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Douglas Arenberg



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    MS15 - How to Get Patients to Quit Smoking; Practical Implementation of Evidence-Based Cessation Practices (ID 78)

    • Event: WCLC 2019
    • Type: Mini Symposium
    • Track: Prevention and Tobacco Control
    • Presentations: 1
    • Now Available
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      MS15.03 - Speaking with Patients, Motivational Interviewing Demonstration (Now Available) (ID 3527)

      11:30 - 13:00  |  Presenting Author(s): Douglas Arenberg

      • Abstract
      • Presentation
      • Slides

      Abstract

      Ongoing tobacco use accounts for significant treatment and disease related morbidity, mortality, and decreased quality of life among patients undergoing cancer treatment. A common misconception is that it is too late to pursue tobacco cessation for individuals with advanced lung cancer. Data from existing studies do not support this, yet support for tobacco cessation services among cancer centers is often lukewarm or frankly lacking. For individuals undergoing active cancer therapy, even brief interventions from their oncologist can have an enormous impact on their willingness, and motivation to make a quit attempt. The purpose of this presentation is to arm lung cancer clinicians with tools to help patient's find internal motivation to make quit attempts, and to support them with counseling, as well as cessation pharmacotherapy. Common misconceptions among both providers and their patients who use tobacco will be presented, along with strategies to undserstand and overcome ambivalence towards tobacco cessation.

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    P2.11 - Screening and Early Detection (ID 178)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.11-35 - Lung Cancer Screening Knowledge, Perceptions and Decision-Making Among African Americans (ID 2007)

      10:15 - 18:15  |  Author(s): Douglas Arenberg

      • Abstract
      • Slides

      Background

      Significant lung cancer disparities exist in the USA, where African American men have the highest incidence rate. However, most available web-based lung cancer screening decision aids have been designed without substantive feedback from African Americans, and few have been validated in this population. Therefore, we sought to evaluate and redesign an existing decision aid with input from African Americans in Detroit.

      Method

      Using insights obtained from participatory design workshops in this population, we implemented content changes to shouldiscreen.com and evaluated this modified version with a before-after study. Surveys took place between April and July 2018. Data were collected from 78 participants who were current/former smokers, had no history of lung cancer, and aged between 45 and 77. Participants were contacted six months after to assess if they took steps to receive lung cancer screening.

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      Result

      Knowledge about risk factors and screening between before and after viewing the decision aid was 6.4 and 8 out of 15 points, respectively (25% increase). Notably, half of the participants felt uncomfortable answering surveys electronically and requested paper versions. There was a 31% improvement in knowledge score among those who took the electronic survey (6.7 to 8.8), and 18% for paper (6.1 to 7.2). Acceptability was high: 93% of all participants said the tool helped them consider screening. Concordance between individual preference and eligibility for screening increased from 22% to 34% (n = 74). The primary source of discordance was from those who should not be screened but prefer to be screened, although the largest improvement came from those who were unsure. There was significant loss to follow-up at six months: only 14 out of 78 participants were successfully contacted. Of these, three were eligible for screening according to USPSTF criteria. Five followed up with their physicians, and the three who were eligible were strongly encouraged to be screened. Two went through with lung cancer screening and one had quit smoking.

      Conclusion

      Use of the tool led to improvements in lung cancer screening knowledge and concordance with current recommendations. Additional design modifications and modes of information delivery of current decision aids should be considered to increase their efficacy in helping populations with lower educational attainment and computer literacy. Partnering with community organizations and community leaders to demonstrate the use of the tool and explain the benefits of screening is paramount to help encourage those who might benefit most from it.

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