Tailored Patient Navigation to Support Lung Cancer Screening and Smoking Cessation in LGBTQ+ Individuals: A Pilot Study.

Abstract

Rationale: Lung cancer is the leading cause of cancer death, with most cases attributable to cigarette smoking. People who identify as LGBTQ+ are more likely to smoke; however, there are limited interventions to support lung cancer prevention in this community. Through prior community-engaged work we developed a patient navigation intervention to support smoking cessation and lung cancer screening (LCS) for LGBTQ+ adults.

Objective: To conduct a prospective pilot study of the patient navigation intervention to evaluate patient satisfaction, acceptability and knowledge change as well as LCS care completion and smoking cessation.

Methods: We enrolled participants who currently smoked, identified as LGBTQ+ and were eligible for LCS into a patient navigation intervention and assessed outcomes over a 90-day period. We administered pre- and post-intervention surveys, tracked navigation and LCS activities in the electronic health record and verified tobacco cessation with exhaled carbon monoxide (CO) measurements. Primary outcomes included post-intervention Acceptability of Intervention Measure (AIM) scores, the Patient Satisfaction with Navigator Interpersonal Relationship (PSN-I) score, and knowledge change on two validated measures. Secondary outcomes included being appropriately up-to-date on LCS and smoking cessation, measured as reported >7 day floating abstinence and end-of-study CO-confirmed ≥30 day cessation.

Results: Forty-one participants enrolled in the study and participated in the navigation program, with 34 completing post-intervention surveys at day 90. Acceptability (mean AIM score 4.5) and patient satisfaction (mean PSN-I score 40.8) were both high. Fifty-nine percent of individuals were appropriately up-to-date on LCS at day 90 compared to 22% at baseline. Of post-survey respondents, 41% reported a period of >7 day smoking abstinence during the study, with 18% reporting CO-confirmed abstinence of ≥30 days at study end.

Conclusions: Tailored patient navigation is a promising approach to enhance LCS uptake and smoking cessation in LCS-eligible LGBTQ+ individuals.

Clinical trial registration: This trial was registered at ClinicalTrials.gov NCT05304390. Primary Source of Funding. This work was funded through a grant from LUNGevity Foundation to Dr. Triplette.