A Unique Collaboration: Lewis Katz School of Medicine Works With Temple Health and Klein College of Media and Communication to Encourage Lung Cancer Screenings in North Philadelphia
In 2021, the U.S. Preventative Services Task Force (USPSTF) changed their guidelines to increase the number of people eligible for lung cancer screenings. According to the American Cancer Society, lung cancer is the third most commonly detected cancer and the deadliest cancer for both men and women across the country, and Pennsylvania has numbers higher than the national average. When it comes to lung cancer, early detection and treatment is vital, as it can dramatically improve survival rates.
Gerard Criner, MD, FACP, FACCP, Director of the Temple’s Lung Center took the updates to these guidelines as an opportunity to increase screenings by creating a lung nodule detection program - the Temple Healthy Chest Initiative (THCI) -- a health system wide program. THCI uses low-dose computed tomography (LDCT) to provide these lung cancer screenings, which can also identify several other conditions such as COPD, emphysema, cornary artery calcification, osteoporosis, and more. 
THCI was designed to make the process easy for patients by using nurse navigators. After determining eligibility, dedicated nurse navigators discuss with patients and set up their screenings. Afterwards, the nurse navigators call back quickly with results and inform patients of necessary follow-ups or procedures. They can assist in setting up those appointments throughout five locations across Temple Health. Additonally, nurse navigators provide resources for smoking cessation and realistic health recommendations, while keeping track of screenings and reminding patients when they are due again.
Temple Health wanted to ensure that the local community understood the benefits of early lung cancer screenings and were made aware of the new guidelines that allowed for increased eligibility. Following their success collaborating with Temple’s Klein College of Media and Communication on the COVID-19 Vaccination Project, Temple Health turned to Klein again for their assistance in evaluating communications strategies to address lung cancer screenings among Temple’s North Philadelphia patient population. A unique partnership model was formed bringing together the Temple Health, Klein College of Media and Communication, and the Lewis Katz School of Medicine’s Center for Urban Bioethics (CUB) to understand communication preferences, identify barriers to healthcare, and increase knowledge regarding lung cancer screenings. This collaborative group decided the best way to grow and tailor THCI was by listening directly to the local community. This was the driving force behind creating a program for students to work with community members to learn their barriers and motivators to finding care. Through the work of Stefanie Murphy, Associate Vice President of Corporate Marketing at Temple Health, Deborah Cai, Senior Associate Dean at Klein, Cornelius Pitts, PharmD, Assistant Professor, Center for Urban Bioethics, and Kathleen Reeves, MD, former Director, Center for Urban Bioethics, they created the Communication for Urban Health Scholars program, or CURBS.
Over the summer of 2022, the CURBS program brought together four Klein undergraduate scholars, two master’s students from Klein’s Communication for Development and Social Change program, and one Klein PhD student who served as project manager. This team of students worked with Cai and Lauren K
ogen, Associate Professor of Media Studies and Production, to conduct formative research in local North Philadelphia communities and to develop a campaign for the THCI. With the help of Dr. Pitts, the scholars conducted focus groups with clients of local community-based organizations in order to learn about concerns and experiences that would prevent them from getting screened. Each focus group mainly consisted of patients between the ages of 50 and 80 who were insured and current or former smokers.
One of the focus groups was held at Mt. Ephraim Baptist Church with the help of their Pastor Julius Renwick, in the Nicetown-Tioga neighborhood near Temple’s campus. Pastor Renwick enjoyed working with the scholars throughout the focus group process noting that they “have such drive and passion for what they do.” Pastor Renwick described the students as “knowledgeable, prepared, and interested in their goals and in the community which they were serving.” The Mt. Ephraim community finds the research very helpful as many of the church’s and local community’s population is affected by smoking and lung cancer.
The findings from the focus groups affirmed that the three main barriers to getting screened were lack of knowledge about lung cancer screenings, concerns about cost, time and transportation, and mistrust of medical systems. This information was then used to refine communication strategies used for patients in the local North Philadelphia community.
The first of these strategies included distribution of educational materials in multiple languages and ensuring they are culturally relevant. With low literacy levels being a barrier to deliver this material, communications materials link back to videos as well as a calculator to help patients learn their pack years. Another strategy shifted the terminology being used in these communications as patients can be intimidated and turn away from scary messaging like the word “cancer.” Updated messaging focused on promoting chest screenings along with comorbid conditions that can be found during these screenings. Along with more positive connotations, new strategies also addressed concerns regarding cost, insurance, 
time, transportation and ease of screening while also emphasizing support from the nurse navigators.
This research was also used by Temple students through Lauren Kogen’s course on communication campaigns. Students from Klein’s Media Studies and Production department and Klein’s master’s program in Communication for Development and Social Change used the research findings to create a theoretically informed poster campaign to encourage North Philadelphians to get screened. The students worked in teams, and now Temple Health is working to select one of the team’s campaigns to launch a community-based advertising campaign.
After implementing the new communications strategies for THCI, there was a significant increase in the number of LDCTs throughout the health system. From 2017 to 2020, Temple Health facilities were averaging 39.7 LDCTs per month. Following the renewed communication launch in 2021, that number has increased, with an average of 187.5 LDCTs per month between April 2022 and January 2023. These changes also resulted in higher percentages of Black (39.94% vs. 4.5%), Hispanic (17.79% vs. 1.8%), and female (53% vs. 41%) patients receiving LDCTs in comparison to the National Lung Screening Trial.
The success of THCI came from the interdisciplinary approach of various schools and programs working within Temple’s local community. Building trust and open lines of communication allowed for critical conversations that will continue to break down barriers that many community members face when accessing healthcare. Each collaborators expertise in this project immediately impacts the North Philadelphia community. Temple Health is spearheading efforts to share this research and the impact of THCI including presenting findings at the 2023 American Thoracic Society International Conference.
- Sabina L. Accetta