Table 1 Summary of the study components for the TELESCOPE and Enhanced Usual Care (EUC) arms
Participants | TELESCOPE arm | EUC arm |
|---|---|---|
Clinicians | • Provided with access to CME webinar on lung cancer screening (LCS) and shared decision-making (SDM) • 2-page LCS Discussion Guide summarizing LCS eligibility, benefits/harms of LCS to consider, insurance coverage, and screening decisions | Same as TELESCOPE arm |
Navigators | Navigator Pre-Intervention Training: • 1-h live didactic webinar on LCS and SDM • 30-min role play session using the decision coaching materialsa and 30-min review of the role play session • 2–3 practice decision coaching sessions with mock patients • 1-h group review of the practice sessions Navigator Ongoing Training: • Monthly review meetings with navigators in first 6 months, then quarterly meetings until recruitment is completed • Weekly knowledge check question • Yearly refresher training Intervention Fidelity: • Review of first 3 recorded coaching sessions using a fidelity checklist and thereafter randomly selected recordings; with individual feedback provided to each patient navigator | Not applicable (no EUC navigators) |
Patients | Telehealth Decision Coaching Session: • Conducted on Zoom/Teams by patient navigator using decision coaching slides • Navigators provide information about the LDCT procedure, benefits and harms of LCS • Navigator assesses and address patient barriers • Navigator assesses screening preferences and places LDCT order if patient elects screening • Navigator offers referral for tobacco treatment to patients who are interested Follow-Up Navigation: • 2 weeks after order is placed and signed: Navigator follows up with patients who wanted to be screened but did not schedule the LDCT yet • 3 months after initial decision coaching session: Navigator re-navigates patients who wanted to be screened but did not complete LCS • Decision coaching booster session: 50% of patients who completed an initial LCS and have low-risk findings are randomly selected to receive a decision coaching booster session 1 month before their next annual screening is due | Clinic visit with EUC arm clinician: EUC clinicians are responsible for discussing LCS, addressing smoking cessation, ordering the LDCT, and following up on the LDCT result with patients |