Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial.
Autor: | Le Compte CG; Biobehavioral Cancer Health Equity Research Lab, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Lu SE; Rutgers Environmental Epidemiology and Statistics, Rutgers University School of Public Health, Rutgers, The State University of New Jersey University, New Brunswick, NJ, USA., Ani J; Biobehavioral Cancer Health Equity Research Lab, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., McDougall J; Department of Internal Medicine, Division of Epidemiology, Biostatistics, and Preventive Medicine, University of New Mexico, Albuquerque, NM, USA., Walters ST; Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA., Toppmeyer D; Stacy Goldstein Breast Cancer Center, LIFE Center, Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Boyce TW; Biostatistics Shared Resource, UNM Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA., Stroup A; New Jersey State Cancer Registry, Stroup Research Center, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Paddock L; Cancer Surveillance Research Program, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Grumet S; LIFE Center, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Lin Y; Department of Biostatistics and Epidemiology, School of Public Health, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey University, New Brunswick, NJ, USA., Heidt E; Biobehavioral Cancer Health Equity Research Lab, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA., Kinney AY; Department of Biostatistics and Epidemiology, School of Public Health, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey University, New Brunswick, NJ, USA. |
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Jazyk: | angličtina |
Zdroj: | Health psychology and behavioral medicine [Health Psychol Behav Med] 2022 Dec 09; Vol. 10 (1), pp. 1190-1215. Date of Electronic Publication: 2022 Dec 09 (Print Publication: 2022). |
DOI: | 10.1080/21642850.2022.2150623 |
Abstrakt: | 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. Competing Interests: No potential conflict of interest was reported by the author(s). (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.) |
Databáze: | MEDLINE |
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