Informing the cultural adaptation of a lung cancer screening shared decision-making and navigation intervention for Hispanic adults: a qualitative study.

Abstract

Background: Lung cancer is the leading cause of cancer-related death among Hispanic men and the second leading cause among Hispanic women in the United States. Despite evidence that lung cancer screening (LCS) reduces lung cancer mortality through early detection, Hispanic adults remain underrepresented in LCS. This study explored perceptions of LCS and shared decision-making (SDM) among Hispanic men and women to guide the cultural adaptation of the TELEhealth Shared decision-making COaching and navigation in Primary carE (TELESCOPE) intervention.

Methods: Hispanic adults aged 50-77 years with a current or former smoking history of at least 20 pack-years participated in virtual focus groups. Discussions were guided by the Cultural Appropriateness Framework and explored perceptions of LCS and communication preferences. Transcripts were analyzed using rapid qualitative analysis. Two members of the research team independently reviewed transcripts, summarized findings in structured matrices, and identified themes through consensus.

Results: Nineteen Hispanic adults participated in three focus groups (one in English and two in Spanish). Participants had a mean age of 60.3 years, a mean smoking history of 30.6 pack-years, 68.4% primarily spoke Spanish, and 57.8% were from South America. Four themes emerged: (1) limited awareness and understanding of LCS; (2) clear and friendly communication preferences; (3) concerns regarding fear and fatalism; and (4) importance of culturally relevant design.

Conclusions: Several important themes that may influence engagement in LCS were identified. These results will inform the cultural adaptation of TELESCOPE and may guide future efforts to improve the acceptability and uptake of LCS among Hispanic adults.