2021 Veterans Affairs Research Scholar Award Jennifer Lewis, MD, MS, MPH Vanderbilt University Medical Center/VA-Tennessee Valley Healthcare System Nashville TN Research Summary Fewer than 10% of eligible Veterans are screened for lung cancer with low-dose computed tomography (LDCT), and a lack of clinician engagement is one important reason for low screening rates. In this proposal, we will modify a survey tool that measures aspects of clinician engagement in lung cancer screening to better understand how to improve clinician engagement. We will perform experiments to evaluate if this measure is capturing the key concepts in engagement. We will evaluate if a provider who scores higher in certain engagement features orders more screening examinations. The results of this proposal will be used to develop an intervention to increase clinician engagement in lung cancer screening and evaluate if engagement changes before and after that intervention. Increasing clinician engagement can lead to improved screening rates and lung cancer outcomes. Technical Abstract Background: Provider engagement is key for successful implementation of evidence-based practices. Our prior work reported that providers’ guideline knowledge is strongly correlated to screening practices but other behavioral factors have not yet been measured in lung cancer screening. Long-term Career Goal: To be a leader in implementation science with expertise in translating evidence-based lung cancer prevention and early detection into clinical practice through mixed-methods research (qualitative and quantitative) and pragmatic trials in the Veterans Affairs (VA). This award will advance the following career goals: To gain experience in: a) measurement science; b) quantitative analysis methods, and to transition to research independence. Specific Aim: To measure and validate providers’ behavioral factors that influence lung cancer screening implementation. Methodology: We will adapt the Determinants of Implementation Behavior Questionnaire (DIBQ) for lung cancer screening and leverage ongoing research infrastructure to survey primary care providers at 10 VA medical centers (VAMCs) participating in the Veterans Affairs Partnership to increase Access to Lung Screening (VA-PALS). The adapted questionnaire will be validated using factor analysis and association with prior screening practices. We will assess which behavioral factors are associated with screening using multivariable regression. Future Directions: The data gathered will be used to design future interventions aimed at increasing provider engagement and measure how provider engagement changes before and after interventions. This proposal will advance the field of implementation science while also leading towards my independence as an implementation researcher. Key words Early detection Health equity Non-small cell lung cancer (NSCLC) Screening Stage I Stage II Veterans Affairs