# Co-Design and Pilot Testing of Peer-led Community Outreach to Improve Equity, Veteran-Centeredness and Uptake of Lung Cancer Screening

> **NIH VA I21** · VA BOSTON HEALTH CARE SYSTEM · 2024 · —

## Abstract

Background: Lung cancer screening (LCS) with annual computed tomography can reduce lung cancer
mortality, but <10% of the estimated 1 million eligible Veterans have been screened, with lower rates among
Black people. Many barriers prevent Black people from engaging in LCS: lack of awareness of LCS or how to
access it, stigma, fatalistic expectations about lung cancer, power differentials with providers, mistrust of VA,
limited self-efficacy, and adverse social determinants of health [entrenched by structural racism]. As a result,
across the US LCS uptake is 50% lower [and adherence is 20% lower] among Black vs white persons.
Significance: Fourteen Veterans die of lung cancer each day (5000/year), and Black men have the highest
incidence and mortality in the US. To improve equity, the 2022 President’s Cancer Panel recommends using
trained community peers (known in VA as Peer Specialists, or “Peers”) to reach vulnerable individuals where
they are and support them in engaging in cancer screening. Our overarching hypothesis for this line of
research is that community outreach, education, and tailored one-to-one support delivered by Veteran Peers
can address barriers that prevent Black Veterans from accessing LCS, thereby closing disparities.
Innovation & Impact: We will use co-design with Black Veterans, Peers, and community partners to develop
an innovative, Veteran-centered intervention (Peer-led program) that meets the needs of Black Veterans. No
prior research has tested VA Peer Specialists in such a role. This work is tightly aligned with Office of
Research & Development priorities on health equity and precision oncology. The 2022 HSR&D priorities call
for health equity studies and for pilot studies testing strategies for Veteran and community engagement.
Specific Aims: This pilot project has the following aims: 1) Co-design the Peer-led program in partnership with
Veterans and community stakeholders; 2) Assess feasibility and acceptability of the Peer-led program; and 3)
[Establish feasibility of study procedures].
Methodology: In Aim 1, we will convene a virtual co-design team of 1-2 Peers and 5-7 Black LCS-eligible
Veterans from across the US, [including at least 2 Black women and Veterans varying in age, ethnicity, and
geographic residence. Using best practices for equity-centered co-design], we will create a plan and messages
for community outreach, content for group LCS orientation, and the process for one-to-one Peer coaching and
navigation to support Black Veterans to engage in LCS. We will seek input from our community partners, [the
National Association for Black Veterans and Tri-Ad Veterans League], external Veteran advisory panels, and
LCS clinical staff to ensure relatability beyond our team and fit with clinical workflow. In Aim 2, we will conduct
a feasibility pilot test of the Peer-led program. The Peer will lead up to 4 group LCS orientations in community
partner sites to reach ~40 LCS-eligible Black Veterans. The Peer will prov...

## Key facts

- **NIH application ID:** 10746210
- **Project number:** 1I21HX003712-01A1
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Renda Soylemez Wiener
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10746210

## Citation

> US National Institutes of Health, RePORTER application 10746210, Co-Design and Pilot Testing of Peer-led Community Outreach to Improve Equity, Veteran-Centeredness and Uptake of Lung Cancer Screening (1I21HX003712-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10746210. Licensed CC0.

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