A randomized controlled intervention to promote readiness to genetic counseling for breast cancer survivors

Monica L. Kasting, Claire C. Conley, Aasha I. Hoogland, Courtney L. Scherr, Jongphil Kim, Ram Thapa, Maija Reblin, Cathy D. Meade, M. Catherine Lee, Tuya Pal, Gwendolyn P. Quinn, Susan T. Vadaparampil*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective: Breast cancer (BC) survivors with a genetic mutation are at higher risk for subsequent cancer; knowing genetic risk status could help survivors make decisions about follow-up screening. Uptake of genetic counseling and testing (GC/GT) to determine BRCA status is low among high risk BC survivors. This study assessed feasibility, acceptability, and preliminary efficacy of a newly developed psychoeducational intervention (PEI) for GC/GT. Methods: High risk BC survivors (N = 119) completed a baseline questionnaire and were randomized to the intervention (PEI video/booklet) or control (factsheet) group. Follow-up questionnaires were completed 2 weeks after baseline (T2), and 4 months after T2 (T3). We analyzed recruitment, retention (feasibility), whether the participant viewed study materials (acceptability), intent to get GC/GT (efficacy), and psychosocial outcomes (eg, perceived risk, Impact of Events Scale [IES]). t tests or chi-square tests identified differences between intervention groups at baseline. Mixed models examined main effects of group, time, and group-by-time interactions. Results: Groups were similar on demographic characteristics (P ≥.05). Of participants who completed the baseline questionnaire, 91% followed through to study completion and 92% viewed study materials. A higher percentage of participants in the intervention group moved toward GC/GT (28% vs 8%; P =.027). Mixed models demonstrated significant group-by-time interactions for perceived risk (P =.029), IES (P =.027), and IES avoidance subscale (P =.012). Conclusions: The PEI was feasible, acceptable, and efficacious. Women in the intervention group reported greater intentions to pursue GC, greater perceived risk, and decreased avoidance. Future studies should seek to first identify system-level barriers and facilitators before aiming to address individual-level barriers.

Original languageEnglish (US)
Pages (from-to)980-988
Number of pages9
JournalPsycho-oncology
Volume28
Issue number5
DOIs
StatePublished - May 2019

Funding

National Cancer Institute designated Comprehensive Cancer Center, Grant/Award Number: 5P30CA076292; NIH/NCI‐funded Center for Infection Research in Cancer, Grant/Award Number: K05‐CA181320; National Cancer Institute of the National Institutes of Health, Grant/Award Number: R25‐CA090314; Biostatistics Core Facility at the Moffitt Cancer Center & Research Institute, Grant/Award Number: 5P30CA076292; National Human Genome Research Institute of the National Institutes of Health, Grant/Award Number: 1 R21 HG006415 This work was supported by funding from the National Human Genome Research Institute of the National Institutes of Health (1 R21 HG006415). It has also been supported, in part, by the Biostatistics Core Facility at the Moffitt Cancer Center & Research Institute; a National Cancer Institute designated Comprehensive Cancer Center (5P30CA076292). While working on this manuscript, Drs. Kasting, Hoogland, and Conley were all supported by the National Cancer Institute of the National Institutes of Health (R25-CA090314; PI: Brandon). Dr. Kasting is further supported by the NIH/NCI-funded Center for Infection Research in Cancer (K05-CA181320; PI: Giuliano). S.T.V. has received research funding from Myriad Genetics Labora- This work was supported by funding from the National Human Genome Research Institute of the National Institutes of Health (1 R21 HG006415). It has also been supported, in part, by the Biostatistics Core Facility at the Moffitt Cancer Center & Research Institute; a National Cancer Institute designated Comprehensive Cancer Center (5P30CA076292). While working on this manuscript, Drs. Kasting, Hoogland, and Conley were all supported by the National Cancer Institute of the National Institutes of Health (R25‐CA090314; PI: Brandon). Dr. Kasting is further supported by the NIH/NCI‐funded Center for Infection Research in Cancer (K05‐CA181320; PI: Giuliano).

Keywords

  • BRCA
  • cancer
  • educational intervention
  • genetic counseling
  • genetic testing
  • hereditary breast cancer
  • oncology
  • stages of change

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Psychiatry and Mental health
  • Oncology

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