Abstract
Introduction: This study aimed to understand Māori perspectives of lung screening in Aotearoa New Zealand, in order to guide equity-focused implementation, including identifying enablers and barriers.
Methods: Twenty-one Māori current or ex-smokers and members of their whānau took part in three focus group phases held in Auckland, Aotearoa NZ. They responded to a proposed lung screening pathway and discussed attitudes and beliefs about both lung cancer and screening. In the last phase, participants reviewed findings and themes. Results were analysed thematically.
Results: There was overwhelming support from participants for a future LCS programme in Aotearoa NZ, with perceived benefits including being more informed about lung cancer and screening and improving the health of future generations. Perceived barriers to accessing a lung screening programme included previous negative experiences of both the health system in general, and of screening in particular, alongside a fear of stigma and worry about the potential results of a lung CT scan. Participants also described practical constraints including access issues, time constraints, cost and transport. Perceived enablers of a culturally acceptable lung screening programme included the provision of culturally competent practices and processes, clear communication, providing additional health services alongside screening and providing support with transport to screening. Participants identified a range of factors influencing a decision to participate in LCS. The results of this study have directly influenced the design of an ongoing clinical trial designed to inform future implementation of lung cancer screening in Māori in Aotearoa, and what aspects of the invitation, risk assessment and other processes work for this population.
Conclusions: Overall, the participants were enthusiastic about a potential lung screening programme being established in Aotearoa, identifying key facilitators that will help establish lung screening successfully, alongside key barriers that need to be addressed. Our findings lend support to the use of lung screening in Aotearoa and have been used to inform the design of a randomised controlled trial of invitation methods to lung screening in a Māori cohort, which is currently underway in Aotearoa NZ. Involving whānau from the beginning of the journey is a foundational approach for this research programme. Emerging from these focus groups, a Consumer Advisory Group, Te Haa Kotahi has been established. This group meets regularly, supported by Health NZ kaumātua , and has contributed significantly to the framing of the research programme, research questions, participant materials, logo and design and to the name of the programme.