A community-based approach to address lung cancer screening disparities in the black community using the Witness Project^® framework: development and pilot trial

TY - JOUR

T1 - A community-based approach to address lung cancer screening disparities in the black community using the Witness Project® framework

T2 - development and pilot trial

AU - Carter-Bawa, Lisa

AU - Ostroff, Jamie S.

AU - Erwin, Deborah O.

AU - Shoulders, Elan N.

AU - Johnson, Detric

AU - Brown, Mikhalya

AU - Valenzona, Francis

AU - Jandorf, Lina

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/12

Y1 - 2025/12

N2 - Background: Disparities in lung cancer outcomes persist among Black Americans, necessitating targeted interventions to address screening inequities. This paper reports the development and refinement of Witness Project® Lung, a community-based initiative tailored to the specific needs of the Black community, aiming to improve awareness and engagement with lung cancer screening. Methods: Utilizing a user-centered design and guided by the original Witness Project® framework – an evidence-based lay health advisor intervention program originally developed to increase knowledge and awareness about breast cancer risk and screening in the Black community and later trans-created to the cervical and colorectal cancer screening contexts - Witness Project® Lung was developed and refined through qualitative input from key stakeholders in the Black faith community. Guided by the PEN-3 model and the Conceptual Model for Lung Cancer Screening Participation, the program underwent a rigorous development process to ensure cultural relevance and was pilot tested in the New York City metropolitan area in faith-based and community-based organizational sites in the Black community. Results: Pilot testing conducted in New York and New Jersey demonstrated high acceptability, satisfaction, and increased knowledge among participants. The community-based approach, culturally sensitive messaging, and partnerships with faith-based organizations were critical to the refinements of Witness Project® to Witness Project® Lung. The program’s focus on addressing social determinants of health and its delivery by trained lay health advisors showcased feasibility and potential effectiveness. Witness Project® Lung presents a promising alternative to traditional health system-based interventions for improving lung screening rates among Black Americans. Conclusions: The community-based, culturally tailored approach, coupled with the involvement of trusted community leaders, has the potential to reduce disparities in lung cancer outcomes. Further research is needed to assess the long-term impact and cost-effectiveness of Witness Project® Lung in promoting lung screening uptake and improving health outcomes within underserved populations.

AB - Background: Disparities in lung cancer outcomes persist among Black Americans, necessitating targeted interventions to address screening inequities. This paper reports the development and refinement of Witness Project® Lung, a community-based initiative tailored to the specific needs of the Black community, aiming to improve awareness and engagement with lung cancer screening. Methods: Utilizing a user-centered design and guided by the original Witness Project® framework – an evidence-based lay health advisor intervention program originally developed to increase knowledge and awareness about breast cancer risk and screening in the Black community and later trans-created to the cervical and colorectal cancer screening contexts - Witness Project® Lung was developed and refined through qualitative input from key stakeholders in the Black faith community. Guided by the PEN-3 model and the Conceptual Model for Lung Cancer Screening Participation, the program underwent a rigorous development process to ensure cultural relevance and was pilot tested in the New York City metropolitan area in faith-based and community-based organizational sites in the Black community. Results: Pilot testing conducted in New York and New Jersey demonstrated high acceptability, satisfaction, and increased knowledge among participants. The community-based approach, culturally sensitive messaging, and partnerships with faith-based organizations were critical to the refinements of Witness Project® to Witness Project® Lung. The program’s focus on addressing social determinants of health and its delivery by trained lay health advisors showcased feasibility and potential effectiveness. Witness Project® Lung presents a promising alternative to traditional health system-based interventions for improving lung screening rates among Black Americans. Conclusions: The community-based, culturally tailored approach, coupled with the involvement of trusted community leaders, has the potential to reduce disparities in lung cancer outcomes. Further research is needed to assess the long-term impact and cost-effectiveness of Witness Project® Lung in promoting lung screening uptake and improving health outcomes within underserved populations.

KW - Community-based research

KW - Disparities

KW - Faith-based

KW - Health equity

KW - Lung cancer screening

KW - Social determinants of health

UR - http://www.scopus.com/inward/record.url?scp=85217356984&partnerID=8YFLogxK

U2 - 10.1186/s12889-025-21623-9

DO - 10.1186/s12889-025-21623-9

M3 - Article

C2 - 39885435

SN - 1471-2458

VL - 25

JO - BMC public health

JF - BMC public health

IS - 1

M1 - 379

ER -