@article{6930f948c37e47afa490604552898f76,
title = "Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial",
abstract = "Background: National guidelines recommend cancer genetic risk assessment (CGRA) (i.e. genetic counseling prior to genetic testing) for women at increased risk for hereditary breast and ovarian cancer (HBOC). Less than one-half of eligible women obtain CGRA, leaving thousands of women and their family members without access to potentially life-saving cancer prevention interventions. Purpose: The Genetic Risk Assessment for Cancer Education and Empowerment Project (GRACE) addressed this translational gap, testing the efficacy of a tailored counseling and navigation (TCN) intervention vs. a targeted print brochure vs. usual care on CGRA intentions. Selected behavioral variables were theorized to mediate CGRA intentions. Methods: Breast and ovarian cancer survivors meeting criteria for guideline-based CGRA were recruited from three state cancer registries (N = 654), completed a baseline survey, and were randomized. TCN and targeted print arms received the brochure; TCN also participated in a tailored, telephone-based decision coaching and navigation session grounded in the Extended Parallel Process Model and Ottawa Decision Support Framework. Participants completed a one-month assessment. Logistic regression was used to compare the rate of CGRA intentions. CGRA intentions and theorized mediator scores (continuous level variables) were calculated using mixed model analysis. Results: CGRA intentions increased for TCN (53.2%) vs. targeted print (26.7%) (OR = 3.129; 95% CI: 2.028, 4.827, p <.0001) and TCN vs. usual care (23.1%) (OR = 3.778, CI: 2.422, 5.894, p <.0001). Perceived risk (p = 0.023) and self-efficacy (p = 0.035) mediated CGRA intentions in TCN. Conclusions: Improvements in CGRA intentions and theorized mediators support the use of a tailored communication intervention among women at increased HBOC risk. (Clinicaltrials.gov: NCT03326713.) Trial registration:ClinicalTrials.gov identifier: NCT03326713.",
keywords = "Genetic testing, cancer, genetic counseling, hereditary breast and ovarian cancer",
author = "{Le Compte}, {Circe Gray} and Lu, {Shou En} and Julianne Ani and Jean McDougall and Walters, {Scott T.} and Deborah Toppmeyer and Boyce, {Tawny W.} and Antoinette Stroup and Lisa Paddock and Sherry Grumet and Yong Lin and Emily Heidt and Kinney, {Anita Y.}",
note = "Funding Information: for this work is supported by the National Cancer Institute of the National Institutes of Health [R01CA211625 to AYK]; the Rutgers Cancer Institute of New Jersey Comprehensive Cancer Center core grant from the National Cancer Institute [NIH/NCI, 3P30CA072720], including the use of the Biostatistics Shared Resource and the University of New Mexico Comprehensive Cancer Center core grant from the National Cancer Institute [NCI P30CA118100] including use of the services provided by the Behavioral Measurement and Population Sciences (BMPS) and Biostatistics Shared Resources. Support is also provided by the New Jersey Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, cooperative agreement NU58DP006279-04-00, from the National Cancer Institute, National Program of Cancer Registries (NPCR), U.S. Centers for Disease Control and Prevention (CDC), the State of New Jersey, and the Rutgers Cancer Institute of New Jersey; New Mexico Tumor Registry [contract number HHSN261201800014I], Task Order HHSN26100001, from the National Cancer Institute; and the Colorado Cancer Registry [cooperative agreement NU58DP006347-02], from the CDC, with data collected and provided, in part, by the Colorado Central Cancer Registry (CCCR), a participating registry in the National Program of Cancer Registries (NPCR), CDC, cooperative agreement number 5 NU58DP006347. Study data were collected and managed using REDCap electronic data capture tools hosted at the University of New Mexico and the Rutgers Cancer Institute of New Jersey. We would like to thank the following staff for their contributions to the study: Dorothy Nesbit, Charles Wiggins, Randi Rycroft, Angela Meissner, Elena Luna, Baichen Xu, Abha Chaudhary, Olivia Foran, Rachel Howell, Rachel Ruckman, Kristina Gallegos, Karen Quezada, Anita Osborn, Yvonne Daily, Matthew Schwartz, Arreum Kim and the Grace Community Board members. Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",
year = "2022",
doi = "10.1080/21642850.2022.2150623",
language = "English",
volume = "10",
pages = "1190--1215",
journal = "Health Psychology and Behavioral Medicine",
issn = "2164-2850",
publisher = "Taylor and Francis Ltd.",
number = "1",
}