TELEhealth Shared Decision-making COaching for Lung Cancer Screening in Primary Care (TELESCOPE) for Hispanics

The investigators expect a recruitment rate of ≥60%.

The Ottawa Acceptability Measure will assess the acceptability of the TELESCOPE intervention from the patient's perspective at 1-week post-intervention. There is no total score for this measure. Responses will be reported descriptively in terms of proportions responding positively or negatively for each criteria.

The investigators expect that ≥90% of Hispanic participants will complete the 1-week follow-up assessments

The investigators expect that ≥80% of the key intervention components will be delivered with 80% fidelity by the patient navigators.

The investigators will assess the rates of completion of LDCT at 3 months post-intervention for all participants. This will be abstracted from patients' medical records.

This will be assessed with the Shared Decision-Making Process Survey (SDM Process_4), which is a 4-item performance measure of the process and outcome of shared decision making. Scores range from 0 to 4, with higher scores indicating a better process.

The feasibility of the intervention (FIM) measure will be completed by clinicians. The total score for this instrument ranges from 4 to 20, with higher scores indicating greater feasibility.

The acceptability of the intervention (AIM) will be completed by clinicians. The total score ranges from 4 to 20, with higher scores indicating greater acceptability.

The Intervention Appropriateness Measure (IAM) will be completed by clinicians. The total score for each instrument ranges from 4 to 20, with higher scores indicating greater acceptability.

Medical records will be reviewed at 3 months post-intervention to determine if a tobacco treatment referral has been generated.

Medical records will be reviewed at 3 months post-intervention to determine if the patient has undergone tobacco treatment.

The investigators will assess cancer fatalism by asking participants to rate how much they agree or disagree with 3 items: 1) It seems like everything causes cancer, 2) There's not much participants can do to lower their chances of getting cancer, and 3) There are so many recommendations about preventing cancer, it's hard to know which ones to follow. Response categories for each item are on a four-point scale ranging from strongly agree to strongly disagree. There is no total score for this survey. Responses will be reported descriptively for each question. This measure has shown good internal consistency (Cronbach's alpha = 0.60).

The Decisional Conflict Scale is a widely used measure of the degree to which a patient feels clear about the options and sure about the choice they make. The scale is scored from 0 to 100, with scores under 25 being associated with implementing decisions, while scores above 37.5 suggest delays in decision making.

The Medical Mistrust Index is a valid and reliable 7-item self-report measure (Cronbach's alpha = 0.76). Participants are asked to rate their agreement with each of the statements on a 4-point Likert scale, ranging from strongly disagree to strongly agree. Scores range from 7 to 28 with higher scores indicating more mistrust.

The investigators will assess patient satisfaction with how the telehealth visit/telephone call with the navigator went for them. Participants are asked 6 questions to determine their perception of the overall quality of their telehealth visit. Response categories for each item are on a 5-point scale ranging from strongly agree to strongly disagree. There is no total score for this survey. Responses will be reported descriptively for each question.