Radon and Tobacco Risk Counseling During Lung Cancer Screening Shared Decision-Making.

Abstract

Examine frequency of tobacco and radon risk counseling during lung cancer screening shared decision making among qualified health care providers and the relationship between radon beliefs, tobacco and radon counseling self-efficacy, and related tobacco and radon risk counseling among providers. Cross-sectional, observational study design employing a mailed self-report survey sent to a stratified random sample of 1,000 qualified health care providers in Kentucky. Regression analyses to examine the association among sociodemographic characteristics, radon beliefs, self-efficacy, familiarity with lung cancer screening guidelines, and tobacco or radon risk reduction counseling during lung cancer screening shared decision making. In all, 149 providers responded to the mailed survey (14.9% participation rate). Participants were largely unsure about their radon beliefs. Providers rated their self-efficacy for tobacco cessation counseling higher than their self-efficacy related to counseling patients on radon testing and mitigation. Participants reported a high frequency of tobacco risk counseling during lung cancer screening shared decision making, but almost never counseled on radon risk. Adjusting for health care provider demographic- and practice-level variables, self-efficacy related to tobacco cessation counseling was the sole significant predictor of frequency of tobacco risk counseling. In the multilevel logistic regression model, no variables were found to be significantly associated with frequency of radon risk counseling during lung cancer screening shared decision making. Risk reduction remains essential to reducing the burden of lung cancer in the United States. Interventions that increase provider beliefs about radon and provider self-efficacy in relation to tobacco and radon counseling during lung cancer screening are needed.