the Health Belief Model, and intentions, perceived importance, and confidence regarding LDCT screening. LCS uptake was assessed via follow-up email three months after the intervention. Data were analyzed using descriptive statistics and paired-samples t-tests.

Results:

Twenty-five participants completed the intervention. Significant improvements were observed across all major study outcomes. Knowledge scores increased markedly (3.76 to 8.60, p < .001), while lung cancer stigma decreased (25.52 to 19.16, p < .001). Health Belief Model constructs showed significant improvements, including perceived susceptibility, perceived benefits, cues to action, and self-efficacy, alongside reductions in perceived barriers and perceived severity (all p < .001). Self-reported intentions, perceived importance, and confidence related to obtaining LDCT screening increased significantly. Of the 22 participants who completed the 3-month follow-up (88%), 13 (59.1%) reported obtaining LDCT screening. Participant satisfaction with the intervention was high (mean = 18.32/20).

Conclusions:

Findings from this pilot study support the feasibility, acceptability, and preliminary efficacy of an online educational intervention created to promote LCS among high-risk individuals. The intervention improved knowledge, reduced stigma, positively influenced health beliefs, and increased screening intentions, perceived importance, confidence, and uptake. Results provide a foundation for a larger-scale study and suggest that online educational platforms may be an effective strategy to reach geographically diverse high-risk populations and promote LDCT screening.