Health promotion describes the process of empowering people to enhance control over and improve their health. Health promotion programs empower and engage communities and individuals to choose healthy lifestyles and make adjustments that lower the possibility of acquiring chronic diseases. One health promotion initiative is lung cancer screening, which encourages early detection and management of lung cancer. This paper creates awareness of lung cancer screening.
Health Promotion Theory
Different health theories provide frameworks for designing health promotion programs. The health belief model is among the commonly used theories guiding disease prevention and health promotion initiatives. This model can also be incorporated into lung cancer screening. HMB predicts and explains individual modifications in health behaviors. Carter-Harris et al. (2017) identify lung cancer screening as a recent recommendation for long-term smokers. As a result, understanding community and individual health beliefs regarding screening are crucial in fostering provider-patient conversations concerning screening participation.
In order to promote lung screening behavior, it is necessary to explore the population’s screening behaviors and attitudes/perceptions about lung cancer screening, underlining the importance of HBM. According to Carter-Harris et al. (2017), lung cancer screening participation depends on numerous factors, including the healthcare system, provider, and individual. Understanding factors that influence screening decisions is necessary to promote shared decision-making. The model is instrumental in this initiative because it identifies vital elements of individual beliefs regarding health conditions that predict a person’s health-related behaviors. It can help identify factors that motivate people to participate in screening programs.
The major constructs integrated from the theory and reflected in developing lung cancer screening include perceived risks, perceived barriers to, self-efficacy for, and benefits of screening efforts. Perceived risk defines a person’s belief in the possibility of developing lung cancer and predicts the intention to undergo screening (Carter-Harris et al., 2017). Perceived benefits underpin the belief in the usefulness or efficacy of an intervention to minimize risk. In the case of lung cancer screening, professed benefits include beliefs about positive outcomes linked to lung cancer screening. Self-efficacy is the confidence people have in their capacity to take action, like performing tasks involved in lung cancer screening. Perceived barriers are beliefs about the costs (psychological and tangible) of the recommended course of action (Carter-Harris et al., 2017). These might include the challenges of participating in lung cancer screening. Thus, HBM sheds light on the issues to consider to ensure successful lung cancer screening.
Population Screening Purpose
Lung cancer is ranked the 2nd most prevalent cancer and a leading cause of death in America. For example, in 2020, 228,820 people were diagnosed with lung cancer, killing 135,720 persons. Smoking is the primary risk factor, accounting for approximately 90 percent of lung cancer cases. Smokers are 20 times more likely to develop lung cancer than nonsmokers. The disease has a poor prognosis, with a 5-year survival rate estimated at 20.5 percent. The prognosis is better when lung cancer is detected in its early stages, explaining the importance of screening. Screening is recommended for “adults (50-80 years) with a 20 pack-year smoking history and currently smoke or has quit within the past 15 years” (p.963)
This lung cancer screening exercise aims to promote early detection of the disease. This is necessary for preventing lung cancer-related deaths and improving symptom management. The exercise will also create awareness of the causes, risk factors, and self-management efforts necessary to address lung cancer. The target population during this exercise is all adults aged 55 and above in Michigan.
The Neighborhood of the Population
The target population is based in Michigan. Michigan’s rate of new lung cancer cases in 63, which is significantly higher compared to the national rate (58) (American Lung Association, 2022). The state ranks 35th among other US states. The state recognizes the importance of lung cancer screening with low-dose CT scans, especially among people with high risk. Recent findings indicate that the high smoking rate (19%) in Michigan caused the high number of lung cancer cases (American Lung Association, 2022). The condition is prevalent among people aged 55-80 and often affects Black people in Michigan. Michigan diagnoses at least 19 percent of lung cancer cases at early stages among African Americans. The state has relatively better screening rate (8%) for high risk cases although it has poor early lung cancer diagnosis. Women and men aged 65-79 are more prone to lung cancer.
Location/Setting
The screening will be held at the Edison Christian Life Services center from 8 a.m to 12 noon on January 17, 2022.
Screening Activity
Lung cancer screening helps detect lung cancer presence in healthy persons at high risk of the disease. The process is recommended for long-term adult smokers who do not show signs/symptoms. Enrolment will be open continuous once the program is started to give encourage all people to participate. Patient education will be provided, especially highlighting underlying beliefs about lung cancer to motivate people. Besides, participants will receive education about the screening process and what they will be expected to do. For instance, demonstrations will be conducted to show participants how to lie on their back on a table, regulate/hold their breath, and the machine works.
The screening exercise will be completed using low-dose computed tomography (LDCT), as the US Preventive Services Task Force (USPSTF) recommends. Expected measures to be taken during this activity include positive measures, normal, and abnormal ranges. Normal measures mean the screening tests does not uncover any abnormalities. A positive LDCT scan will be the one that shows noncalcified mass or module of 4 mm and above in diameter. Abnormalities like pleural effusions or adenopathy will be categorized as positive measures. Large nodules will be referred to a specialist, while small ones will be monitored during screening. Follow-up tests will be given to participants with suspicious spots.
This screening activity seeks to achieve three goals/outcomes. First, it will facilitate early detection of lung cancer during early stages. The specialist will use LDCT to generate scans to outlining the health status of each participant’s lung health. This will prompt early detection of lung cancer. Secondly, the activity will reduce harm to participants without lung cancer. Additional scans can expose individuals to radiation, which carries serious risks. Measures will be taken to prevent adverse effects on healthy participants. Lastly, the exercise will offer education on lung cancer management among affected individuals.
Cost Analysis
| Item | Cost ($) |
| Testing instrument costs with source for pricing | |
| Staff costs | The screening exercise will rely on volunteer staff. |
| Rental costs | 350/day |
| Simple supply costs | |
| Attendee costs | |
| Total |
Conclusion
The health belief model is vital in promoting lung cancer screening efforts in Michigan. The theory helps identify and incorporate individual beliefs (perceived risks, perceived benefits, self-efficacy, and perceived barriers) when designing health promotion initiatives. Lung cancer is prevalent and causes thousands of deaths in the US, indicating the need to promote screening efforts. This screening activity focused on older adults in Michigan by using LDCT. Education and follow-up services will be provided to participants. The exercise will facilitate early lung cancer detection, reduce harm to participants, and educate individuals.
References
Carter-Harris, L., Slaven, J. E., 2nd, Monohan, P., & Rawl, S. M. (2017). Development and Psychometric Evaluation of the Lung Cancer Screening Health Belief Scales. Cancer Nursing, 40(3), 237–244. https://doi.org/10.1097/NCC.0000000000000386
American Lung Association. (2022). Michigan. State of Lung Cancer. https://www.lung.org/research/state-of-lung-cancer/states/michigan
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