title: An interactive computer program can effectively educate patients about genetic testing for breast cancer susceptibility.
abstract: As genetic testing for susceptibility to breast cancer becomes more widespread, alternative methods for educating individuals prior to testing will be needed. Our objective was to compare face-to-face education and counseling by a genetic counselor with education by an interactive computer program, assessing the effects of each on knowledge of breast cancer genetics and intent to undergo genetic testing. We used a randomized, controlled trial. Seventy-two self-referred women with a first-degree relative with breast cancer received outpatient education and counseling at the Clinical Center of the National Institutes of Health (NIH). Twenty-nine received individualized counseling from a genetic counselor (counseling group), 29 received education from an interactive computer program followed by individualized counseling (computer group), and 14 were controls. Both pre- and postintervention assessment of knowledge about breast cancer genetics and intent to undergo genetic testing were measured. The control group participants correctly answered 74% of the knowledge questions; the counselor group, 92%; and the computer group, 96% (P <.0001). Unadjusted mean knowledge scores were significantly higher in the computer group than the counselor group (P =.048), but they were equivalent when adjusted for demographic differences (P = 0.34). Intent to undergo genetic testing was influenced by the interventions: preintervention, a majority in all groups (69%) indicated that they were likely (definitely and most likely) to undergo testing; after either intervention coupled with counseling, only 44% indicated that they were likely to do so (P =.0002; odds ratio = 2.8, 95% CI = 1.7-4.9). We concluded that a computer program can successfully educate patients about breast cancer susceptibility, and, along with genetic counseling, can influence patients' intentions to undergo genetic testing.
authors.affiliation: Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania 17033, USA. mjg15@psu.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Green
authors.forename: B B
authors.initials: BB
authors.lastname: Biesecker
authors.forename: A M
authors.initials: AM
authors.lastname: McInerney
authors.forename: D
authors.initials: D
authors.lastname: Mauger
authors.forename: N
authors.initials: N
authors.lastname: Fost
mesh_terms: D000328:Adult; D001296:Audiovisual Aids; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics*; D018961:Educational Technology / Q000379:methods*; D006580:Genetic Carrier Screening; D005817:Genetic Counseling / Q000523:psychology; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005820:Genetic Testing / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008838:Microcomputers; D008875:Middle Aged; D009154:Mutation