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 (e.g. 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=0.027). Mixed models demonstrated significant group-by-time interactions for perceived risk (p=0.029), IES (p=0.027), and IES avoidance subscale (p=0.012). 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.

A culturally targeted video to promote genetic counseling in a community sample of at‐risk US Latina women: The role of the concrete mindset

“…Importantly, the narrative erased the ethnicity effect found before the intervention. Focusing on GCT of BRCA1/2 mutations, a recent study assessed the effects of a psychoeducational video; the study found that women who watched the video reported greater intentions of genetic counseling, greater perceived risk, and decreased avoidance (Kasting et al, 2019). Our results support the benefits of using narrative messages to reduce health disparities and promote genetic counseling found in previous research and extend these effects by describing the influence on the audience's mindset.…”

“…The video lasted 18 min. Narrative persuasion messages are usually long to facilitate emotional transportation and identification with characters in the story to reduce counterarguments and reactance (see Kasting et al, 2019;Murphy et al, 2013Murphy et al, , 2015. In a previous test, when women were asked about the video length, participants thought the duration was acceptable, reporting that they were engaged the entire time (see Hurtado- de-Mendoza et al, 2020).…”

Culturally Targeted Video Improves Psychosocial Outcomes in Latina Women at Risk of Hereditary Breast and Ovarian Cancer

“…We assessed breast cancer genetics knowledge with Erblich and colleagues’ (2005) [53] validated 13-item scale about breast cancer genetics. We assessed knowledge of genetic counseling with Kasting and colleagues’ 9-item scale [54]. We developed a 20-item scale that tapped into the main informational messages about HBOC delivered in the video (e.g., HBOC risk factors, purpose of GCT) (α = 0.49 pre; α = 0.61 post).…”

Factors Influencing Discussion of Cancer Genetic Testing with Health-Care Providers in a Population-Based Survey

“…Exposure to factors that prompt action; belief that they can successfully perform the action to control the illness (self-efficacy); and psychosocial factors (e.g., worry) may also facilitate behavior change. HBM is well validated and has been shown to predict a broad variety of health behaviors including cancer prevention behaviors in genetics [13, 14]. Additionally, we enhanced the HBM with constructs known to influence health decision-making, such as information seeking and related beliefs [15].…”