Developing a Conceptual Framework for a Person-Centered Approach to Improving Adherence and Outcomes in Lung Cancer Screening: The Engaged Approach to Lung Cancer Screening: A Brief Report

Abstract

Introduction: Translating outcomes from randomized trials of lung cancer screening into community practice settings has been challenging. We developed a framework—the Engaged Approach to Lung Cancer Screening (EA-LCS)—for improving adherence and individual and population health outcomes in LCS. Methods: Employing community-engaged research, we conducted semistructured interviews with LCS program staff (N = 15) and participants (N = 7) and administered brief surveys to understand LCS adherence. We combined our knowledge of LCS implementation with data to formulate the EA-LCS framework, including principles and strategies instrumental for LCS adherence. Results: Program staff identified four factors that facilitated adherence: (1) the use of specialized tracking software, (2) the importance of personal connection and a reliable touchpoint, (3) centralized program operations, and (4) standardization and streamlining of reports to participants and clinicians. Participant data identified four factors supporting adherence: (1) a single contact point and information availability, (2) tailored communications, (3) personalized results delivery, and (4) increased scan accessibility. Combined analyses identified three overarching themes in the EA-LCS framework: (1) respect, (2) trust, and (3) engagement. Conclusions: The EA-LCS conceptual model integrates three foundational principles (person-centeredness, trustworthy relationships, and sustained communications) to enhance LCS adherence. Efforts are underway to translate the EA-LCS framework into materials to support adherence.

Keywords

• Lung cancer screening
• LCS
• Person-centered care
• Adherence
• Low-dose computed tomography
• LDCT