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Previsit Preparation for Shared Decision-Making in Lung Cancer Screening in Primary Care Using a Paper Decision Aid

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An automated text message strategy significantly improved lung cancer screening (LCS) knowledge and nearly tripled completion rates in eligible patients. This approach enhances shared decision-making (SDM) in primary care.

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Area of Science:

  • Primary Care Research
  • Health Communication
  • Clinical Decision Support

Background:

  • Shared decision-making (SDM) is crucial for lung cancer screening (LCS) but challenging in primary care.
  • Innovative methods are needed to prepare LCS-eligible patients for SDM and increase screening rates.

Purpose of the Study:

  • To pilot previsit preparation strategies for LCS shared decision-making in primary care.
  • To compare a paper decision aid (DA) with an enhanced strategy including DA and automated text messages (DA+TM).
  • To assess feasibility and preliminary effects on LCS discussions, SDM, and uptake.

Main Methods:

  • A sequential quasi-experimental pilot study in an academic health care system.
  • Eligible patients received either a paper DA or DA+TM before their visit.
  • Exploratory analyses assessed LCS discussion, SDM, knowledge, decision conflict, and LCS completion.

Main Results:

  • The DA+TM group showed significant improvement in LCS knowledge (P=.003).
  • Decision conflict decreased significantly in both groups.
  • LCS completion rates at 3 months were 5% (DA) vs. 31% (DA+TM), P=.07.

Conclusions:

  • Previsit preparation using a text message-enhanced strategy is feasible in primary care.
  • This approach may improve patient engagement, informed decision-making, and LCS uptake.
  • Automated text messages show potential for reaching LCS-eligible populations.