Ready to screen implementation trial protocol: a cluster randomized implementation trial comparing a bundled...

Area of Science:

• Public Health
• Implementation Science
• Oncology

Background:

• Lung cancer screening (LCS) uptake remains low in high-risk populations globally.
• Primary care providers are crucial for identifying eligible patients and facilitating LCS referrals.
• Targeted strategies are needed to overcome barriers like low awareness, eligibility assessment challenges, and system preparedness issues.

Purpose of the Study:

• To evaluate a bundled implementation strategy to enhance lung cancer screening (LCS) uptake within Australia's National Lung Cancer Screening Program.
• To compare the effectiveness of a bundled approach (core elements plus digital resources and reminders) against a standard approach (brochure only).

Main Methods:

• A cluster randomized controlled implementation trial involving 28 Australian general practices.
• Practices will identify eligible patients (aged 50-70, with smoking history) and invite them to participate.
• The primary outcome is participant intention to screen, with secondary outcomes assessed using the RE-AIM framework and PRISM model.

Main Results:

• The trial aims to determine the effectiveness and cost-effectiveness of the bundled implementation strategy.
• Data will be collected through practice records, participant and provider surveys, and interviews.
• Analysis will focus on intention to screen, reach, adoption, implementation, and maintenance of LCS.

Conclusions:

• This trial will provide crucial evidence on the effectiveness and cost-effectiveness of a bundled strategy for delivering LCS in primary care.
• Results will offer insights into contextual factors influencing implementation success.
• Findings will guide the future scaling and sustainability of lung cancer screening programs in Australia and internationally.