Knowledge and attitudes towards low dose computed tomography lung cancer screening and smoking among African Americans-a mixed method study

Background: The purpose of this study is to investigate knowledge, attitudes, and smoking cessation needs for African Americans who receive low dose computed tomography (LDCT) in an effort to reduce the health burden of lung cancer. Methods: A mixed method study was conducted among African Americans who received LDCT. Data were gathered using a self-administered questionnaire and structured in-depth interview. Descriptive statistics were used to provide summary information on knowledge, attitude and smoking behaviors. Thematic analysis was used to analyze interview data. The sample size for both the quantitative and qualitative approach was fifteen. Results: The results showed that 73% of participants were male, the mean age was 61.8 (SD = 4.6) years old, and 66.7% of participants had an income less than $ 20,000. Eighty percent had an education level of high school or below and 73.3% were overweight or obese. Smoking history was long (mean years = 39 SD = 14.9), but the number of cigarettes smoked per day was low (mean = 9.2 SD = 7.3), and 64% of the patients had a low nicotine dependence. Assessment of knowledge and attitudes towards LDCT revealed that participants had a moderate/lower knowledge score (mean = 4.3 SD = 2.6), and most had a positive attitude. All participants planned to quit smoking, with 73% planning to quit within the next 6 months. Similar findings were also observed in the qualitative analysis. Conclusions: African Americans who receive LDCT lung cancer screening in this study have a moderate/lower knowledge score and positive attitude towards LDCT. Most were not heavy smokers and had a lower nicotine dependence. Understanding the factors associated with smoking cessation among at-risk African American smokers will help reduce disparities in lung cancer burden, and is important to improve health for medically underserved minority populations.