1
|
Wong LY, Choudhary S, Kapula N, Lin M, Elliott IA, Guenthart BA, Liou DZ, Backhus LM, Berry MF, Shrager JB, Lui NS. Barriers to Completing Low Dose Computed Tomography Scan for Lung Cancer Screening. Clin Lung Cancer 2024; 25:424-430. [PMID: 38749902 DOI: 10.1016/j.cllc.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/21/2024] [Accepted: 04/24/2024] [Indexed: 06/30/2024]
Abstract
INTRODUCTION Annual low-dose computed tomography (LDCT) screening has been shown to reduce lung cancer mortality in high-risk individuals by detecting the disease at an earlier stage. This study aims to assess the barriers to completing LDCT in a cohort of patients who were determined eligible for lung cancer screening (LCS). METHODS We performed a single institution, mixed methods, cross-sectional study of patients who had a LDCT ordered from July to December 2022. We then completed phone surveys with patients who did not complete LDCT to assess knowledge, attitude, and perceptions toward LCS. RESULTS We identified 380 patients who met inclusion criteria, including 331 (87%) who completed LDCT and 49 (13%) who did not. Patients who completed a LDCT and those who did not were similar regarding age, sex, race, primary language, household income, body mass index, median pack years, and quit time. Positive predictors of LDCT completion were: meeting USPSTF guidelines (97.9% vs 81.6%), being married (58.3% vs 44.9%), former versus current smokers (55% vs 41.7%), personal history of emphysema (60.4% vs 42.9%), and family history of lung cancer (13.9% vs 4.1%) (all P < .05). Of the patients who participated in the phone survey, only 7% of respondents thought they were high risk for developing lung cancer despite attending a shared decision-making visit and only 10% wanted to re-schedule their LDCT. CONCLUSION There exist barriers to completing LDCT even after patients are identified as eligible and complete a shared decision-making visit secondary to knowledge barriers, misperceptions, and patient disinterest.
Collapse
Affiliation(s)
- Lye-Yeng Wong
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Sania Choudhary
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Ntemena Kapula
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Margaret Lin
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305
| | - Irmina A Elliott
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Brandon A Guenthart
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Douglas Z Liou
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Leah M Backhus
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305; VA Palo Alto Health Care System, Palo Alto CA
| | - Mark F Berry
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305
| | - Joseph B Shrager
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305; VA Palo Alto Health Care System, Palo Alto CA
| | - Natalie S Lui
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Falk Building, Stanford, CA 94305.
| |
Collapse
|
2
|
Buitenhuis AH, Tuinman MA, Hagedoorn M. A dyadic planning intervention to quit smoking in single-smoking couples: design of a randomized controlled trial. BMC Psychol 2018; 6:53. [PMID: 30419956 PMCID: PMC6233499 DOI: 10.1186/s40359-018-0266-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/29/2018] [Indexed: 11/10/2022] Open
Abstract
Background Tobacco use is the largest preventable cause of death. Smoking cessation interventions that use implementation intentions show promising results. Implementation intentions are if-then plans that specify a certain behaviour within a situational context. This study will examine whether involving a non-smoking partner could improve planning interventions, and whether and which partner interactions underlie this effectiveness. Methods This single-blind randomized controlled trial has a longitudinal design with a baseline questionnaire, end-of-day measurements for three weeks starting on the quit date, and a follow-up questionnaire after three months. Participants: single-smoking couples who live together and are in a relationship for more than one year. Setting: couples are randomized to either a dyadic or individual planning condition. After the intervention the smoker attempts to quit smoking and the diary measurements start. Measurements: The primary outcome variable is smoking abstinence. Secondary outcome measures are smoking behaviour and relationship satisfaction. Partner interactions are examined as a possible mediator. Discussion This RCT is the first to examine the effectiveness of dyadic planning to quit smoking in single-smoking couples. Partner interactions are thought to play an important role during the quit attempt, and therefore in the effectiveness of the intervention. This RCT will provide more insight into which daily partner interactions are beneficial for smoking abstinence and the couples’ relationship satisfaction, and whether the type of intervention is related to different types or levels of partner interactions and smoking behaviour. When proven effective, this planning intervention in combination with coaching for the non-smoking partner will be a valuable and low-cost addition to existing smoking interventions. Trial registration The trial is retrospectively registered on 19/04/2017 on www.trialregister.nl (TC: 6398). Electronic supplementary material The online version of this article (10.1186/s40359-018-0266-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anne H Buitenhuis
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, De Brug, FA12, POB 30.001, 9700, RB, Groningen, The Netherlands.
