A culturally adapted intervention called Empower LCS tripled low-dose CT lung cancer screening ordering rates among Hispanic patients, increasing screening rates from 13.3% to 50% compared to standard care, according to research published in the Journal of the American College of Radiology.
- Empower LCS increased LDCT ordering to 50% in the intervention group versus 13.3% in the control group at four months
- The multilevel intervention included a culturally adapted decision aid, provider notifications, patient text reminders, and health-related social needs support
- 86.7% of participants found the decision aid helpful and easy to understand, with 85.7% reporting it provided new information
- LCS discussions were 40.0% in the Empower LCS arm versus 16.7% in the control arm
- Empower LCS is a low-cost, scalable approach that does not require resource-intensive navigation programs
A culturally adapted multilevel intervention called Empower LCS tripled low-dose CT (LDCT) ordering rates among Hispanic patients, according to a study published October 22 in the Journal of the American College of Radiology.
A group from the University of California Irvine examined the preliminary efficacy of Empower LCS for improving lung cancer screening (LCS) uptake, with findings suggesting culturally tailored, low-cost interventions can reduce disparities in LCS participation.
"The multilevel Empower LCS intervention showed promising preliminary efficacy among Hispanic patients, increasing screening discussions, and LDCT ordering," noted lead author Mahnur Bharucha, a medical student at the University of California Riverside, and colleagues.
Hispanic patients face persistent barriers to LCS engagement, and culturally adapted multilevel interventions remain an underexplored approach to improving uptake in this population, the authors wrote.
To bridge the gap, the researchers enrolled 60 Hispanic patients between 50 and 80 years old who met 2021 U.S. Preventive Services Task Force LCS eligibility criteria between February 2024 and August 2025 and randomized 1:1 to Empower LCS or enhanced usual care (EUC). Empower LCS included a culturally adapted decision aid, provider notifications, patient text reminders, and health-related social needs support. EUC consisted of a one-page educational handout. The primary outcome was LDCT ordering within four months, assessed by medical record review or self-report.
At four months, LDCT ordering was 50% in the Empower LCS arm versus 13.3% in the EUC arm, the authors found. LCS discussions were also higher in the intervention group (40.0% versus 16.7%). LDCT completion trended higher with Empower LCS (30.0% versus 13.3%) but did not reach statistical significance, likely due to the small sample size, the authors noted.
In addition, among Empower LCS participants who completed follow-up surveys (n=18), 86.7% (13/15) reported reading the decision aid, 100% (14/14) found it helpful for decision-making and easy to understand, and 85.7% (12/14) reported it provided new information. Also, 70.6% (12/17) found patient reminders helpful, while 64.7% (11/17) found provider notifications helpful.
"These findings support culturally tailored, low-cost, scalable interventions to reduce disparities in LCS participation," the authors wrote.
The authors noted that although patient navigation has been shown to improve LCS uptake, navigation programs are often resource-intensive and non-billable, while Empower LCS is a low-cost, scalable approach demonstrating promising results.
Future studies should evaluate the implementation costs, sustainability, and cost-effectiveness of Empower LCS in routine clinical practice, including the personnel and time required to deliver the intervention, the researchers concluded.
The full study is available here.
