Read time: 4 minutes.
The LUNGevity Conversations that Count speaker series offers an opportunity to stay informed, engage in critical discussions, and learn from top experts revolutionizing lung cancer care for underserved populations. The series is intended for healthcare professionals, community health equity champions, and anyone interested in equitable access to healthcare.
In February, we welcomed Randi Williams, PhD, MPH, of the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center.
Her research focuses on methods to promote the adoption of evidence-based lung cancer control practices to advance health equity. In the video below, Dr. Williams talks about utilizing multiple strategies to advance equitable implementation of lung cancer screening.
You can watch the full video or use the timestamps to view specific sections.
Meet Dr. Randi Williams: 2:00-6:50
Dr. Williams shares her journey into lung cancer research, from obtaining a psychology degree at Syracuse University in 2004 to her current role as an assistant professor in the Department of Oncology at the University of Georgetown.
Disparities & Barriers in Lung Cancer: 6:50-11:15
Dr. Williams shares more about the strategy behind her research by explaining how focusing on disparities and barriers creates opportunities for better outcomes. She highlights and shares research data for:
- Disparities in Burden
- Disparities in Availability
- Disparities in Utilization
She then names and explains how barriers result in lower screening rates:
- Policy-level barriers: Guidelines do not account for sociocultural factors (racial, ethnic, or socioeconomic) or differences in smoking behaviors
- Healthcare system-level barriers: Investment by systems in additional resources to identify eligible patients
- Provider-level barriers: Provider time constraints; familiarity with screening criteria; implicit bias
- Patient-level barriers: Stigma; nihilism; medical mistrust; knowledge and awareness
Research Roadmap & Early Results: 11:15-36:10
The guiding research question that directs much of Dr. Williams’ work is, "How do we utilize multiple strategies to advance equitable implementation of lung cancer screening?" She shares the specific actions her research team has already taken to address each of the barriers listed above. This includes:
- Educating Quitline users (people using the national tobacco cessation counseling service) about lung cancer screening
- Educating providers about health disparities in lung cancer screening
- Implementing a quality improvement program in the electronic health record system to address disparities
- Comparing the implications and use of different lung cancer screening guidelines
Moving into her ongoing work, Dr. Williams shares about the Providing Reminders and Education Prior to Lung Cancer Screening (PREP) study that she’s leading. The study’s goal is to target provider and patient-level barriers by improving communication and utilization of lung screening. The roadmap for this study includes:
- Evaluating the feasibility and acceptability of implementing a provider message in primary care
- Developing and pre-testing the patient education component
- Testing the multilevel intervention on provider-patient communication and screening
To learn more about the initial results of this ongoing study, make sure to watch this entire section, starting at 11:15.
Best Practices and Lessons Learned: 36:10-40:45
Dr. Williams shares these best practices for advancing health equity:
- Community to clinic linkages
- Multilevel determinants require multilevel solutions
- Co-development of interventions and strategies
- Engagement with partners
- Use of phased and mixed method approaches
Lessons she’s learned during her career include:
- Navigating varying needs from the patient, provider, and systems perspectives
- Continuity in conceptualization through measurement and evaluation for multilevel research
- Communicating how health equity advances health for everyone
For more context on each item, make sure to watch this entire section, starting at 36:10.
Audience Questions: 40:45-50:00
Dr. Williams answers these audience questions:
- Why did the study population prefer the printed lung cancer screening booklet over online screening resources?
- Did participating in your study lead to providers using the electronic health record system more?
- What items, or pieces of your research, do you think need to be tailored to specific populations? Additionally, what items can be used more globally?