# Population Health Management Approaches to Increase Lung Cancer Screening in Community Health Centers

> **NIH NIH UG3** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $639,095

## Abstract

Lung cancer is the leading cause of cancer-related mortality in the U.S., accounting for approximately 1 in 5
cancer-related deaths. Approximately 80% of lung cancers are attributable to cigarette smoking. Annual Low-
Dose Computed Tomography screening for lung cancer (hereafter referred to as Lung Cancer Screening or LCS)
is recommended by the U.S. Preventive Services Task Force (USPSTF). Despite evidence of effectiveness and
the USPSTF recommendations, implementation of LCS into clinical practice has been exceedingly limited, with
only 6.5% of eligible individuals screened in 2020, and there are major health inequities in LCS related to
race/ethnicity and socioeconomic status. The long-term goal of this program of research is to increase the
reach of LCS at scale among low resource healthcare settings and populations that have been historically
marginalized. The proposed project, LungSMART Utah, is a two phase, Sequential Multiple Assignment
Randomized Trial (SMART) conducted in Utah Community Health Centers (CHCs). Utah has 14 CHC systems
with 50 primary care clinics. Each of the Utah CHCs are Federally Qualified Health Centers, providing
comprehensive primary care to >160,000 patients annually. Utah CHC patients are: 50% Latino, 8% Native
American, 38% best served in a language other than English, 61%<100% of federal poverty level, 45%
uninsured, and 41% of the clinics are in rural areas (RUCC >4). LungSMART Utah is guided by a
comprehensive conceptual framework and is designed to directly address LCS implementation challenges to
ensure equitable implementation and reduce health inequities. LungSMART Utah utilizes a Population Health
Management (PHM) framework, in which scalable, accessible, and sustainable telehealth interventions are
used to engage patients in LCS. Phase 1 of the SMART leverages ubiquitous technologies to enable CHC
patients to be assessed for LCS eligibility, engage in Shared Decision Making (SDM) if eligible, and be referred
for LCS. Phase 2 of the SMART tests telehealth interventions designed to address logistical barriers and
hesitancy around completing LCS among referred patients. LungSMART Utah leverages smartphone/internet
technologies when available, and also supports patients whose only telehealth connectivity is a cellphone. A
centralized “Hub” enables eligibility assessment, SDM with clinical decision support, screening referral, and
screening logistics assistance at scale to help overcome numerous social determinants of health that impact low
resource settings and historically marginalized populations. All study procedures and interventions will be
conducted in English or Spanish based on the patient's preferred language. In sum, LungSMART Utah will be
conducted in a real-world context across multiple, independent healthcare delivery systems with limited
resources (i.e., CHCs) and among historically marginalized populations (i.e., low SES, rural, Latino).
LungSMART Utah will provide a critical evidence-base for ...

## Key facts

- **NIH application ID:** 10786837
- **Project number:** 1UG3CA287109-01
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** GUILHERME DEL FIOL
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $639,095
- **Award type:** 1
- **Project period:** 2024-05-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10786837

## Citation

> US National Institutes of Health, RePORTER application 10786837, Population Health Management Approaches to Increase Lung Cancer Screening in Community Health Centers (1UG3CA287109-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10786837. Licensed CC0.

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