Online Intervention on Lung Cancer Screening Among High-Risk Individuals: Pilot Intervention Study

Lung cancer remains the leading cause of cancer deaths in the United States; however, uptake of lung cancer screening (LCS) with low-dose computed tomography (LDCT) among eligible individuals remains low. Evidence suggests that limited knowledge, stigma, and false health beliefs contribute to the underuse of LDCT screening.

This pilot study aimed to examine an online educational intervention designed to improve knowledge, attitudes, health beliefs, behavioral intentions, perceived importance, and confidence related to LCS among high-risk individuals.

A single-group preintervention and postintervention design was used. High-risk individuals who smoke, defined according to the US Preventive Services Task Force criteria, completed baseline questionnaires followed by 5 self-directed online educational modules delivered through Research Electronic Data Capture (REDCap). Postintervention questionnaires assessed changes in lung cancer and screening knowledge, lung cancer stigma, health beliefs based on the health belief model and precaution adoption process model, and intentions, perceived importance, and confidence regarding LDCT screening. LCS uptake was assessed via follow-up email 3 months after the intervention. Data were analyzed using descriptive statistics and paired-samples two-tailed t tests.

A total of 25 participants completed the intervention. Significant improvements were observed across all major study outcomes. Knowledge scores increased markedly (score=3.76-8.60; P<.001), while lung cancer stigma decreased (score=25.52-19.16; P<.001). Health belief model constructs showed significant improvements, including perceived susceptibility, perceived benefits, cues to action, and self-efficacy, alongside reductions in perceived barriers and perceived severity (all P<.001). Self-reported intentions, perceived importance, and confidence related to obtaining LDCT screening increased significantly. Of the 22 (88%) participants who completed the 3-month follow-up, 13 (59.1%) reported obtaining LDCT screening. Participant satisfaction with the intervention was high, with a mean score of 18.32 (SD 2.33) out of 20.

Findings from this pilot study support the feasibility, acceptability, and preliminary efficacy of an online educational intervention created to promote LCS among high-risk individuals. The intervention improved knowledge; reduced stigma; positively influenced health beliefs; and increased screening intentions, perceived importance, confidence, and uptake. Results provide a foundation for a larger-scale study and suggest that online educational platforms may be an effective strategy to reach geographically diverse high-risk populations and promote LDCT screening.