Development and testing of “Is Lung Cancer Screening for You?” A computer-based decision aid

Abstract

Purpose: To reduce lung cancer mortality, individuals at high-risk should receive a low-dose computed tomography screening annually. To increase the likelihood of screening, interventions that promote shared decision-making are needed. The goal of this study was to investigate the feasibility, acceptability, usability, and preliminary effectiveness of a computer-based decision aid. Methods: Thirty-three participants were recruited through primary-care clinics in a small southeastern-US city. Participants used a computer-based decision aid (“Is Lung Cancer Screening for You?”) during a clinic appointment. Paper surveys collected self-reported feasibility, acceptability, and usability data. A research coordinator was present to observe each patient’s and health-care provider’s interactions, and to assess the fidelity of shared decision-making. Results: The decision aid was feasible, acceptable for use in a clinic setting, and easy for participants to use. Patients had low decisional conflict following use of the decision aid and had high screening intention and actual screening rates. Shared decision-making discussions using the decision aid were nearly 6 min on average. Conclusion: Computer-based decision aids are feasible for promoting shared lung cancer–screening decisions. A more robust study is warranted to measure the added value of a computer-based version of this aid versus a paper-based aid.