title: Cancer genetic counselor information needs for risk communication: a qualitative evaluation of interview transcripts.
abstract: Personalized medicine is a model of healthcare that is predictive, personalized, preventive and participatory ("P4 Medicine"). Genetic counselors are an ideal group to study when designing tools to support cancer P4 Medicine activities more broadly. The goal for this work was to gain a better understanding of the information cancer genetic counselors seek from their patients to facilitate effective information exchange for discussing risk. This was an analysis of a qualitative data set from interviews of eight cancer genetic counselors, recruited from three institutions. Genetic counselors at each site were interviewed using a semi-structured, open-ended questionnaire. A selective coding approach was used to determine major themes associated with genetic counseling information needs for communicating risk. We generated a model for understanding categories of genetic counseling information needs to support risk communication activities. Common activities for risk communication included risk assessment and tailoring communication. Categories of information needs included: (a) clinical patient characteristics, (b) social and cognitive patient characteristics and (c) patient motivation and goals for the genetic counseling session. A logical next step is for this model to inform the design of software systems for pre-visit patient planning and delivering just-in-time educational information to facilitate cancer risk communication activities.
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA ; Program for Personalized and Genomic Medicine and Center for Health-Related Informatics and Bioimaging, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Casey Lynnette
authors.initials: CL
authors.lastname: Overby
authors.affiliation: Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Chung
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.
authors.forename: George
authors.initials: G
authors.lastname: Hripcsak
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Kukafka
keywords: cancer genetic counseling; information exchange; information needs; needs assessment