ABSTRACT
The national rate of lung cancer screening, approximately 3-5%, is too low and strategies which include shared decision-making and increase screening are needed. A feasibility study in one large primary care practice of telephone-based delivery of decision support via an online tool, the Decision Counseling Program© (DCP) was administered to patients eligible for lung cancer screening according to USPSTF screening guidelines. We collected data on demographics, decisional conflict, and conducted chart audits to ascertain screening. From electronic medical record data, we identified 829 age-eligible current or former smokers. Of the 297 individuals reached, 54 were eligible and 28 were recruited to the study and 20 underwent the DCP© intervention. Participants in the intervention were more likely to complete low-dose CT scans at 90 days. Current smokers were less likely to complete the DCP. Women were less likely to complete LDCT. This non-persuasive, high-quality shared decision-making intervention significantly increased lung cancer screening and was feasible in real-world clinical care. This intervention offers a promising model whereby patients can be supported in a decision, based on their values and beliefs while also supporting gains in lung cancer screening.
Subject(s)
Clinical Decision-Making , Decision Making, Shared , Early Detection of Cancer/psychology , Lung Neoplasms/diagnosis , Primary Health Care/statistics & numerical data , Smokers/statistics & numerical data , Telephone/statistics & numerical data , Aged , Aged, 80 and over , Early Detection of Cancer/methods , Female , Health Knowledge, Attitudes, Practice , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/psychology , Male , Middle Aged , Physician-Patient Relations , Tomography, X-Ray Computed/methodsABSTRACT
OBJECTIVE: Readers will be able to identify the impact of the Alliance for Adolescent Pregnancy Prevention (AAPP) in improving knowledge and attitudes regarding risky sexual health behaviors. METHODS: Three AAPP, Be Proud! Be Responsible!(BPBR), Making Proud Choices! (MPC) and Wise Guys: Male Responsibility (Wise Guys), are assessed using 3 similar pre- and post-surveys which are designed specifically for these curricula. These surveys measure changes in knowledge and attitudes toward sexual health and risky behaviors at baseline and completion of the course. RESULTS: In Delaware, adolescents who completed any of the three AAPP programs have shown an increase in knowledge around condom usage; an increase in awareness of the factors around safe sexual health practices and healthy relationships; and, a positive change in attitude around communication - both with a partner and their parent(s)/guardian(s). Post-survey scores improved for BPBR, MPC and Wise Guys by 8%, 18% and 8%, respectively. CONCLUSIONS: Reproductive health education is essential for teenagers, giving them the tools to make safer choices if they choose to have sex (Delaware Department of Health and Social Services, n.d.). In Delaware, the Youth Risk Behavior Survey (YRBS) indicates that teens continue to take risks with their sexual health. Programs like AAPP have the capacity to continue to make a positive impact on reducing the risk of STI and HIV transmission, along with potentially lowering the number of teens who become pregnant.
