INTRODUCTION: The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) community represents a high-risk group for lung cancer given higher smoking rates. We evaluated implementation of a pilot patient navigation intervention for smoking cessation services combined with lung cancer screening (LCS) care for eligible LGBTQ+ adults. METHODS: We completed a concurrent mixed-methods evaluation of the intervention to enhance adaptation and future scale. Forty-one LGBTQ+-identifying individuals who were eligible for LCS and currently smoking were enrolled, completed baseline surveys, and underwent the intervention for a 90-day period. Thirty-four participants completed post-intervention surveys and 15 were invited for semi-structured interviews. We conducted a thematic analysis of qualitative data, integrated with quantitative and qualitative survey data through joint displays, guided by the Health Equity Implementation Framework. RESULTS: We identified fourteen themes in three topical domains. Key themes related to Intervention Success included: flexible communication; iterative contact through a longitudinal relationship; improved confidence and comfort; multimodal and tailored elements. Themes related specifically to LGBTQ+ Care included: LGBTQ+-specific social challenges; the impact of historic discrimination; emphasis on non-judgmental care; and varied responses to LGBTQ+-specific tailoring. Themes related to Future Adaptations included: more education and information on the LGBTQ+-tailored approach; synergy with trusted primary care clinicians; upfront information on financial risks; community connection and peer support; and variable need for more intense support. CONCLUSIONS: LGBTQ+-tailored patient navigation is an acceptable and well-suited intervention to facilitate and integrate LCS care and smoking cessation. Further adaptation should include more education and incorporate components of community support.
Murphy et al. (Tue,) studied this question.