{"doi":"10.1111/hex.70571","title":"Reducing Stigma in Lung Cancer Screening: Co‐Design of a Targeted Resource for Health Professionals in Australia","abstract":"<jats:title>ABSTRACT</jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction</jats:title>\n                    <jats:p>Organised lung cancer screening (LCS) programs are being developed worldwide in response to recent landmark trial evidence. Targeting high‐risk individuals primarily based on smoking history, LCS faces challenges from smoking‐related stigma, which can cause psychological harm and hinder participation. With limited interventions addressing this issue, this study aimed to co‐design a communication‐based strategy to reduce stigma in the LCS context.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      Using best‐practice co‐design principles, this study involved workshops, focus groups, and interviews with 5 consumers (people eligible for LCS in Australia) and 44 health professionals and other experts (including clinicians, radiographers, behavioural scientists, and health managers). Participants were purposively sampled to achieve representation across key variables – e.g., smoking history for consumers, professional roles for experts. Consultation with experts was conducted as part of a larger project developing a suite of information materials for the National Lung Cancer Screening Program in Australia. Key literature and concurrent qualitative research with consumers (\n                      <jats:italic>n</jats:italic>\n                       = 24) also informed co‐design. Qualitative data were analysed using abductive thematic analysis.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>Early consultation identified the preferred format for the strategy as a resource targeted for health professionals involved in the LCS pathway. Resource content was iteratively revised, with three key themes developed: (1) Taking the onus off the individual; (2) Fostering understanding and empathy; (3) Positive framing. A lexicon guide promoting person‐first and empowerment language was also included guided by previous literature. The final resource was a four‐page A4 document for health professionals and LCS staff, designed to support effective, stigma‐sensitive communication during LCS.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>We co‐designed a practical, scalable resource to reduce stigma for use in the Australian National Lung Cancer Screening Program, expected to ultimately reduce psychological harm for LCS participants and enhance screening participation. Future research should evaluate the resource as an implementation strategy for LCS uptake. Cultural adaptation and tailoring of the resource for specific populations considering intersectional stigmas is also needed.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution</jats:title>\n                    <jats:p>We collaborated with a consumer advisor for the project's duration, including study design, co‐facilitation of consumer workshops, analysis and manuscript writing.</jats:p>\n                  </jats:sec>","journal":"Health Expectations","year":2026,"id":643803,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":620781,"name":"Nathan J. Harrison","orcid":"0000-0002-1011-8745","position":1,"is_corresponding":false},{"id":1675323,"name":"Shiho Rose","orcid":"0000-0001-7651-5076","position":2,"is_corresponding":false},{"id":1675324,"name":"Giselle Hollinshead","orcid":null,"position":3,"is_corresponding":false},{"id":1675325,"name":"Nicole M. Rankin","orcid":null,"position":4,"is_corresponding":false},{"id":1418979,"name":"Marianne Weber","orcid":"0000-0001-5731-9651","position":5,"is_corresponding":false},{"id":1649766,"name":"Kate L.A. Dunlop","orcid":"0000-0001-9544-9764","position":6,"is_corresponding":false},{"id":485443,"name":"Dan Luo","orcid":"0000-0001-6408-3165","position":7,"is_corresponding":false},{"id":1675326,"name":"Brooke Nickel","orcid":null,"position":8,"is_corresponding":false},{"id":592240,"name":"Nehmat Houssami","orcid":"0000-0002-3641-952X","position":9,"is_corresponding":false},{"id":1286762,"name":"Rachael H Dodd","orcid":"0000-0002-8080-6359","position":10,"is_corresponding":false},{"id":1675322,"name":"Kathleen McFadden","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Reducing Stigma in Lung Cancer Screening: Co‐Design of a Targeted Resource for Health Professionals in Australia","abstract":"<jats:title>ABSTRACT</jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction</jats:title>\n                    <jats:p>Organised lung cancer screening (LCS) programs are being developed worldwide in response to recent landmark trial evidence. Targeting high‐risk individuals primarily based on smoking history, LCS faces challenges from smoking‐related stigma, which can cause psychological harm and hinder participation. With limited interventions addressing this issue, this study aimed to co‐design a communication‐based strategy to reduce stigma in the LCS context.