A co-design process with a 10-member Community Advisory Board successfully developed the CHATS intervention, a culturally adapted, CHW-delivered protocol for lung cancer screening and tobacco treatment.
A co-design process with a Community Advisory Board successfully developed an equity-focused, culturally adapted Community Health Worker intervention to promote lung cancer screening and tobacco cessation in underserved populations.
Abstract Rationale Black and Latino communities experience disproportionate lung cancer mortality and lower engagement in both lung cancer screening (LCS) and tobacco treatment. Community health workers (CHWs) serve as trusted health advocates within underserved communities and can help address psychosocial and structural barriers to preventive care. However, evidence on CHW-delivered interventions that jointly address LCS and tobacco treatment is limited. The Community Health Worker Advocacy for Tobacco Treatment and Lung Screening (CHATS) study seeks to fill this gap through community-engaged intervention development. Objective To develop a culturally responsive, community-engaged CHW intervention protocol to promote lung cancer screening and tobacco treatment at community health centers that primarily serve Black and Latino adults receiving care in community health centers. Methods We created a Community Advisory Board (CAB) composed of 10 members, including CHWs, tobacco treatment specialists, patients with lived experience, and community leaders. The CAB met monthly from August 2024 to July 2025. Using a co-design approach, each virtual or hybrid session was structured to ensure shared understanding and collaboration. Together, members collaboratively defined the CHW role, core intervention components, and implementation strategies. Consensus was achieved through polls, breakout group discussions, and iterative intervention refinement. Results The co-design process produced a CHW-delivered intervention organized around four intervention components: (1) patient outreach, (2) shared decision making for LCS, (3) tobacco treatment support, and (4) navigation and follow-up. Input from the CAB led to several refinements to the PI’s original design aimed at promoting equity: 1-Language and Cultural Adaptation: Simplified technical terminology and refined Spanish translation to ensure clarity and linguistic resonance. 2-Trust-Building Strategies: Developed a CHW script emphasizing empathy and rapport. 3-Enhanced Reach: Designed multimodal outreach plans combining calls, text messages, and improved mailed invitations to enhance engagement. 4-Survey Refinement: Streamlined assessment tools to minimize burden while maintaining data quality. Conclusions The co-design process with the CAB was essential to developing an equity-focused CHW intervention to promote lung cancer screening and tobacco cessation. The resulting CHATS intervention reflects community and patient priorities, addresses language and psychosocial barriers, and offers an equitable model for integrating CHWs into preventive care delivery for populations disproportionately affected by lung cancer. This abstract is funded by: NCI K08
Nunez et al. (Fri,) conducted a other in Lung cancer screening and tobacco use (n=10). Community Health Worker Advocacy for Tobacco Treatment and Lung Screening (CHATS) intervention was evaluated on Development of a culturally responsive, community-engaged CHW intervention protocol. A co-design process with a 10-member Community Advisory Board successfully developed the CHATS intervention, a culturally adapted, CHW-delivered protocol for lung cancer screening and tobacco treatment.