| | - Marrit A Tuinman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, De Brug, FA12, POB 30.001, 9700, RB, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, De Brug, FA12, POB 30.001, 9700, RB, Groningen, The Netherlands
| |
Collapse
|
3
|
Jonsdottir H, Amundadottir OR, Gudmundsson G, Halldorsdottir BS, Hrafnkelsson B, Ingadottir TS, Jonsdottir R, Jonsson JS, Sigurjonsdottir ED, Stefansdottir IK. Effectiveness of a partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease: a pragmatic randomized controlled trial. J Adv Nurs 2015; 71:2634-49. [PMID: 26193907 DOI: 10.1111/jan.12728] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 11/28/2022]
Abstract
AIMS To evaluate the effectiveness of a 6-month, partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease. BACKGROUND Self-management is a widely valued concept used to address contemporary issues of chronic health problems. Findings of self-management programmes for people with chronic obstructive pulmonary disease are inconclusive. DESIGN Pragmatic randomized control trial. METHODS Patients, 45-65 years old, with mild and moderate chronic obstructive pulmonary disease were invited with a family member. Experimental group (n = 48) participated in a 6-month, partnership-based self-management programme consisting of: (a) three to four conversations between nurse and patient-family member; (b) 6 months of smoking cessation; and (c) interdisciplinary team-patient-family member group meeting. Control group (n = 52) received usual care. Data were collected at months zero, six and 12. The trial lasted from June 2009-March 2013. RESULTS Patients with mild and moderate chronic obstructive pulmonary disease who participated in the partnership-based self-management programme perceived less intrusiveness of the disease and its treatment than patients in the control group. Patients in the experimental group did not have better health-related quality of life, less anxiety or depression, increased physical activity, fewer exacerbations or better smoking status than patients in the control group. Patients in both groups found participation in the research useful and important. CONCLUSION The partnership-based self-management programme had benefits concerning perception of the intrusiveness of chronic obstructive pulmonary disease and its treatment on lifestyles, activities and interests for young patients with the disease in its early stages. High satisfaction in control group, low family attendance and the relatively short treatment period may explain the less than expected benefits of the programme.
Collapse
Affiliation(s)
- Helga Jonsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Olof R Amundadottir
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.,Department of Physical Therapy, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Gunnar Gudmundsson
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Bryndis S Halldorsdottir
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Birgir Hrafnkelsson
- Faculty of Physical Sciences, School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Thorbjorg Soley Ingadottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Rosa Jonsdottir
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Jon Steinar Jonsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Primary Health Care at Gardabaer, Gardabaer, Iceland
| | | | | |
Collapse
|
4
|
Nelson CC, Li Y, Sorensen G, Berkman LF. Assessing the relationship between work-family conflict and smoking. Am J Public Health 2012; 102:1767-72. [PMID: 22720765 DOI: 10.2105/ajph.2011.300413] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between smoking and work-family conflict among a sample of New England long-term-care facility workers. METHODS To collect data, we conducted in-person, structured interviews with workers in 4 extended-care facilities. RESULTS There was a strong association between smoking likelihood and work-family conflict. Workers who experienced both stress at home from work issues (i.e., work-to-home conflict) and stress at work from personal issues (i.e., home-to-work conflict) had 3.1 times higher odds of smoking than those who did not experience these types of conflict. Workers who experienced home-to-work conflict had an odds of 2.3 compared with those who did not experience this type of conflict, and workers who experienced work-to-home conflict had an odds of 1.6 compared with workers who did not experience this type of conflict. CONCLUSIONS The results of this study indicate that there is a robust relationship between work-family conflict and smoking, but that this relationship is dependent upon the total amount of conflict experienced and the direction of the conflict.
