Implementing a Tribally Engaged Lung Cancer Screening Pilot Program in Rural Oklahoma

Area of Science:

• Public Health
• Health Services Research
• Oncology

Background:

• Lung cancer screening (LCS) is crucial for early detection, but uptake remains low, particularly in underserved populations.
• Tribally operated health systems face unique challenges in implementing evidence-based screening programs.

Purpose of the Study:

• To co-design and pilot a community-based lung cancer screening program within a large, tribally operated health system.
• To assess the impact of a tailored, comprehensive LCS program on screening rates and patient/clinician experiences.

Main Methods:

• A pre-post quasi-experimental pilot study was conducted in two primary care clinics serving the Choctaw Nation of Oklahoma.
• The intervention involved screening quality assessment, academic detailing, practice facilitation, health system enhancements, and community outreach.
• Data collection included pre- and post-intervention surveys, chart extraction for LCS completion, and semi-structured interviews.

Main Results:

• The proportion of participants up to date with LCS increased significantly from 39% to 58% (p<0.01).
• Approximately 40% of patients reported improved awareness of lung cancer and LCS receipt.
• Key facilitators and barriers to LCS implementation were identified at practice and health system levels.

Conclusions:

• A comprehensive, community-engaged LCS program significantly improved screening acceptance and uptake in an underserved, tribal setting.
• This pilot intervention provides valuable insights for future large-scale trials and improving LCS delivery in similar communities.