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

doi:10.1002/pon.5059

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

Communication Studies

Research output: Contribution to journal › Article › peer-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 language	English (US)
Pages (from-to)	980-988
Number of pages	9
Journal	Psycho-oncology
Volume	28
Issue number	5
DOIs	https://doi.org/10.1002/pon.5059
State	Published - 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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/pon.5059

Cite this

@article{a3e53d3ea17c47efbb963e0fb3de5958,

title = "A randomized controlled intervention to promote readiness to genetic counseling for breast cancer survivors",

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.",

keywords = "BRCA, cancer, educational intervention, genetic counseling, genetic testing, hereditary breast cancer, oncology, stages of change",

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

note = "Funding Information: 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 Funding Information: 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). Funding Information: S.T.V. has received research funding from Myriad Genetics Labora- Funding Information: 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). Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons, Ltd.",

year = "2019",

month = may,

doi = "10.1002/pon.5059",

language = "English (US)",

volume = "28",

pages = "980--988",

journal = "Psycho-oncology",

issn = "1057-9249",

publisher = "John Wiley and Sons Ltd",

number = "5",

}

TY - JOUR

T1 - A randomized controlled intervention to promote readiness to genetic counseling for breast cancer survivors

AU - Kasting, Monica L.

AU - Conley, Claire C.

AU - Hoogland, Aasha I.

AU - Scherr, Courtney L.

AU - Kim, Jongphil

AU - Thapa, Ram

AU - Reblin, Maija

AU - Meade, Cathy D.

AU - Lee, M. Catherine

AU - Pal, Tuya

AU - Quinn, Gwendolyn P.

AU - Vadaparampil, Susan T.

N1 - Funding Information: 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 Funding Information: 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). Funding Information: S.T.V. has received research funding from Myriad Genetics Labora- Funding Information: 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). Publisher Copyright: © 2019 John Wiley & Sons, Ltd.

PY - 2019/5

Y1 - 2019/5

N2 - 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.

AB - 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.

KW - BRCA

KW - cancer

KW - educational intervention

KW - genetic counseling

KW - genetic testing

KW - hereditary breast cancer

KW - oncology

KW - stages of change

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SN - 1057-9249

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JO - Psycho-oncology

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

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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