Appalachian women are at high risk for lung cancer, which is the leading cause of cancer-related death for women in the region. Although lung cancer rates have declined steadily among men, such decreases have not been seen among women, including alarming mortality rates in Appalachia. Interventions to reduce lung cancer risk among Appalachian women need to consider social and environmental contexts. The K99 phase research has identified few existing interventions to reduce lung cancer risk in this population. The majority of existing studies focus on individual behavior change (e.g., tobacco cessation) during pregnancy with few studies on multi-level factors, those for non-smokers, or those during other phases of the life course. This project, titled Reducing Lung Cancer Risk among Appalachian Women Using Community-Engaged Intervention Research, relies on community perspectives to guide the adaptation and pilot testing of an intervention to reduce lung cancer risk among Appalachian women. We will continue community-engaged research from the K99 phase using the NIH model for creating behavioral intervention trials, including refining an intervention through direct community input (Phase 1a; Aim 1) and pilot testing the adapted intervention protocol using a 2-armed randomized controlled trial (Phase 1b; Aim 2). In the pilot, we will demonstrate the feasibility of the adapted intervention protocol, including demand, acceptability, and implementation. The adapted intervention will seek to increase knowledge, self-efficacy, and targeted behaviors among Appalachian women thereby reducing their future lung cancer risk. This R00 proposal will provide evidence for a future R01 to test the efficacy of the community-informed lung cancer risk reduction intervention among Appalachian women.
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