Collapse
Affiliation(s)
- Candace C Nelson
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | | | | | | |
Collapse
|
5
|
Chiew M, Weber MF, Egger S, Sitas F. A cross-sectional exploration of smoking status and social interaction in a large population-based Australian cohort. Soc Sci Med 2012; 75:77-86. [PMID: 22495512 DOI: 10.1016/j.socscimed.2012.02.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 01/31/2012] [Accepted: 02/28/2012] [Indexed: 11/19/2022]
Abstract
We used cross-sectional data to investigate whether current, past and never smokers report different levels of social interaction and whether the level of social interaction varied according to the type of interaction being measured. Self-reported questionnaire data were obtained from 239,043 men and women aged 45 years or older living in Australia between February 2006 and February 2010. The study participation rate was 18%. Poisson regression models were used to estimate the percentage differences in the mean values of four social interaction outcomes according to smoking status after adjusting for age, place of residence, income, education, health insurance status, physical limitation, psychological distress and exposure to passive smoke: number of times 1) spent with friends/family, 2) spoken on the telephone, 3) attended social meetings in the past week, and 4) number of people outside of home that can be depended upon. 7.6% of males and 6.9% of females were current smokers, 43.6% of males and 28.6% of females were ex-smokers and 48.8% of males and 64.5% of females had never smoked. Compared to never smokers, current smokers reported significantly fewer social interactions in the past week and had fewer people outside the home that they could depend on. Men and women current smokers attended 24.0% (95% CI, 20.3, 27.5) and 31.1% (95% CI, 28.1, 34.1) fewer social group meetings on average than never smokers. Smokers exposed to passive smoke reported higher levels of social interaction than those not exposed. Past smokers reported levels of social interaction that were intermediate to those of current and never smokers and the more years they had abstained from smoking, the more social interaction they reported on average. Our data are in line with previous research showing that smokers are not only worse off economically, physically and mentally, but are also less likely to be socially connected.
Collapse
Affiliation(s)
- May Chiew
- Cancer Research Division, Cancer Council NSW, 153 Dowling St., Woolloomooloo 2011, Australia
| | | | | | | |
Collapse
|
6
|
Holm KE, LaChance HR, Bowler RP, Make BJ, Wamboldt FS. Family factors are associated with psychological distress and smoking status in chronic obstructive pulmonary disease. Gen Hosp Psychiatry 2010; 32:492-8. [PMID: 20851269 PMCID: PMC2943490 DOI: 10.1016/j.genhosppsych.2010.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 06/24/2010] [Accepted: 06/29/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to test three hypotheses in a sample of individuals with chronic obstructive pulmonary disease (COPD): (1) unsupportive family relationships are associated with psychological distress, (2) psychological distress is associated with smoking status and (3) unsupportive family relationships are indirectly associated with smoking status via psychological distress. METHOD Cross-sectional data were collected via self-report questionnaires completed by 455 individuals with COPD who had at least a 10-pack-year smoking history. The hypotheses were tested with structural equation modeling. RESULTS All three hypotheses were supported. Unsupportive family relationships were associated with psychological distress (β=.67, P<.001), psychological distress was associated with smoking status (β=.40, P<.001), and unsupportive family relationships were indirectly associated with smoking status via psychological distress (β=.27, P<.001). CONCLUSION Results of this study suggest that family relationships are an important factor to include in future longitudinal research that attempts to elucidate social and psychological influences on smoking behavior.
Collapse
Affiliation(s)
| | - Heather R. LaChance
- Department of Medicine, National Jewish Health,Department of Psychiatry, University of Colorado Denver
| | - Russell P. Bowler
- Department of Medicine, National Jewish Health,Department of Medicine, University of Colorado Denver
| | - Barry J. Make
- Department of Medicine, National Jewish Health,Department of Medicine, University of Colorado Denver
| | - Frederick S. Wamboldt
- Department of Medicine, National Jewish Health,Department of Psychiatry, University of Colorado Denver
| |
Collapse
|
7
|
Escoffery C, Kegler MC, Butler S. Formative research on creating smoke-free homes in rural communities. HEALTH EDUCATION RESEARCH 2009; 24:76-86. [PMID: 18222939 PMCID: PMC2721667 DOI: 10.1093/her/cym095] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Accepted: 11/20/2007] [Indexed: 05/25/2023]
Abstract
The home is a significant place for exposure to secondhand smoke for children and non-smoking adults. This study explored factors that would convince families to adopt household smoking bans and actions to create and maintain smoke-free homes. Interviews were conducted with adults in 102 households in rural Georgia. Participating families had a young adolescent and included households with a mix of smokers and non-smokers and smoking ban status. Families reported they would consider a total ban to protect children from secondhand smoke and protect family members if they got sick. Few described difficulties in enforcement with over half of smokers accepting the rules. Situations that made it hard to enforce restrictions were if there was a visitor who smoked, a smoker who had cravings, and bad weather outside when the smoker desired to smoke. Smokers explained that family members could assist them in quitting by talking to them, not purchasing cigarettes for them, not smoking around them, and supporting them. Ideas for promoting smoke-free homes were having a no smoking sign, saying no to visitors who want to smoke, removing ashtrays, and creating a place outside for smokers. These findings can inform interventions designed to create and maintain smoke-free households.
Collapse
Affiliation(s)
- Cam Escoffery
- Department of Behavioral Sciences.ealth Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | | | | |
Collapse
|