Lung Cancer Screening Eligibility Assessment

Using a Simplified Tool to Predict Lung Cancer Screening (LCS) Eligibility: Experiment to Test Effects of Messaging on Response Rates

The primary purpose of this study evaluate if different messaging impacts response rates to a brief survey (i.e., the simplified eligibility tool) that is designed to estimate pack-year eligibility for lung cancer screening (LCS). This will help inform the best way to increase response rates to the tool in future intervention studies designed to increase LCS, and expand upon survey methodology in general.

Study Overview

• Status: Completed
• Conditions: Lung Cancer
• Intervention / Treatment: Behavioral: Framed Introductory Message A; Behavioral: Framed Tobacco Use Message A; Behavioral: Financial Incentive; Behavioral: Framed Tobacco Use Message B; Behavioral: Framed Introductory Message B; Behavioral: Framed Introductory Message C

Detailed Description

Despite growing evidence that lung cancer screening (LCS) reduces lung cancer-specific mortality, LCS across the United States is remarkably low. This is due in part to challenges with identifying adults who meet eligibility criteria for lifetime smoking intensity (i.e., 20 pack-years or greater), which is often missing from the electronic medical record. We have developed a simplified eligibility tool that has shown accuracy in estimating pack-years. But given the potential for low response rates, there is a great need to identify effective strategies to increasing response rates equitably prior to using it in practice or in future studies. The primary purpose of this study evaluate if different messaging impacts response rates to a brief survey (i.e., the simplified eligibility tool) that is designed to estimate pack-year eligibility for lung cancer screening (LCS). This will help to identify the best way to increase response rates to the tool in future intervention studies designed to increase LCS, and expand upon survey methodology in general.

• Study Type: Interventional
• Enrollment (Actual): 6125
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • University of Pennsylvania

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. meet age eligibility (50-80 years old) for LCS based on 2021 USPSTF guidelines; and
2. have completed at least one primary care visit at Penn Medicine in 2020-2025

Exclusion Criteria:

1. have a documented history of lung cancer;
2. have a documented history of completing LCS at Penn Medicine;
3. are listed as not wanting to be contacted or solicited for research; or
4. do not otherwise meet inclusion criteria.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

12

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm 1 (Introductory Message A + Tobacco Use Message A + Incentive); Participants will receive two framed messages (AA) plus an incentive	Behavioral: Framed Introductory Message A; Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).; Behavioral: Framed Tobacco Use Message A; Randomly assign patients to receive norming message related to tobacco use (version A).; Behavioral: Financial Incentive; Randomly assigned patients to be entered into a drawing to receive a $100 gift card.
Experimental: Arm 2 (Introductory Message A + Tobacco Use Message A); Participants will receive two framed messages (AA)	Behavioral: Framed Introductory Message A; Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).; Behavioral: Framed Tobacco Use Message A; Randomly assign patients to receive norming message related to tobacco use (version A).
Experimental: Arm 3 (Introductory Message A + Tobacco Use Message B + Incentive); Participants will receive two framed messages (AB) plus an incentive	Behavioral: Framed Introductory Message A; Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).; Behavioral: Financial Incentive; Randomly assigned patients to be entered into a drawing to receive a $100 gift card.; Behavioral: Framed Tobacco Use Message B; Randomly assign patients to receive norming message related to tobacco use (version B).
Experimental: Arm 4 (Introductory Message A + Tobacco Use Message B); Participants will receive two framed messages (AB)	Behavioral: Framed Introductory Message A; Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).; Behavioral: Framed Tobacco Use Message B; Randomly assign patients to receive norming message related to tobacco use (version B).
Experimental: Arm 5 (Introductory Message B + Tobacco Use Message A + Incentive); Participants will receive two framed messages (BA) plus an incentive	Behavioral: Framed Tobacco Use Message A; Randomly assign patients to receive norming message related to tobacco use (version A).; Behavioral: Financial Incentive; Randomly assigned patients to be entered into a drawing to receive a $100 gift card.; Behavioral: Framed Introductory Message B; Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Experimental: Arm 6 (Introductory Message B + Tobacco Use Message A); Participants will receive two framed messages (BA)	Behavioral: Framed Tobacco Use Message A; Randomly assign patients to receive norming message related to tobacco use (version A).; Behavioral: Framed Introductory Message B; Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Experimental: Arm 7 (Introductory Message B + Tobacco Use Message B + Incentive); Participants will receive two framed messages (BB) plus an incentive	Behavioral: Financial Incentive; Randomly assigned patients to be entered into a drawing to receive a $100 gift card.; Behavioral: Framed Tobacco Use Message B; Randomly assign patients to receive norming message related to tobacco use (version B).; Behavioral: Framed Introductory Message B; Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Experimental: Arm 8 (Introductory Message B + Tobacco Use Message B); Participants will receive two framed messages (BB)	Behavioral: Framed Tobacco Use Message B; Randomly assign patients to receive norming message related to tobacco use (version B).; Behavioral: Framed Introductory Message B; Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Experimental: Arm 9 (Introductory Message C + Tobacco Use Message A + Incentive); Participants will receive two framed messages (CA) plus an incentive	Behavioral: Framed Tobacco Use Message A; Randomly assign patients to receive norming message related to tobacco use (version A).; Behavioral: Financial Incentive; Randomly assigned patients to be entered into a drawing to receive a $100 gift card.; Behavioral: Framed Introductory Message C; Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Experimental: Arm 10 (Introductory Message C + Tobacco Use Message A); Participants will receive two framed message (CA)	Behavioral: Framed Tobacco Use Message A; Randomly assign patients to receive norming message related to tobacco use (version A).; Behavioral: Framed Introductory Message C; Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Experimental: Arm 11 (Introductory Message C + Tobacco Use Message B + Incentive); Participants will receive two framed messages (CB) plus an incentive	Behavioral: Financial Incentive; Randomly assigned patients to be entered into a drawing to receive a $100 gift card.; Behavioral: Framed Tobacco Use Message B; Randomly assign patients to receive norming message related to tobacco use (version B).; Behavioral: Framed Introductory Message C; Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Experimental: Arm 12 (Introductory Message C + Tobacco Use Message B); Participants will receive two framed messages (CB)	Behavioral: Framed Tobacco Use Message B; Randomly assign patients to receive norming message related to tobacco use (version B).; Behavioral: Framed Introductory Message C; Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Full Survey Completion	The proportion of participants that answers all three survey questions via text message among all those randomized.	7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Partial Survey Completion	The proportion of participants that answer at least one of three survey questions via text message among all those randomized.	7 days

Collaborators and Investigators

• Sponsor: Abramson Cancer Center at Penn Medicine
• Collaborators: National Cancer Institute (NCI); National Institutes of Health (NIH)
• Investigators: Principal Investigator: Katharine A Rendle, PhD,MSW,MPH, University of Pennsylvania

Study record dates

Study Major Dates

• Study Start (Actual): July 31, 2023
• Primary Completion (Actual): January 31, 2024
• Study Completion (Actual): January 31, 2024

Study Registration Dates

• First Submitted: October 18, 2023
• First Submitted That Met QC Criteria: November 10, 2023
• First Posted (Actual): November 18, 2023

Study Record Updates

• Last Update Posted (Actual): May 31, 2025
• Last Update Submitted That Met QC Criteria: May 29, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Keywords: Lung Cancer Screening
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Respiratory Tract Diseases; Lung Diseases; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Neoplasms
• Other Study ID Numbers: UPCC 16523; P50CA271338-02 (U.S. NIH Grant/Contract); 853337 (Other Identifier: UPenn IRB)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No