A Multilevel Intervention to Improve Lung Cancer Screening Among Hispanic Patients: A Pilot Randomized Controlled Trial.

PURPOSE: We evaluated the preliminary efficacy of Empower LCS, a culturally-adapted multilevel intervention, compared with enhanced usual care (EUC) for improving LCS uptake among Hispanic patients.

METHODS

In this pilot randomized controlled trial, Hispanic patients aged 50-80 years who met 2021 US Preventive Services Task Force LCS eligibility criteria were enrolled between February 2024 and August 2025. Participants were randomized 1:1 to EUC or Empower LCS. EUC included usual care plus a one-page educational handout. Empower LCS included a culturally adapted decision aid, provider notifications, patient text reminders, and health-related social needs support. The primary outcome was LDCT ordering within 4 months, assessed by medical record review or self-report. Analyses used chi-square tests and logistic regressions.

RESULTS

Sixty patients were randomized (mean age, 60.8 years ± 7.4; 37/60 [61.7%] male; 21/60 [35.0%] Spanish-speaking). At 4 months, LDCT ordering was higher with Empower LCS than with EUC (15/30 [50.0%] vs 4/30 [13.3%]; p=0.002), as were LCS discussions (12/30 [40.0%] vs 5/30 [16.7%]; p=0.045). LDCT completion was higher but not significant (9/30 [30.0%] vs 4/30 [13.3%]; p=0.117), likely due to small sample size. In exploratory adjusted models, Empower LCS was associated with higher odds of LCS ordering (OR, 7.32; 95% CI, 1.97-34.16), and discussion (OR, 4.1; 95% CI, 1.20-16.28). Qualitative interviews identified provider trust and logistical barriers as drivers of screening engagement and completion, respectively.

CONCLUSIONS

Empower LCS increased LDCT ordering and screening discussions in this pilot trial. These findings support culturally tailored, low-cost, scalable interventions to reduce disparities in LCS participation.