A community intervention for increasing screening through engaging primary care providers (I-STEP)
Cancer Epidemiology Biomarkers and Prevention Conference: 15th AACR Conference onthe Science of Cancer Health Disparities in Racial/Ethnic Minoritiesand the Medically Underserved Philadelphia, PA United States
; 32(1 Supplement), 2023.
Article
in English
| EMBASE | ID: covidwho-2228018
ABSTRACT
Background:
While lung cancer is a leading cause of death in the U.S., annual lung cancer screening (LCS) rates remain low at 12.7%. The WUSTL research group began a community intervention to increase LCS called I-STEP (Increasing Screening Through Engaging Primary Care Providers) to address this quality gap. A customizable Toolkit was administered to a collaborative of six hospital systems in Missouri and Illinois, encompassing LCS eligibility and follow up guidelines, navigating LCS referral, and smoking cessation. The COVID-19 pandemic prompted brief suspension of screening, with lingering effects on LCS delivery and I-STEP implementation. Method(s) This was a step-wedged cluster randomized control trial from January 2019 - March 2021. Six hospital systems sequentially entered a three-month training phase, followed by I-STEP implementation into primary care settings. Primary outcomes were mean number of screenings and mean percent change in LCS from baseline. Data were collated into a dashboard. Analyses compared outcomes within I-STEP sites pre- and post- intervention. To investigate whether I-STEP sites recovered screening numbers during the pandemic, we compared I-STEP sites to six comparator hospitals within the collaborative that did not participate in the intervention. Result(s) Mean LCS increased by 63% amongst I-STEP sites (130.8 to 212). Mean screenings increased significantly from pre- to post-intervention phases within I-STEP sites (p = 0.0272). Across I-STEP sites and comparator hospitals, mean LCS increased significantly following emergence of the pandemic in March 2020 (p = 0.0002, LSM difference -72.0, 95% CI [-100.9, -43]) - data adjusted for the three-month period in which LCS was suspended. Findings were similar for mean percent change in LCS. There was no difference in outcomes between I-STEP and comparator sites. Conclusion(s) I-STEP implementation successfully increased mean LCS from pre-intervention baseline. Findings suggest a possible effect of the I-STEP intervention in promoting increased LCS amidst the pandemic.
cancer screening; conference abstract; controlled study; coronavirus disease 2019; eligibility; follow up; hospital planning; human; Illinois; lung cancer; lung development; Missouri; multicenter study; outcome assessment; pandemic; patient referral; practice guideline; primary medical care; randomized controlled trial; smoking cessation; suspension
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Cohort study
/
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Language:
English
Journal:
Ethnic Minoritiesand the Medically Underserved Philadelphia, PA United States
Year:
2023
Document Type:
Article
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