title: Providers' perceptions and practices regarding BRCA1/2 genetic counseling and testing in African American women.
abstract: We examined healthcare providers' perceptions of genetic counseling and testing in African American women at moderate to high-risk of carrying a BRCA1/2 mutation. We conducted 20 in-depth interviews with genetic counselors (n = 5), medical oncologists (n = 8), obstetrician/gynecologists (n = 2) and surgeons (n = 5). Interviews were audiotaped, transcribed and independently coded by two individuals using a content analysis approach. Seven themes emerged relevant to providers' perceptions of African American women's use of BRCA1/2 genetic services: access factors, cultural beliefs and preferences, effects of testing, patient motivators for genetic counseling and testing, patient-provider communication, reasons for provider referral, and reasons for patient refusal. Providers identified individual- and system-level barriers to African American women's use of genetic services, including lack of follow-up after referrals to genetic specialists and challenges to obtaining financial coverage for under- and uninsured high-risk women. Results have implications for physician and patient education regarding appropriate referrals to and uptake of genetic services in at-risk African American women.
authors.affiliation: Lombardi Comprehensive Cancer Center, Cancer Control Program, Fisher Center for Familial Cancer Research, Georgetown University, Washington, DC 20007, USA.
authors.forename: Kristi D
authors.initials: KD
authors.lastname: Graves
authors.forename: Juleen
authors.initials: J
authors.lastname: Christopher
authors.forename: Toni Michelle
authors.initials: TM
authors.lastname: Harrison
authors.forename: Beth N
authors.initials: BN
authors.lastname: Peshkin
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.forename: Vanessa B
authors.initials: VB
authors.lastname: Sheppard
mesh_terms: D001291:Attitude of Health Personnel; D044383:Black People; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D006801:Humans; D009154:Mutation; D001741:Black or African American