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Introduction: Translating outcomes from randomized trials of lung cancer screening into community practice settings has been challenging. We developed a framework-the Engaged Approach to Lung Cancer Screening (EA-LCS)-for improving adherence and individual and population health outcomes in LCS., Methods: Employing community-engaged research, we conducted semistructured interviews with LCS program staff (N = 15) and participants (N = 7) and administered brief surveys to understand LCS adherence. We combined our knowledge of LCS implementation with data to formulate the EA-LCS framework , including principles and strategies instrumental for LCS adherence., Results: Program staff identified four factors that facilitated adherence: (1) the use of specialized tracking software, (2) the importance of personal connection and a reliable touchpoint, (3) centralized program operations, and (4) standardization and streamlining of reports to participants and clinicians. Participant data identified four factors supporting adherence: (1) a single contact point and information availability, (2) tailored communications, (3) personalized results delivery, and (4) increased scan accessibility. Combined analyses identified three overarching themes in the EA-LCS framework: (1) respect, (2) trust, and (3) engagement., Conclusions: The EA-LCS conceptual model integrates three foundational principles (person-centeredness, trustworthy relationships, and sustained communications) to enhance LCS adherence. Efforts are underway to translate the EA-LCS framework into materials to support adherence., Competing Interests: Dr. Studts has provided consulting to Genentech and J&J to support efforts facilitate lung cancer screening. The remaining authors declare no conflict of interest., (© 2024 The Authors.)