1. Tobacco/Lung Cancer Working Group Participating Institutions: Case Western Reserve University; University of Washington; University of Iowa; University of North Carolina; University of South Carolina; University of Kentucky; CDC; NCI This presentation was supported by Cooperative Agreement Number INSERT YOUR CENTER'S NUMBER HERE from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

2. Project Objectives To understand the barriers and facilitators faced by Federally Qualified Health Centers related to implementing: –Tobacco assessment and cessation assistance –Low-dose computed tomography (LDCT) for lung cancer screening

3. Research Questions What resources do FQHCs have available for tobacco assistance? What cessation advice and assistance practices are used and how is this documented? Do FQHCs have the capacity to make eReferrals? Do FQHCs have the ability to identify and approach eligible patients for lung cancer screening with LDCT? What’s the current state of lung cancer screening with LDCT in FQHCs?

4. Background Tobacco use screening & cessation counseling are preventive measures that FQHCs are required to collect and annually report as part of the Uniform Data System (UDS) Recently, the USPSTF gave lung cancer screening with LDCT a “B” recommendation & CMS issued a final coverage recommendation –“Eligible” = patient must have a history of 30+ pack-years of smoking; age 55-77(80) Some concern about disparities in implementation of LCS/reach among target population

5. Work Completed to Date Bi-weekly calls with all project partners Reviewed early studies on readiness to implement LCS (including prior CDC SIP in New Mexico) Survey drafted, edited and completed Survey pre-pilot tested IRB submitted Working version of sampling strategy and data collection process

6. Work in Progress Finalizing sampling strategy Refining recruitment and data collection strategy Finalizing survey for Qualtrics

7. Next Steps Survey recruitment and rollout phase (June – September 2016) Establish data collection, monitoring and data cleaning process Data analysis and dissemination Complete brief paper on the burden of tobacco at FQHCs

8. Contribution/Impact in D&I Ground work necessary to inform an implementation approach –Specific to addressing smoking rates –Lung cancer screening

9. Contribution/Impact in Cancer Prevention Lung cancer remains the leading cause of cancer mortality in the United States Smoking rates have not improved for socially and economically disadvantaged populations FQHCs bear a high burden of patients who use tobacco This survey will inform current practices and capacity of FQHCs to address tobacco use and lung cancer screening

10. Topics for Discussion The challenges in conducting survey research at overburdened community health centers –How to gain attention of survey respondents? –How to properly incentivize? –Plan B and C for poor response rates Suggestions for survey roll out and recruitment Using the UDS data and its benefits/challenges