MyLungHealth, a Patient-Facing Education Tool for Lung Cancer Screening: Qualitative User-Centered Design Study

Clinical Snapshot

Key Findings

• P Value: Not applicable for qualitative research

• Effect Size: Not applicable for qualitative research

• Primary Outcome: Six themes organized into three domains: interpretation of risk information, autonomy and interface preferences, and clinical workflow integration

• Nnt Or Sensitivity: Practical design modifications including simplified risk presentation, multimodal content delivery, and EHR integration

• Confidence Interval: Not applicable for qualitative research

Clinical Application

High feasibility given integration with existing EHR systems and focus on user-centered design principles Relevant to Australian practice given similar lung cancer screening guidelines and EHR implementation; findings could inform development of decision aids aligned with Cancer Australia recommendations Adults eligible for lung cancer screening in healthcare systems with electronic health records

Abstract

BACKGROUND: Lung cancer remains the leading cause of cancer-related mortality worldwide, with low-dose computed tomography screening demonstrating an approximately 20% reduction in mortality among high-risk individuals. Despite this benefit, screening prevalence remains suboptimal, with often less than 20% of eligible individuals reported to be up to date on screening. Shared decision-making is essential for effective lung cancer screening (LCS) implementation, with decision aids shown to enhance patient knowledge and engagement. OBJECTIVE: The aim of this study is to identify patient preferences, concerns, and design considerations through qualitative evaluation of MyLungHealth, a personalized patient-facing educational tool for LCS integrated with electronic health records, and to describe how these findings informed iterative design modifications. METHODS: We employed qualitative research methods through focus groups (n=34) and individual interviews (n=18) with individuals who met screening eligibility criteria. Participants were recruited from the University of Utah Health and New York University Langone Health between May and December 2023. Feedback was analyzed using Braun and Clarke's thematic analysis principles. RESULTS: Six themes were organized into three overarching domains. Domain A included interpretation and impact of personalized risk information: theme 1, difficulties interpreting risk information, and theme 2, varied impacts of risk information on motivation. Domain B included autonomy, privacy, and user interface preferences: theme 3, desire for autonomy and control over personal health data, and theme 4, preference for straightforward language and multiple information formats. Domain C included integration with clinical workflows and patient portal systems: theme 5, expectations for integration with health care provider workflows, and theme 6, mixed experiences with personal health record systems. These insights led to key design modifications, including simplified risk presentation, multimodal content delivery options (video and text), and implementation of electronic health record alerts for clinicians. CONCLUSIONS: The user-centered design process for MyLungHealth revealed important considerations for developing effective patient education tools for LCS. The findings highlighted the need for simplified risk presentation, personalized information delivery, and integration with clinical workflows. These findings underscore the importance of balancing comprehensive risk communication with user accessibility.

References

1. 1.Balbin, C. A., Stevens, L., Dalrymple, R., Tiase, V. L., Kaphingst, K. A., Stevens, E. R., Kukhareva, P. V., Caverly, T. J., Del Fiol, G., Mann, D., Kwon, J., Fagerlin, A., Butler, J. M., & Kawamoto, K. (2026). MyLungHealth, a Patient-Facing Education Tool for Lung Cancer Screening: Qualitative User-Centered Design Study. JMIR Formative Research. https://doi.org/10.1093/jamia/ocv189