Developing and testing a brief clinic‐based lung cancer screening decision aid for primary care settings |
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| Authors: | Karen Kane McDonnell PhD RN OCN Scott M Strayer MD MPH Erica Sercy MSPH Callie Campbell BA Daniela B Friedman PhD Kathleen B Cartmell PhD MPH Jan M Eberth PhD |
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| Institution: | 1. College of Nursing, University of South Carolina, Columbia, SC, USA;2. Department of Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA;3. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;4. Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;5. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA;6. College of Nursing, Medical University of South Carolina, Columbia, SC, USA |
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| Abstract: | Background Cancer screening‐related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. PCPs play an essential role in facilitating comprehensive shared decision making (SDM). Objective To develop and test a decision aid (DA) and SDM strategy for PCPs and high‐risk patients. Design The DA was tested with 20 dyads. Each dyad consisted of one PCP and one patient eligible for screening. A prospective, one‐group, mixed‐method study design measured fidelity, patient values, screening intention, acceptability and satisfaction. Results Four PCPs and 20 patients were recruited from an urban academic medical centre. Most patients were female (n = 14, 70%), most had completed high school (n = 15, 75%), and their average age was 65 years old. Half were African American. Patients and PCPs rated the DA as helpful, easy to read and use and acceptable in terms of time frame (observed t = 11.6 minutes, SD 2.7). Most patients (n = 16, 80%) indicated their intent to be screened. PCPs recommended screening for most patients (n = 17, 85%). Conclusions Evidence supports the value of lung cancer screening with LDCT for select high‐risk patients. Guidelines endorse engaging patients and their PCPs in SDM discussions. Our findings suggest that using a brief, interactive, plain‐language, culturally sensitive, theory‐based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting. |
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| Keywords: | decision support early detection of cancer lung neoplasms patient preferences primary care providers |
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