title: Medical genetic counseling for breast cancer in primary care: a synthesis of major determinants of physicians' practices in primary care settings.
abstract: OBJECTIVE
  This paper aims to identify relevant potential predictors of medical genetic counseling for breast cancer (MGC-BC) in primary care and to develop a comprehensive questionnaire to study MGC-BC.
  
  
  METHODS
  A scoping review was conducted to identify the predictors of MGC-BC among primary care physicians. Relevant articles were identified in selected databases (PubMed, Embase, CINAHL, ISI Web of Science, PsycINFO, and Cochrane CENTRAL) and 4 selected relevant electronic journals.
  
  
  RESULTS
  An inductive analysis of the 193 quantitatively tested variables, conducted by 3 researchers, showed that 6 conceptual categories of determinants, namely (1) demographic, (2) organizational, (3) experiential, (4) professional, (5) psychological, and (6) cognitive, influence MGC-BC practices.
  
  
  CONCLUSIONS
  There is a scarcity of literature addressing the medical behavior determinants of MGC-BC. Future research is needed to identify effective strategies put into action to support the integration of MGC-BC in primary care medical practices and routines. However, our results shed light on 2 levels of actions that could improve genetic counseling services in primary care: (1) medical training and educational efforts emphasizing family history collection (individual level), and (2) clarification of roles and responsibilities in ordering and referral practices in genetic counseling and genetic testing for better healthcare management (organizational level).
authors.affiliation: Centre de formation médicale du Nouveau-Brunswick, Université de Moncton, Moncton, N.B., Canada.
authors.forename: Jalila
authors.initials: J
authors.lastname: Jbilou
authors.forename: Norrin
authors.initials: N
authors.lastname: Halilem
authors.forename: Jolyane
authors.initials: J
authors.lastname: Blouin-Bougie
authors.forename: Nabil
authors.initials: N
authors.lastname: Amara
authors.forename: Réjean
authors.initials: R
authors.lastname: Landry
authors.forename: Jacques
authors.initials: J
authors.lastname: Simard
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000517:prevention & control; D005260:Female; D005817:Genetic Counseling / Q000941:ethics / Q000523:psychology / Q000706:statistics & numerical data*; D005820:Genetic Testing / Q000941:ethics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000193:education / Q000941:ethics / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires