Abstract B054: Development of a decisional values measure for lung cancer screening among long-term African American smokers

Abstract

Abstract Introduction: The burden of lung cancer is significant for African Americans, especially African American men, who have the highest lung cancer death rates compared to all other racial and ethnic groups. There is mounting evidence that lung cancer screening via low-dose computed tomography (LDCT) reduces lung cancer-specific mortality. However, due to the limitations and possible harms associated with LDCT, most medical organizations are endorsing the process of informed and shared decision-making. To promote informed decision-making in this context, individuals’ decisional needs must be met, including addressing any gaps in knowledge about lung cancer and lung cancer screening, considering personal values related to screening, and the role the patient wants to play in the decision-making process. To avoid racial disparities in screening rates for LDCT, which will ultimately increase the racial disparity in lung cancer mortality, it is important to uncover any considerations unique to patients who are eligible for LDCT. Methods: Key informant interviews (N=9) identified factors important to African American smokers’ screening decisions. Based on these interviews, we developed decisional values items for LDCT and report initial psychometric properties. The pool of items was administered to a convenience sample of 119 African American smokers. Results: An exploratory factor analysis revealed two components explaining 64% of the variance. The components were Cons of Screening (e.g., ‘…screening will not find all lung cancers or all lung cancer early’) and Pros of Screening (e.g., ‘lowering your risk of dying from lung cancer’). The final 12-item measure had very good internal consistency (α=.89 overall; α=.86 and .88 for subscales, respectively). To determine whether the decisional values items predicted participants’ intention to be screened for lung cancer via LDCT in the next six months, linear regression analyses were conducted with the sub-scales. The Pros of Screening sub-scale significantly predicted screening intentions such that higher reported pros were associated with greater likelihood of screening intention (B=.10, SE=.04, p<.05). The Cons of Screening sub-scale was not significantly associated with likelihood of screening. Conclusion: Values may be specific to the type of decision and the characteristics of those making the decision. This tool provides a promising values measure for lung cancer screening among African Americans and could inform future values clarification tools promoting informed decision-making. Our next steps in this line of research will include conducting cognitive testing of the items and assessing the reliability of this tool in sub-groups. Citation Format: Randi M. Williams, Kathryn L. Taylor, Cheryl L. Knott. Development of a decisional values measure for lung cancer screening among long-term African American smokers [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B054.