Stakeholders' Voices of Lung Cancer Screening in Hong Kong: Study Protocol for a Mixed Methods Study

Introduction: This study aims to (1) explore physicians' perceptions and experiences of lung cancer screening in Hong Kong, (2) evaluate physicians' readiness of implementing lung cancer screening in Hong Kong, (3) explore high-risk smokers' health beliefs of lung cancer and screening, (4) identify barriers and facilitators for high-risk Hong Kong smokers to screening for lung cancer, and (5) validate the Chinese Lung Cancer Screening Health Belief Scale in relation to high-risk smokers in Hong Kong. Methods and analysis: A mixed methods design will be used in this study. Individual qualitative interviews will be conducted with physicians who have experience with high-risk smokers. Physicians' perceptions and experiences of lung cancer screening, and their readiness to accept lung cancer screening in Hong Kong, will be gathered through the qualitative interviews. A semi-structured interview guide will be used in the qualitative interviews. In addition, a quantitative survey with qualitative questions will be conducted on high-risk smokers to investigate their health beliefs of lung cancer and screening and barriers and facilitators for them to screening lung cancer. A lung cancer screening health belief scale, sociodemographic questionnaire, smoking and lung cancer screening history questionnaire, lung cancer and screening knowledge questionnaire, lung cancer stigma scale, generalized anxiety disorder scale, patient health questionnaire-9, patients' medical trust scale and preferred lung cancer screening intervention delivery questionnaire will be conducted in the quantitative survey. Constant comparison and content analysis will be used to analyze the qualitative data. Descriptive data analysis, validity and reliability analysis, one-way analysis of variance and post hoc analyses will be used to analyze quantitative data. Discussions: This study explores physicians' and high-risk smokers' perceptions and experiences toward lung cancer screening in Hong Kong. Findings from this study can help healthcare providers and policy makers become aware of the stakeholder's voices. In addition, these findings can help to inform the design of future interventional lung cancer screening programs and provide a tool to measure Chinese high-risk smokers' health beliefs toward lung cancer screening. A major limitation of this mixed methods study is the amount of time taken to complete the overall study. Also, its complexity requires more collaboration and networking among researchers. Ethics and dissemination: This study has minimal risk to the participants. It will be submitted to the university IRB for ethical approval. Findings related to physicians' perceptions and experiences of lung cancer screening in Hong Kong, physicians' readiness of implementing lung cancer screening, high-risk smokers' health beliefs of lung cancer and screening, barriers, and facilitators for high-risk Hong Kong smokers to screening lung cancer will be disseminated in journals and conferences. The reliability and validity of the Chinese lung cancer screening health belief scale will be reported in methodological research journals.