Randomized comparison of group versus individual genetic education and counseling for familial breast and/or ovarian cancer.
OBJECTIVE
An efficient approach to education and counseling before BRCA1 and BRCA2 mutation testing is necessary for effective utilization of testing in the community. Education and counseling, when delivered individually, are limited by a shortage of trained health care providers as well as by financial and time constraints. The purpose of this study was to determine whether pretest education and counseling for breast cancer genetics in a group setting is equivalent to that provided on an individual basis.


METHODS
One hundred forty-two patients at high risk for harboring a BRCA mutation were randomly assigned to group or individual education and counseling sessions. Group education was followed by brief individual counseling. Knowledge and Impact of Events Scales (IES) were administered at baseline and after education and counseling and at 1 week and 3, 6, and 12 months. Satisfaction with education and counseling was measured at completion of the session. Preferred method of education and counseling was solicited at 3 months.


RESULTS
There was no difference in knowledge or IES scores between groups. When stratified by genetic test results, knowledge scores showed no difference. Regardless of group, post-test IES scores in patients with positive results were higher than patients with negative or uninformative results but returned to baseline by 12 months. Participants were equally satisfied with either method they were assigned. Significantly more time was spent per patient in individual sessions (1.25 hours) than in group education (0.74 hours).


CONCLUSIONS
Our data suggest that group education and counseling may confer similar benefits compared with traditional individual sessions. Additional investigation of this approach in larger numbers of patients is warranted.
Calzone
Kathleen A
KA
National Cancer Institute, Center for Cancer Research, Genetics Branch, 8901 Wisconsin Ave, Bldg 8, Rm 5101, Bethesda, MD 20889-5105, USA. calzonek@mail.nih.gov
Prindiville
Sheila A
SA
Jourkiv
Oxana
O
Jenkins
Jean
J
DeCarvalho
Maria
M
Wallerstedt
Dawn B
DB
Liewehr
David J
DJ
Steinberg
Seth M
SM
Soballe
Peter W
PW
Lipkowitz
Stan
S
Klein
Pamela
P
Kirsch
Ilan R
IR
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000235:genetics* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000379:methods; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000628:therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods; D018570:Risk Assessment; D012959:Socioeconomic Factors