Clear-lung: community-level effectiveness to advance reach in lung cancer screening

The National Cancer Institute awarded Hackensack University Medical Center $769,923 on July 20, 2026, under the Cancer Cause and Prevention Research program (CFDA 93.393) to conduct a community-based lung cancer screening intervention study.

The funded project, CLEAR-LUNG, tests the effectiveness of Witness Project Lung—a culturally tailored, peer- and narrative-based intervention—versus a time- and attention-matched general cancer education program on verified lung cancer screening completion among Black adults in New York and New Jersey. The study uses a Type 1 hybrid effectiveness-implementation cluster randomized trial design with 400 participants. The project examines three primary aims: comparing screening completion rates at six months and measuring secondary outcomes across individual (mistrust, stigma, knowledge, barriers), interpersonal (social influence, social sharing), and community (built environment) levels; testing whether reductions in stigma and mistrust mediate screening completion and identifying contextual moderators; and assessing implementation readiness and sustainability using pragmatic RE-AIM indicators. The intervention operates in trusted community venues upstream of the healthcare system, developed in partnership with the National Witness Project using community-based participatory research methods. The long-term goal addresses disparities in lung cancer survival among Black Americans, which the source attributes to later-stage diagnosis and persistently low uptake of screening.

The project period runs from the award date through June 30, 2031. Place of performance is Edison, New Jersey.

Abstract

Black americans have the lowest rates of lung cancer survival in the U.S., largely due to later-stage diagnosis and persistently low uptake of lung cancer screening. To address these gaps, interventions must directly target barriers such as stigma, mistrust, and low awareness using culturally grounded strategies developed in partnership with the black american community. Our long-term goal is to increase lung cancer screening and reduce mortality among black adults. The short-term objective is to rigorously test a community-delivered intervention to improve screening uptake among screening-eligible black adults in new york and new jersey as a platform for broader dissemination. In collaboration with leaders of the national witness project® and using a community-based participatory research approach, this study has three aims: (1) compare the effectiveness of witness project® lung - a culturally crafted, peer- and narrative-based intervention - versus a time- and attention-matched general cancer education program on verified lung cancer screening completion at 6 months (primary outcome) and secondary outcomes at the individual (mistrust, stigma, knowledge, barriers), interpersonal (social influence, social sharing), and community (built environment) levels in a type 1 hybrid effectiveness-implementation cluster randomized trial (n=400); (2) test whether reductions in stigma and mistrust and improvements in knowledge mediate screening completion, and identify contextual moderators such as faith-community engagement, social networks, and socioeconomic barriers; and (3) assess implementation readiness and sustainability using pragmatic RE-aim indicators and stakeholder input. This project is innovative because IT shifts engagement upstream of the healthcare system, situating education and navigation in trusted community venues. IT is significant because IT will generate the first rigorous evidence for a scalable, culturally grounded strategy to increase lung cancer screening among black adults, with findings poised to inform national dissemination.