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 lesbian, gay, bisexual, transgender, queer/questioning (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. Objectives: 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 in a patient navigation intervention and assessed outcomes over a 90-day period. We administered pre- and postintervention surveys, tracked navigation and LCS activities in the electronic health record, and verified tobacco cessation with exhaled carbon monoxide (CO) measurements. Primary outcomes included postintervention Acceptability of Intervention Measure scores, the Patient Satisfaction with Navigator Interpersonal Relationship 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 [Formula: see text]30-day cessation. Results: Forty-one participants enrolled in the study and participated in the navigation program, with 34 completing postintervention surveys at Day 90. Acceptability (mean Acceptability of Intervention Measure score, 4.5) and patient satisfaction (mean Patient Satisfaction with Navigator Interpersonal Relationship score, 40.8) were both high. Fifty-nine percent of individuals were appropriately up-to-date on LCS at Day 90, as compared with 22% at baseline. Of postsurvey respondents, 41% reported a period of >7-day smoking abstinence during the study, with 18% reporting CO-confirmed abstinence of [Formula: see text]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 registered with www.clinicaltrials.gov (NCT05304390).