Co-Design and Pilot Testing of Peer-led Community Outreach to Improve Equity, Veteran-Centeredness and Uptake of Lung Cancer Screening (VPC)

Co-design will be implemented to develop an innovative, Veteran-centered intervention (Vet Peer Connects program) that meets the needs of Black Veterans.

Next, a feasibility pilot test of the Vet Peer Connects program will be conducted. The Peer will lead up to 5 group lung cancer screening orientations in community partner sites to reach up to 40 lung cancer screening eligible Black Veterans. The Peer will provide one-to-one tailored support to up to 15 Veterans (coaching, goal-setting, navigation to access Veterans Affairs lung cancer screening). Then, the study team will evaluate program delivery through ethnographic observation and field notes, Peer activity logs, and weekly check-ins between the study team and Peer. Investigators will interview Veteran participants, community partners, and lung cancer screening clinical staff to explore feasibility and acceptability of the Vet Peer Connects program and solicit suggestions for improvement. Preliminary data on the outcomes of the Vet Peer Connects program will be collected by study team through administering surveys to assess change in Social Cognitive Theory constructs, and extracting lung cancer screening uptake and tobacco treatment 3 months post enrollment from VA's Corporate Data Warehouse. This work will inform a subsequent multi-site stepped-wedge trial to assess effectiveness, implementation, and cost of the Vet Peer Connects program in VA lung cancer screening sites and neighboring branches of the National Association for Black Veterans.

Study Overview

• Status: Completed
• Conditions: Lung Cancer
• Intervention / Treatment: Other: Veterans peer connect Program

• Study Type: Interventional
• Enrollment (Actual): 3
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02130
      • VA Boston Healthcare System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Self-identified Black Veterans
• Meet United States Preventive Services Task Force guidelines for lung cancer ( still smoking cigarettes or quit within past 15 years, greater than or equal to 20 pack-years total)
• Have not yet undergone lung cancer screening

Exclusion Criteria:

• Non-Black Veterans

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Peer led intervention; The peer-led program will be pilot tested enrolling up to 40 self-identified lung cancer screening eligible Black Veterans.

Other: Veterans peer connect Program; To assess outcomes of the Peer-led program, the study team will collect information from Veteran pilot test participants via surveys and data abstraction on healthcare utilization (Lung cancer screening completion, tobacco treatment) from the Veterans Affairs Corporate Data Warehouse. Survey data will be collected at 3 timepoints: baseline, post-Peer-led orientation, and 3-months post-enrollment. Healthcare utilization data will be abstracted from the corporate data warehouse to reflect the 3-month post-enrollment timepoint. Finally, interviews will be conducted with a subset of participants.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lung Cancer Screening Uptake	Electronic health record review on all enrolled subjects to determine if low dose chest CT for lung cancer screening occurred between the time of study enrollment and 3 months post-enrollment.	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Tobacco Cessation Treatment	Electronic health record review on all enrolled subjects to determine if the participant was provided tobacco cessation treatment, including nicotine replacement therapy, other pharmacotherapy, or referral for smoking cessation counseling, between the time of study enrollment and 3 months post-enrollment.	3 months
Stigma Related to Smoking	Assess via qualitative interviews	between 3-7 months post-enrollment, after completion of peer support intervention
Perceived Support From Peer	Assess via qualitative interviews	between 3-7 months post-enrollment, after completion of peer support intervention
Lung Cancer Screening Knowledge	Assessed via survey measure: Knowledge of risks and benefits of lung cancer screening. Scale 0-18, higher score means a better outcome	3 months
Lung Cancer Screening Fatalism	Assessed via survey measure: Adapted Illness Perception Questionnaire. Scale 10-50, higher score means better outcome	3 months
Trust in VA	Assessed via survey measure: Adapted Modified trust scale for Veterans Affairs health system. New Scale 4-20, higher score means a better outcome	3 months
Lung Cancer Self-efficacy	Assessed via survey measure: Lung cancer screening health belief self-efficacy scale. Scale 9-36, higher score means a better outcome	3 months
General Cancer Self-efficacy	Assessed via survey measure: New General Self-efficacy scale. Scale 8-40, higher score means a better outcome	3 months
Intention to Engage in Shared Decision Making	Assessed via survey measure: Preparation for Decision Making, scale 10-40, lower score means better outcome	3 months
Motivation to Quit Smoking	Assessed via survey measure: Readiness to change smoking behavior, contemplation ladder, scale 1-10, higher score means a better outcome	3 months
Intention to Undergo Lung Cancer Screening	Assessed via survey measure: Low Literacy Decisional Conflict Scale. Scale 0-9, higher score means a better outcome	3 months

Collaborators and Investigators

• Sponsor: VA Office of Research and Development
• Investigators: Principal Investigator: Renda Wiener, MD, VA Boston Healthcare System, Boston MA

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2025
• Primary Completion (Actual): June 28, 2025
• Study Completion (Actual): October 15, 2025

Study Registration Dates

• First Submitted: April 1, 2024
• First Submitted That Met QC Criteria: April 25, 2024
• First Posted (Actual): April 29, 2024

Study Record Updates

• Last Update Posted (Actual): August 11, 2026
• Last Update Submitted That Met QC Criteria: July 17, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: 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: PPO 22-161; 1692052 (Other Identifier: VA Boston Healthcare System)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Datasets meeting VA standards for disclosure to the public will be made available within 1 year of publication. Prior to distribution, a local privacy officer will certify that all datasets contains no protected health information. Final data sets will be maintained locally until enterprise-level resources become available for long-term storage and access. Guidance on request and distribution processes will be provided by office of research and development. Those requesting data will be asked to sign a Letter of Agreement.
• IPD Sharing Time Frame: Within 1 year of publication
• IPD Sharing Access Criteria: Those requesting data will be asked to sign a Letter of Agreement.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No