Implementation of a hybrid lung health program for Northeast Texas: study protocol

Lung cancer is the leading cause of cancer-related mortality in the United States. Lung cancer screening is recommended to individuals with a history of heavy cigarette smoking; it is proven to be effective in reducing lung cancer-related mortality, but the uptake remains low. In this project, we employ a hybrid model to ensure consistent screening for tobacco use and lung cancer screening eligibility, provision of tobacco cessation care, shared decision making for lung cancer screening, subsequent completion of screening, and navigation to follow-up care as needed, in Northeast Texas.

The project is a partnership between a comprehensive cancer center, a university-affiliated hospital system, and a Federally Qualified Health Center. The intervention is designed as a hybrid lung cancer screening program, with a mix of centralized and decentralized features, to deliver high-quality tobacco cessation and lung cancer screening care for individuals in Northeast Texas. Major components of the intervention include training clinicians in shared decision making for lung cancer screening and tobacco cessation interventions; ensuring consistent screening for tobacco use and identification of patients eligible to lung cancer screening; provision of tobacco cessation interventions; and lung cancer screening completion support and navigation for further care, including follow-up testing and lung cancer treatment, as needed.

Through a hybrid care model, the project aims to enhance the quality of tobacco cessation care and shared decision making for lung cancer screening, increase screening uptake by eligible patients, and promote adherence to follow-up care and annual screening. The project also contributes to increased awareness of lung cancer and lung cancer screening in the community through dissemination and outreach strategies.