title: Genetic counseling content: How does it impact health behavior?
abstract: Women with hereditary breast-ovarian cancer face decisions about screening (transvaginal ultrasound, CA125, mammography, breast exams) and proactive (before cancer) or reactive (after cancer) surgery (oophorectomy, mastectomy). The content of genetic counseling and its relation to these key health behaviors is largely unexamined. Ashkenazi Jewish women (n = 78) were surveyed through the process of genetic testing and had audiorecorded counseling sessions available for Linguistic Inquiry and Word Count analysis. Proportions for participant and counselor cognitive and affective content during sessions were used as primary predictor variables in linear mixed models for change in intentions for screening and treatment and in self-reported screening. Cognitive and affective content were important predictors of behavior. Counselor cognitive content was associated with ovarian screening. An interaction effect also emerged for CA-125, such that counselor cognitive content plus participant cognitive content or counselor affective content were associated with more screening. Teasing out the factors in risk communication that impact decision-making are critical, and affect from a risk communicator can spur action, such as cancer screening.
authors.affiliation: Mary Babb Randolph Cancer Center and School of Pharmacy, Health Science Center, West Virginia University, PO Box 9510, Morgantown, WV, 26506, USA. kmkelly@hsc.wvu.edu.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Kelly
authors.affiliation: College of Nursing, University of Utah, Salt Lake City, UT, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Ellington
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Schoenberg
authors.affiliation: Department of Statistics, Indiana University, Bloomington, IN, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Jackson
authors.affiliation: Department of Statistics, Indiana University, Bloomington, IN, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dickinson
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Porter
authors.affiliation: Institute for Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Andrykowski
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics; D003376:Counseling; D005260:Female; D019398:Genes, BRCA1; D005817:Genetic Counseling; D005820:Genetic Testing; D015438:Health Behavior; D006801:Humans; D007585:Jews; D008327:Mammography; D008408:Mastectomy; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics*; D010052:Ovariectomy; D012306:Risk
keywords: BRCA1; BRCA2; Cancer screening; Genetic counseling; Surgery