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Published on: August 1, 2019
A Multilevel Intervention to Improve Lung Cancer Screening Among Hispanic Patients: A Pilot Randomized Controlled
Mahnur Bharucha1, Omar Gutierrez2, Aarushi Madan2
1School of Medicine, University of California Riverside, CA, USA.
Purpose:
We evaluated the preliminary efficacy of Empower LCS, a culturally-adapted multilevel intervention, compared with enhanced usual care (EUC) for improving LCS uptake among Hispanic patients.
Methods:
In this pilot randomized controlled trial, Hispanic patients aged 50-80 years who met 2021 US Preventive Services Task Force LCS eligibility criteria were enrolled between February 2024 and August 2025. Participants were randomized 1:1 to EUC or Empower LCS. EUC included usual care plus a one-page educational handout. Empower LCS included a culturally adapted decision aid, provider notifications, patient text reminders, and health-related social needs support. The primary outcome was LDCT ordering within 4 months, assessed by medical record review or self-report. Analyses used chi-square tests and logistic regressions.
Results:
Sixty patients were randomized (mean age, 60.8 years ± 7.4; 37/60 [61.7%] male; 21/60 [35.0%] Spanish-speaking). At 4 months, LDCT ordering was higher with Empower LCS than with EUC (15/30 [50.0%] vs 4/30 [13.3%]; p=0.002), as were LCS discussions (12/30 [40.0%] vs 5/30 [16.7%]; p=0.045). LDCT completion was higher but not significant (9/30 [30.0%] vs 4/30 [13.3%]; p=0.117), likely due to small sample size. In exploratory adjusted models, Empower LCS was associated with higher odds of LCS ordering (OR, 7.32; 95% CI, 1.97-34.16), and discussion (OR, 4.1; 95% CI, 1.20-16.28). Qualitative interviews identified provider trust and logistical barriers as drivers of screening engagement and completion, respectively.
Conclusions:
Empower LCS increased LDCT ordering and screening discussions in this pilot trial. These findings support culturally tailored, low-cost, scalable interventions to reduce disparities in LCS participation.
