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A Personalized Digital Outreach Intervention for Lung Cancer Screening

Award Number: R01CA237240
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 01/01/2020
PERIOD OF PERFORMANCE END DATE: 12/31/2025

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A Personalized Digital Outreach Intervention for Lung Cancer Screening - Using annual chest CTs to screen for lung cancer, the leading cause of cancer death in the United States, can reduce mortality by up to 20%; however, fewer than 4% of eligible Americans are screened. The US Preventive Services Task Force endorses lung cancer screening (LCS) for high risk current and former smokers. At the same time, LCS poses significant risks, such as false positives and invasive procedures. Accordingly, guidelines recommend and Medicare requires that patients engage in a shared decision making visit prior to screening. Unfortunately, primary care providers rarely discuss, and consequently patients rarely receive, LCS. Patient, provider, and system barriers contribute to low LCS rates. Many patients are unaware that LCS exists, that it is effective, or that they qualify for screening. The risks and benefits of LCS vary substantially according to patients’ risk factors making general education about LCS difficult. Healthcare providers have poor understanding of the screening criteria and lack the time and personalized information needed for shared decision making discussions. Decision aids for LCS are a partial solution; they can increase patient awareness, deliver personalized information, and help patients make a screening decision. However, they fail to address many provider and system barriers. Our team has developed an innovative digital outreach strategy called mPATH-Lung (mobile Patient Technology for Health – Lung) based on Social Ecological Theory and the Integrative Model of Behavior. mPATH-Lung has multilevel functionality: it (a) queries the electronic health record to identify potential screening candidates, (b) sends those individuals electronic invitations to visit a web-based LCS decision aid that helps them make a screening decision concordant with their values, and (c) empowers patients to electronically request an LCS clinic appointment for the mandated shared decision making and subsequent screening. Electronic program summaries are sent to patients and providers, ensuring shared decision making visits occur with informed participants. This project will determine the impact of mPATH-Lung on patient decision making and receipt of LCS in a pragmatic randomized controlled trial using a mixed methods design. The Specific Aims of the proposal are to: 1) Determine the effect of mPATH-Lung on receipt of LCS in a pragmatic randomized-controlled trial of 1318 primary care patients in two large health networks with a catchment area extending to 5 states; 2) Elucidate the drivers of patients’ LCS decisions and screening behavior using a values clarification exercise and semi-structured interviews with at least 60 patients selected to represent the spectrum of decision-behavior concordance; and 3) Explore implementation outcomes that will impact the sustainability and dissemination of mPATH-Lung using program data, surveys, and interviews. This project could decrease lung cancer morbidity and mortality by broadening the use of LCS while simultaneously supporting patient-centered care. Importantly, our digital outreach design could have broad applicability to other health conditions, expanding the impact of this proposal beyond LCS.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	000	5	5/12/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $497,435 )
2024	2024	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	001	5	6/28/2024	NON-COMPETING CONTINUATION	$497,435
2024	2023	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	000	4	4/15/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $497,435

Issue Date FY: 2023 ( Subtotal = $607,592 )
2023	2023	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	000	4	2/15/2023	NON-COMPETING CONTINUATION	$607,592
														Subtotal = $607,592

Issue Date FY: 2022 ( Subtotal = $568,742 )
2022	2022	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	001	3	7/8/2022	NON-COMPETING CONTINUATION	$46,428
2022	2022	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	000	3	1/17/2022	NON-COMPETING CONTINUATION	$522,314
														Subtotal = $568,742

Issue Date FY: 2021 ( Subtotal = $567,242 )
2021	2021	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	000	2	12/10/2020	NON-COMPETING CONTINUATION	$538,879
2021	2021	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	001	2	1/27/2021	NON-COMPETING CONTINUATION	$28,363
														Subtotal = $567,242

Issue Date FY: 2020 ( Subtotal = $635,420 )
2020	2020	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	000	1	11/26/2019	NEW	$620,440
2020	2020	WAKE FOREST UNIVERSITY HEALTH SCIENCES	MEDICAL CENTER BLVD	WINSTON SALEM	NC	27157	FORSYTH	USA	Cancer Cause and Prevention Research	001	1	1/24/2020	NEW	$14,980
														Subtotal = $635,420

Grand Total All Awards = $2,876,431

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A Personalized Digital Outreach Intervention for Lung Cancer Screening

Award Number: R01CA237240

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 01/01/2020

PERIOD OF PERFORMANCE END DATE: 12/31/2025

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