Author Affiliations: College of Nursing, Augusta University, Georgia (Drs Williams and McCall and Mr Joshua); College of Nursing, University of Kentucky, Lexington (Dr Williams); and Department of Population Health Sciences (Dr Looney) and Departments of Pediatrics and Population Health Sciences, the Georgia Prevention Institute (Dr Tingen), Medical College of Georgia, Augusta University.
Cancer Nurs. 2021;44(2):89-97. doi: 10.1097/NCC.0000000000000748.
Lung cancer is the no. 1 cause of cancer death in the United States. Racial/ethnic minority and medically underserved populations suffer higher mortality than whites. Early detection through uptake of low-dose computed tomography (LDCT) among screening-eligible adults may mitigate high mortality. However, nearly 5 years since the publication of the US Preventive Services Task Force lung cancer screening guideline, population awareness of LDCT is low, and only 4% of screening-eligible adults have undergone screening.
This project used an education intervention to change participants' knowledge, attitudes, and beliefs about cancer risk factors and lung cancer and to connect eligible individuals to LDCT screening and tobacco cessation services.
INTERVENTIONS/METHODS: Community-engaged strategies were used to deliver a 4-week educational program in 13 community sites. Trained community health workers delivered the intervention. The intervention was guided by the Health Belief Model. Data were collected by survey to 481 participants; 93% were African American, the majority was female (73.1%), mean age was 58.3 (SD, 10.9) years.
There were knowledge increase regarding lung cancer screening (P = .001), a significant decrease in Perceived Severity and Perceived Barriers subscales (P = .001), and an overall increase in response to Perceived Benefits of lung cancer screening and Self-efficacy (P = .001). Fifty-four percent of tobacco users engaged in cessation; 38% of screening-eligible participants underwent LDCT screening.
Community health workers are effective in increasing awareness of lung cancer screening and affecting behavior change among disparate populations.
Community health workers may have a clinical role in LDCT shared decision making.
肺癌是美国癌症死亡的首要原因。少数族裔和医疗服务不足的人群比白人的死亡率更高。在有筛查资格的成年人中通过采用低剂量计算机断层扫描（LDCT）进行早期检测，可能会降低高死亡率。然而，自美国预防服务工作组发布肺癌筛查指南近 5 年以来，公众对 LDCT 的认识仍然很低，只有 4%的有筛查资格的成年人接受了筛查。
本项目使用教育干预措施来改变参与者对癌症风险因素和肺癌的知识、态度和信念，并将符合条件的个体与 LDCT 筛查和戒烟服务联系起来。
干预措施/方法：采用社区参与策略在 13 个社区场所开展为期 4 周的教育计划。经过培训的社区卫生工作者提供干预措施。该干预措施以健康信念模型为指导。通过调查收集了 481 名参与者的数据；93%的参与者为非裔美国人，大多数为女性（73.1%），平均年龄为 58.3（SD，10.9）岁。
参与者对肺癌筛查的知识有所增加（P=.001），对肺癌筛查的感知严重程度和感知障碍子量表的得分显著降低（P=.001），对肺癌筛查的感知益处和自我效能的反应整体增加（P=.001）。54%的吸烟者参与了戒烟；38%的有筛查资格的参与者接受了 LDCT 筛查。
社区卫生工作者在提高不同人群对肺癌筛查的认识和影响行为改变方面是有效的。
社区卫生工作者可能在 LDCT 共享决策方面发挥临床作用。