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      Using best‐practice co‐design principles, this study involved workshops, focus groups, and interviews with 5 consumers (people eligible for LCS in Australia) and 44 health professionals and other experts (including clinicians, radiographers, behavioural scientists, and health managers). Participants were purposively sampled to achieve representation across key variables – e.g., smoking history for consumers, professional roles for experts. Consultation with experts was conducted as part of a larger project developing a suite of information materials for the National Lung Cancer Screening Program in Australia. Key literature and concurrent qualitative research with consumers (\n                      <jats:italic>n</jats:italic>\n                       = 24) also informed co‐design. Qualitative data were analysed using abductive thematic analysis.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>Early consultation identified the preferred format for the strategy as a resource targeted for health professionals involved in the LCS pathway. Resource content was iteratively revised, with three key themes developed: (1) Taking the onus off the individual; (2) Fostering understanding and empathy; (3) Positive framing. A lexicon guide promoting person‐first and empowerment language was also included guided by previous literature. The final resource was a four‐page A4 document for health professionals and LCS staff, designed to support effective, stigma‐sensitive communication during LCS.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>We co‐designed a practical, scalable resource to reduce stigma for use in the Australian National Lung Cancer Screening Program, expected to ultimately reduce psychological harm for LCS participants and enhance screening participation. Future research should evaluate the resource as an implementation strategy for LCS uptake. Cultural adaptation and tailoring of the resource for specific populations considering intersectional stigmas is also needed.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution</jats:title>\n                    <jats:p>We collaborated with a consumer advisor for the project's duration, including study design, co‐facilitation of consumer workshops, analysis and manuscript writing.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"42043285","pmcid":"PMC13114764","openalex_id":"https://openalex.org/W7156299623","authors":[],"funders":[{"funder_name":"NHMRC","grant_id":"1194410","title":"Comparative effectiveness of breast tomosynthesis and mammography in real-world population screening: Evidence to underpin and improve breast cancer screening"},{"funder_name":"BN is supported by a NHMRC Investigator Emerging Leader Research Fellowship","grant_id":"1194108","title":null},{"funder_name":"NH receives funding via a NBCF Chair in Breast Cancer Prevention grant","grant_id":"EC-21-001","title":null},{"funder_name":"This work was supported by the Australian Government National Lung Cancer Screening Program.","grant_id":"","title":null},{"funder_name":"This work was supported by the Australian Government National Lung Cancer Screening Program.","grant_id":"","title":null}],"total_grants":5,"fwci":0.0,"citation_percentile":0.45408132,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1111/hex.70571","host_type":"journal"},{"url":"https://doi.org/10.1111/hex.70571","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/hex.70571","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/hex.70571","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/42043285","host_type":"repository"},{"url":"https://doaj.org/article/5b7b757db53446dfbceb2b2905564626","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13114764/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC13114764","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC13114764?pdf=render","host_type":"Europe_PMC"},{"url":"https://espace.library.uq.edu.au/view/UQ:1288d24","host_type":""}],"fields_of_study":["Lung Cancer Diagnosis and Treatment","Global Cancer Incidence and Screening","Delphi Technique in Research","Humans","Lung Neoplasms","Australia","Early Detection of Cancer","Social Stigma","Focus Groups","Health Personnel","Female","Qualitative Research","Smoking","Male","Communication","Middle Aged","Interviews as Topic","Mass Screening"],"mesh_terms":["Adult","Australia","Communication","Female","Health Personnel","Humans","Interviews as Topic","Lung Neoplasms","Male","Mass Screening","Middle Aged","Smoking","Focus Groups","Qualitative Research","Early Detection of Cancer","Social Stigma"],"keywords":["Thematic analysis","Focus group","Resource (disambiguation)","Psychological intervention","Stigma (botany)","Qualitative research","Health professionals","Empowerment","Grey literature","Smoking","Implementation","stigma","Preventive Health","Lung Cancer Screening","Co‐Design","4206 Public health","Tobacco","42 Health Sciences","4203 Health services and systems","Language"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-08T18:58:45.899410Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}