Telehealth coaching to support lung cancer screening decisions for Hispanic adults

TELEhealth Shared Decision-making COaching for Lung Cancer Screening in Primary Care (TELESCOPE) for Hispanics

This project will test a culturally adapted telehealth decision-coaching and navigation program delivered by bilingual navigators to help Hispanic adults at high risk decide about and access low-dose CT lung cancer screening.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 91 (estimated)
• Ages: 50 Years to 77 Years
• Sex: All
• Sponsor: Rutgers, The State University of New Jersey (other)
• Locations: 1 site (New Brunswick, New Jersey)
• Trial ID: NCT07165691 on ClinicalTrials.gov

What this trial studies

The study will culturally adapt an existing TELESCOPE telehealth shared decision-making and navigation intervention for Hispanic patients using iterative feedback from a Community Advisory Board, focus groups, and interviews. Bilingual patient navigators will deliver the adapted intervention and the team will run a pilot randomized trial comparing the adapted intervention to enhanced usual care in primary care settings. Primary outcomes are feasibility and acceptability, measured by recruitment and completion rates, intervention fidelity, and participant and clinician ratings; a secondary outcome is uptake of low-dose CT screening. The pilot will inform whether a larger trial is warranted and how best to implement the approach in Hispanic communities.

Who should consider this trial

Good fit: Hispanic or Latino adults aged 50–77 who are current or former smokers with at least a 20 pack-year history, able to read and speak English or Spanish, and (for the pilot phase) scheduled for a routine primary care visit are ideal candidates.

Not a fit: People who are not Hispanic, are outside the 50–77 age range, have under a 20 pack-year smoking history, cannot communicate in English or Spanish, or otherwise meet the trial exclusion criteria (for example recent hemoptysis) are unlikely to benefit from this tailored intervention.

Why it matters

Potential benefit: If successful, the program could improve informed decision-making and increase appropriate lung cancer screening among Hispanic patients, potentially enabling earlier detection.

How similar studies have performed: Similar shared-decision coaching and navigation programs, including the original TELESCOPE intervention, have shown promise for improving decision quality and screening uptake, but culturally tailored telehealth coaching specifically for Hispanic populations is relatively novel.

Eligibility criteria

Inclusion Criteria:

Aim 1 (Cultural Adaptation):

To be eligible, patients must:

1. Identify as Hispanic and/or Latino(a)
2. Able to read and speak in English or Spanish
3. Be 50 to 77 years of age
4. Be a current or former smoker
5. Have at least a 20-pack-year smoking history

Aims 2-3 (Pilot Randomized Controlled Trial)

To be eligible, patients must:

* Identify as Hispanic or Latino(a)
* Able to speak and read in English or Spanish
* Be 50 to 77 years of age
* Be a current or former smoker having quit within the past 15 years
* Have at least a 20 pack-year smoking history
* Be scheduled for a non-acute care visit at one of the study sites.
* Not coughing up blood in the last two weeks

Interviews

Providers completing the semi-structured interviews will be:

* A practicing primary care clinician or a clinic director (n=20), nursing director, or clinic practice administrator at one of the participating sites, or a TELESCOPE study patient navigator and nurse navigator
* Age 18 or older
* Fluent in English

Online surveys

Providers completing online PRISM construct surveys will be:

* A practicing primary care provider at one of the participating sites or a TELESCOPE study navigator
* Age 18 or older
* Fluent in English

Exclusion Criteria:

For the cluster randomized trial, excluded will be patients who:

* Do not speak English
* Are not Hispanic or Latino(a)
* Have a history of lung cancer
* Had a CT scan in the past 12 months
* Has been coughing up blood in the last two weeks
* Have health conditions that make them poor candidates for curative treatment as determined by the primary care provider,
* Are unable to provide informed consent Interviews

Providers/administrators will be excluded if they:

* Are unable to provide informed consent Online surveys
* Are unable to provide informed consent
* Women who are pregnant.

Where this trial is running

New Brunswick, New Jersey

• Rutgers Cancer Institute — New Brunswick, New Jersey, United States (RECRUITING)

Study contacts

• Principal investigator: Evelyn Arana, DrPH — Rutgers Cancer Institute of NJ
• Study coordinator: Evelyn Arana, DrPH

Conditions: Lung Neoplasms, lung cancer screening, shared decision making, Respiratory Tract Neoplasms, Thoracic Neoplasms, Neoplasms by Site, Neoplasms, Lung Diseases