Support and Outreach to Increase Screening for Lung Cancer in Patients With a History of Smoking

PRIMARY OBJECTIVES: I. Assess intervention impact on lung cancer screening (LCS). II. Assess intervention impact on shared decision making (SDM). SECONDARY OBJECTIVES: I. Identify mediators and moderators of LCS. II. Assess intervention implementation barriers and facilitators. EXPLORATORY OBJECTIVES: I. Assess intervention impact on: Ia. LCS referral; Ib. Tobacco treatment services referral; Ic. Repeat annual LCS among participants with a normal initial screening result; Id. Follow-up diagnostic evaluation for participants with an abnormal screening result. OUTLINE: In accordance with the 2X2 cluster randomized design, primary care practices along with providers initially are randomized to 1 of 2 groups. Then, patients within the practices are randomized to 1 of 2 groups. PROVIDERS: GROUP A: PROVIDER SUPPORT GROUP: Providers complete baseline and endpoint surveys once on study. Providers also undergo online educational activity on study. Participants undergo distance learning on study. GROUP B: PROVIDER CONTROL GROUP: Participants complete baseline and endpoint surveys once on study. PATIENTS: GROUP A: PROVIDER SUPPORT + PATIENT OUTREACH GROUP: Providers receive support once on study. Patients undergo educational activity and SDM counseling once on study and complete baseline and endpoint surveys. GROUP B: PROVIDER SUPPORT + PATIENT CONTROL GROUP: Providers receive support once on study. Patients receive usual care once on study and complete baseline and endpoint telephone surveys. GROUP C: PROVIDER CONTROL + PATIENT OUTREACH GROUP: Providers receive usual care once on study. Patients undergo educational activity and SDM counseling once on study and complete baseline and endpoint surveys. Group D: PROVIDER CONTROL + PATIENT CONTROL GROUP: Providers receive usual care once on study. Patients receive usual care once on study and complete baseline and endpoint telephone surveys.