Ready, Set, Screen: Evaluating Community Readiness for Lung Cancer Screening Among Non-Hispanic Black Populations in...

Lung cancer is the leading cause of cancer death in the United States, with non-Hispanic Black populations facing disproportionately high mortality and low lung cancer screening (LCS) rates. Despite national efforts to expand screening, limited evidence on community readiness may constrain implementation. This study assessed community readiness to implement LCS in Black communities in Broward County, Florida.

We used the community readiness model, which scores the following five dimensions: knowledge of efforts, leadership, community climate, knowledge of the issue, and resources, on a nine-point scale from 1 ("no awareness") to 9 ("high community ownership"). From June to August 2023, we conducted semi-structured interviews with 19 purposively sampled leaders across community, health care, academic, and government sectors. Two trained coders independently scored transcripts; consensus scores were averaged to determine readiness.

The mean overall readiness score was 1.92, corresponding to the "no awareness" stage. Community knowledge of LCS efforts was minimal (1.24), with participants noting limited outreach despite available screening services. Leadership engagement (1.92) was low, with LCS found as a lower priority amid other health demands. Knowledge of lung cancer (1.82) was limited, shaped by misinformation and lack of awareness. Community climate (1.61) reflected barriers such as cost, lack of insurance, and caregiving burdens. Resources scored higher (3.03), but existing assets remained uncoordinated and underutilized.

Black communities in Broward County demonstrated low readiness for LCS, driven less by hesitancy and more by invisibility. Building readiness will require targeted awareness building, leadership engagement, and coordination of existing resources before pursuing uptake-focused implementation.