Preliminary Testing of A Web-Based Lung Cancer Screening Decision Coaching Tool for Older Chinese American Smokers and Their Providers

J Natl Med Assoc. 2023 Apr;115(2):223-232. doi: 10.1016/j.jnma.2023.01.009. Epub 2023 Feb 16.

Abstract

Objectives: To examine the acceptability of a culturally targeted lung cancer screening decision aid developed for older Chinese Americans with a smoking history and primary care providers serving this patient population.

Methods: Study participants reviewed a web-based decision aid (DA) for lung cancer screening named "Lung Decisions Coaching Tool (LDC-T)." Participants completed a baseline survey and were invited to join an interview. During the interview, participants engaged with the Lung Decisions Coaching Tool and then completed standardized measures of acceptability, usability, and satisfaction.

Results: Chinese American smokers (N =22) and Chinese American physicians (N=10) rated the acceptability and usability of a patient version and provider versions of the LDC-T, respectively. Patient version demonstrated high levels of acceptability, usability and satisfaction. Most participants rated the information provided as good or excellent, the amount of tool information was just right, and they thought the tool would be useful for making a screening decision. The tool was well received by participants for ease of use and well-integrated functions. Furthermore, participants indicated they would like to use the tool to help prepare for lung cancer screening shared decision-making with their provider. Similar results were found for the provider version of the LDC-T.

Conclusions: Lung cancer screening represents an evidence-based approach to reducing lung cancer morbidity and mortality among chronic high-frequency smokers. Study results suggest the acceptability of a culturally targeted lung cancer screening decision aid for Chinese American smokers and providers. Additional research is needed to determine the effectiveness of the DA in increasing appropriate levels of screening in this underserved population.

Keywords: Chinese American; Culturally targeted; Decision-aid; LDCT lung cancer screening; Tobacco use.

MeSH terms

  • Attitude of Health Personnel / ethnology
  • Culturally Competent Care* / ethnology
  • Culturally Competent Care* / standards
  • Decision Support Techniques*
  • Early Detection of Cancer* / methods
  • Early Detection of Cancer* / psychology
  • Early Detection of Cancer* / standards
  • East Asian People* / psychology
  • Humans
  • Internet
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / ethnology
  • Lung Neoplasms* / etiology
  • Medically Underserved Area
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / psychology
  • Physicians / psychology
  • Psychometrics
  • Smokers / psychology
  • Smoking / adverse effects
  • United States