Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake

Background: The U.S. Preventive Services Task Force (USPSTF) currently recommends annual lung cancer screening (LCS) with low-dose computed tomography (LDCT) for asymptomatic 50- to 80-year-old adults with a 20-pack year history who currently smoke or have quit smoking within the past 15 years. Fore...

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Main Authors: Jennifer Leng, Florence Lui, Chloe Chan, Ruo Yan Chen, Minlun Wu, Bharat Narang, Francesca Gany
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Public Health in Practice
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666535225000400
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author Jennifer Leng
Florence Lui
Chloe Chan
Ruo Yan Chen
Minlun Wu
Bharat Narang
Francesca Gany
author_facet Jennifer Leng
Florence Lui
Chloe Chan
Ruo Yan Chen
Minlun Wu
Bharat Narang
Francesca Gany
author_sort Jennifer Leng
collection DOAJ
description Background: The U.S. Preventive Services Task Force (USPSTF) currently recommends annual lung cancer screening (LCS) with low-dose computed tomography (LDCT) for asymptomatic 50- to 80-year-old adults with a 20-pack year history who currently smoke or have quit smoking within the past 15 years. Foreign-born Chinese livery drivers are a group at disproportionately high risk for lung cancer due to high smoking prevalence and occupational exposure to airborne contaminants and carcinogens. This paper describes a pilot randomized controlled trial to educate and navigate high-risk, previously unscreened Chinese livery drivers to lung cancer screening, and describes barriers to recruitment and retention. Study design: Pre-pilot and pilot randomized controlled trial. Methods: The study was conducted in two phases, a pre-pilot and pilot randomized controlled trial between December 2019 and June 2023. In the pilot RCT, eligible participants were randomized to either (1) the CHW (Community Health Worker) intervention group or (2) a written materials only control group and participated for 6–12 months. Results: From December 2019 to June 2023, 25 subjects were enrolled: 12 in Phase 1 and 13 in Phase 2 (of 1018 approached). Recruitment barriers included the COVID-19 pandemic, institutional mistrust, smoking-related beliefs, and primary care provider-related barriers. Conclusions: We identified specific socioenvironmental and cultural barriers to LCS uptake among Chinese immigrant men who smoke. Farther upstream cancer education interventions (e.g., provider and community-level education initiatives on LCS) conducted in partnership with community-based organizations should be considered to meet the needs of this population.
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spelling doaj-art-13e2cf5c49834284bc0714e3e8a22c102025-08-20T02:02:19ZengElsevierPublic Health in Practice2666-53522025-06-01910062110.1016/j.puhip.2025.100621Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptakeJennifer Leng0Florence Lui1Chloe Chan2Ruo Yan Chen3Minlun Wu4Bharat Narang5Francesca Gany6Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA; Corresponding author. Immigrant Health and Cancer Disparities Service Memorial Sloan Kettering Cancer Center 633 Third Ave., 4th Floor, New York, NY, 10017, USA.Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA; Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USAImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USAImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USAImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USAImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USAImmigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USABackground: The U.S. Preventive Services Task Force (USPSTF) currently recommends annual lung cancer screening (LCS) with low-dose computed tomography (LDCT) for asymptomatic 50- to 80-year-old adults with a 20-pack year history who currently smoke or have quit smoking within the past 15 years. Foreign-born Chinese livery drivers are a group at disproportionately high risk for lung cancer due to high smoking prevalence and occupational exposure to airborne contaminants and carcinogens. This paper describes a pilot randomized controlled trial to educate and navigate high-risk, previously unscreened Chinese livery drivers to lung cancer screening, and describes barriers to recruitment and retention. Study design: Pre-pilot and pilot randomized controlled trial. Methods: The study was conducted in two phases, a pre-pilot and pilot randomized controlled trial between December 2019 and June 2023. In the pilot RCT, eligible participants were randomized to either (1) the CHW (Community Health Worker) intervention group or (2) a written materials only control group and participated for 6–12 months. Results: From December 2019 to June 2023, 25 subjects were enrolled: 12 in Phase 1 and 13 in Phase 2 (of 1018 approached). Recruitment barriers included the COVID-19 pandemic, institutional mistrust, smoking-related beliefs, and primary care provider-related barriers. Conclusions: We identified specific socioenvironmental and cultural barriers to LCS uptake among Chinese immigrant men who smoke. Farther upstream cancer education interventions (e.g., provider and community-level education initiatives on LCS) conducted in partnership with community-based organizations should be considered to meet the needs of this population.http://www.sciencedirect.com/science/article/pii/S2666535225000400Chinese immigrants and emigrantsLivery driversLimited English proficiencyLung cancer screeningCommunity health workersUnderserved populations
spellingShingle Jennifer Leng
Florence Lui
Chloe Chan
Ruo Yan Chen
Minlun Wu
Bharat Narang
Francesca Gany
Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
Public Health in Practice
Chinese immigrants and emigrants
Livery drivers
Limited English proficiency
Lung cancer screening
Community health workers
Underserved populations
title Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
title_full Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
title_fullStr Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
title_full_unstemmed Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
title_short Recruitment and retention of Chinese men at high risk for lung Cancer: Lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
title_sort recruitment and retention of chinese men at high risk for lung cancer lessons learned from a pilot trial of a community health worker intervention to increase lung cancer screening uptake
topic Chinese immigrants and emigrants
Livery drivers
Limited English proficiency
Lung cancer screening
Community health workers
Underserved populations
url http://www.sciencedirect.com/science/article/pii/S2666535225000400
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