# Utilizing the NIMHD Framework to Explore Barriers and Facilitators to Lung Cancer Screening Among Black Adults in NYC

## TL;DR

This study explores why Black adults in NYC have low lung cancer screening rates and suggests ways to improve access and awareness.

## Contribution

The study applies the NIMHD framework to identify multilevel barriers and facilitators to lung cancer screening in Black communities.

## Key findings

- Four key themes—preparation, partnership, prioritization, and placement—were identified from interviews.
- Community mistrust and lack of knowledge are major barriers to screening uptake.
- Culturally tailored strategies like mobile units and community engagement are recommended.

## Abstract

Lung cancer is the leading cause of cancer-related death in the United States, with Black individuals experiencing the highest incidence and mortality rates. Despite the benefits of early detection through low-dose computed tomography (LDCT), lung cancer screening rates remain disproportionately low among Black adults. This study explores barriers and facilitators to inform culturally tailored interventions that promote equitable screening uptake.

Guided by the National Institute on Minority Health and Health Disparities (NIMHD) research framework, we conducted semi-structured interviews with screening-eligible Black adults in New York City (NYC). Participants were recruited through community canvassing and stakeholder partnerships. Transcripts were analyzed using thematic content analysis to identify key themes across individual, interpersonal, community, and societal levels.

Analysis of 11 interviews identified four key thematic constructs inclusive of participants’ perceptions of barriers and facilitators to lung cancer screening in the Black community. Preparation is concerned with community members’ lack of knowledge about lung cancer and screening, and strategies for community outreach and education. Partnership emphasizes the ways in which discrimination, mistrust, and stigma impact how the Black community engages in healthcare and other collaborative relationships to promote uptake of lung cancer screening. Prioritization highlights individual and community perceptions of healthcare and screening prioritization and demonstrates a need for greater prioritization of lung cancer screening in the healthcare setting. Finally, placement stresses the importance of embedding screening services within communities for improved access.

Addressing lung cancer screening disparities requires multilevel strategies that enhance provider communication, expand access, and engage community partners. Culturally responsive approaches, such as social network engagement, mobile screening units, stigma reduction, and targeted education are essential to increasing awareness and early detection in Black communities.