The Importance of Lay Navigators in Lung Cancer Screening Among Asian Americans in an Integrated Healthcare System
Abstract
BACKGROUND
Lung cancer is a leading cause of death in Asian Americans (AsA), yet prior findings within our health system revealed lung cancer screening (LCS) rates are low in AsA. This study evaluates the effectiveness of active versus passive outreach in improving LCS uptake among AsA.
METHODS
This clinical trial included 1000 AsA who met LCS eligibility using electronic health records, assigned to either active or passive outreach using stratified random sampling based on age, sex, smoking status, and service area. The active outreach group was contacted about LCS by a lay navigator. The passive group received outreach about LCS by email only. Both groups were surveyed and followed to compare outcomes, including LCS referral, shared decision-making, and low-dose computerized tomography for LCS.
RESULTS
A total of 997 participants received outreach; 3 were excluded from the active outreach group, due to death prior to contact. Outcomes were more prevalent in active (vs. passive) group participants: LCS referral (25% vs. 12%), shared decision-making (16% vs. 7%), and low-dose computerized tomography screening (11% vs. 4.4%, ). After adjustment for demographic factors, active (vs. passive) group participants were 2.99x more likely to receive a LCS referral. Of the 12% of participants completed the survey, 76% of active group respondents had a favorable view of the lay navigator and 94% indicated no negatives to being contacted by the navigator.
CONCLUSIONS
This novel study…
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