title: Recruiting African American women to participate in hereditary breast cancer research.
abstract: OBJECTIVE
  This study evaluated the process of recruiting African American women to participate in genetic counseling research for BRCA1 and BRCA2 (BRCA1/2) mutations with respect to referral, study enrollment, and participation in genetic counseling.
  
  
  METHODS
  African American women (n = 783) were referred for study enrollment.
  
  
  RESULTS
  Of 783 referrals, 164 (21%) women were eligible for enrollment. Eligible women were most likely to be referred from oncology clinics (44%) and were least likely to be referred from general medical practices (11%; chi(2) = 96.80; P = .0001). Overall, 62% of eligible women enrolled onto the study and 50% of enrollees completed genetic counseling. Women with a stronger family history of cancer (odds ratio [OR] = 3.18; 95% CI, 1.36 to 7.44; P = .01) and those referred from oncology clinics and community oncology resources (OR = 2.97; 95% CI, 1.34 to 6.58; P = .01) were most likely to enroll onto the study. Referral from oncology clinics was associated significantly with participation in genetic counseling (OR = 5.46; 95% CI, 1.44 to 20.60; P = .01).
  
  
  CONCLUSIONS
  Despite receiving a large number of referrals, only a small subset of women were eligible for enrollment. Oncology settings were the most effective at identifying eligible African American women and general medical practices were the least effective. Factors associated with enrollment included having a stronger family history of cancer and being referred from oncology clinics and community oncology resources. Referral from oncology clinics was the only factor associated significantly with participation in genetic counseling. Education about hereditary breast cancer may be needed among primary care providers to enhance appropriate referral of African American women to genetic counseling for BRCA1/2 mutations.
authors.affiliation: Abramson Cancer Center, Department of Psychiatry, University of Pennsylvania, Philadelphia, 19104, USA. Chanita@mail.med.upenn.edu
authors.forename: Chanita Hughes
authors.initials: CH
authors.lastname: Halbert
authors.forename: Kiyona
authors.initials: K
authors.lastname: Brewster
authors.forename: Aliya
authors.initials: A
authors.lastname: Collier
authors.forename: Chachira
authors.initials: C
authors.lastname: Smith
authors.forename: Lisa
authors.initials: L
authors.lastname: Kessler
authors.forename: Benita
authors.initials: B
authors.lastname: Weathers
authors.forename: Jill E
authors.initials: JE
authors.lastname: Stopfer
authors.forename: Susan
authors.initials: S
authors.lastname: Domchek
authors.forename: E Paul
authors.initials: EP
authors.lastname: Wileyto
mesh_terms: D001294:Attitude to Health / Q000208:ethnology; D044383:Black People / Q000235:genetics / Q000523:psychology / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000208:ethnology* / Q000235:genetics* / Q000523:psychology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D018579:Patient Selection; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D001741:Black or African American