Empower Latinx: Empowering Hispanic Patient’s Lung Cancer Screening Uptake

Purpose: Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is recommended by the USPSTF, yet Hispanic patients have lower screening uptake compared with non-Hispanic White individuals. We assessed the preliminary efficacy of a culturally tailored, multi-level intervention (Empower Latinx) versus enhanced usual care (EUC) in improving LCS uptake among Hispanic patients.

Methods/Materials: We conducted a randomized controlled trial enrolling Hispanic patients aged 50-80 years meeting LCS eligibility criteria. Participants were randomized to EUC (usual care plus a one-page educational material) or Empower Latinx (a culturally tailored decision aid, financial navigation resources, patient reminders to discuss LCS, and provider notifications of eligibility). The primary outcome was LDCT ordering within 4 months. Secondary outcomes included completion of LDCT and LCS discussions. Univariable and multivariable analyses were performed.

Results: Sixty patients were enrolled (mean age 60.8 years; 61.7% male; 35% Spanish-speaking). Insurance coverage included Medicaid (65.0%), Medicare (21.6%), private insurance (6.7%), and uninsured (6.7%). Common LCS barriers included concern about finding an abnormality (73.3%), scan cost (45.0%), and anticipated costs after a positive result (36.7%). At 4 months, Empower Latinx demonstrated higher rates of LCS discussions (40.0% vs. 16.7%; p = 0.045) and LDCT ordering (50.0% vs. 13.3%; p = 0.002) compared with EUC. LDCT completion was higher in the intervention arm but not significant in unadjusted analyses (30.0% vs. 13.3%; p = 0.117), likely due to limited sample size. In multivariable models adjusting for patient sociodemographic and clinical factors, Empower Latinx was independently associated with higher odds of LDCT completion (OR 8.7, 95% CI 1.2–120.3).

Conclusions: A culturally tailored, multi-level intervention significantly improved LCS discussions and LDCT ordering among Hispanic patients. Although completion did not differ in unadjusted analyses, adjusted models demonstrated a significant intervention effect on LDCT completion, suggesting Empower Latinx may help overcome structural barriers to LCS in this underserved population.