Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial

Date

2022-12-16

Authors

Le Compte, Circe G.
Lu, Shou-En
Ani, Julianne
McDougall, Jean
Walters, Scott T.
Toppmeyer, Deborah
Boyce, Tawny W.
Stroup, Antoinette
Paddock, Lisa
Grumet, Sherry

ORCID

0000-0003-4074-6141 (Walters, Scott T.)

Journal Title

Journal ISSN

Volume Title

Publisher

Informa UK Limited, trading as Taylor & Francis Group

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.

Description

Citation

Le Compte, C. G., Lu, S. E., Ani, J., McDougall, J., Walters, S. T., Toppmeyer, D., Boyce, T. W., Stroup, A., Paddock, L., Grumet, S., Lin, Y., Heidt, E., & Kinney, A. Y. (2022). Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial. Health psychology and behavioral medicine, 10(1), 1190-1215. https://doi.org/10.1080/21642850.2022.2150623

Rights

© 2022 The Author(s).

License

Attribution 4.0 International (CC BY 4.0)