title: Follow-up effects of a tailored pre-counseling website with question prompt in breast cancer genetic counseling.
abstract: OBJECTIVE
  Pre-counseling education helps counselees to prepare for breast cancer genetic counseling and might subsequently result in more positive experiences, improved cognitive outcomes and more experienced control. This study assessed the effects of a website with tailored information and a blank sheet to fill in questions (question prompt; QP), at 1 week and 1 year post-counseling.
  
  
  METHODS
  Consecutive counselees were randomized to the usual care group (UC) or the intervention group (UC+website+QP). Counselees completed questionnaires pre- and post-counseling and 1 year follow-up. We conducted multilevel regression analyses corrected for time.
  
  
  RESULTS
  Intervention group counselees (n = 103) were more satisfied about their final visit (β = .35; CI: .06-.65; P = .02; n = 156) than UC group counselees (n = 94). Intervention group counselees also reported more positive experiences with the counseling (β = .32; CI: .06-.59; P = .02; n = 188) and higher perceived personal control 1 year post-counseling (β = .51; CI: .18-.84; P = .002; n = 193). No significant effects were found on recall, knowledge, anxiety, cancer worry, risk perception alignment and adherence to breast surveillance advice.
  
  
  CONCLUSIONS
  This study shows that pre-counseling education providing tailored information and QP, might lead to improvements in experiences with the counseling and perceived personal control 1 year post-counseling.
  
  
  CONCLUSIONS
  Online pre-visit information is a feasible tool to enhance counselees' experiences.
authors.affiliation: Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: a.albada@umcutrecht.nl.
authors.forename: Akke
authors.initials: A
authors.lastname: Albada
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway.
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Spreeuwenberg
authors.affiliation: Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Margreet G E M
authors.initials: MG
authors.lastname: Ausems
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005817:Genetic Counseling / Q000523:psychology*; D020022:Genetic Predisposition to Disease; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008875:Middle Aged; D010353:Patient Education as Topic; D010549:Personal Satisfaction; D011369:Professional-Patient Relations; D012017:Referral and Consultation; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Breast cancer; Genetic counseling; Internet; Longitudinal; Patient information; Website