title: Patient Perceptions of Telephone vs. In-Person BRCA1/BRCA2 Genetic Counseling.
abstract: Telephone genetic counseling (TC) for hereditary breast/ovarian cancer risk has been associated with positive outcomes in high risk women. However, little is known about how patients perceive TC. As part of a randomized trial of TC versus usual care (UC; in-person genetic counseling), we compared high risk women's perceptions of: (1) overall satisfaction with genetic counseling; (2) convenience; (3) attentiveness during the session; (4) counselor effectiveness in providing support; and (5) counselor ability to recognize emotional responses during the session. Among the 554 participants (TC, N = 272; UC, N = 282), delivery mode was not associated with self-reported satisfaction. However, TC participants found counseling significantly more convenient than UC participants (OR = 4.78, 95 % CI = 3.32, 6.89) while also perceiving lower levels of support (OR = 0.56, 95 % CI = 0.40-0.80) and emotional recognition (OR = 0.53, 95 % CI = 0.37-0.76). In exploratory analyses, we found that non-Hispanic white participants reported higher counselor support in UC than in TC (69.4 % vs. 52.8 %; OR = 3.06, 95 % CI = 1.39-6.74), while minority women perceived less support in UC vs. TC (58.3 % vs. 38.7 %; OR = 0.80, 95 % CI = 0.39-1.65). We discuss potential research and practice implications of these findings which may further improve the effectiveness and utilization of TC.
authors.affiliation: Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. peshkinb@georgetown.edu.|Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA. peshkinb@georgetown.edu.
authors.forename: Beth N
authors.initials: BN
authors.lastname: Peshkin
authors.affiliation: Department of Epidemiology and Biostatistics, George Washington University, Washington, DC, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Kelly
authors.affiliation: GeneDx, Gaithersburg, MD, USA.
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Nusbaum
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Similuk
authors.affiliation: Cancer Genetic Counseling Program, Inova Translational Medicine Institute, Inova Health System, Falls Church, VA, USA.
authors.forename: Tiffani A
authors.initials: TA
authors.lastname: DeMarco
authors.affiliation: NextGxDx, Inc, Franklin, TN, USA.
authors.forename: Gillian W
authors.initials: GW
authors.lastname: Hooker
authors.affiliation: Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|Department of Psychology, Reyjavik University, Reyjavik, Iceland.
authors.forename: Heiddis B
authors.initials: HB
authors.lastname: Valdimarsdottir
authors.affiliation: Department of Clinical Genetics, Risk Assessment Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Forman
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, Marlene and Stewart Greenebaum Cancer Center, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Jessica Rispoli
authors.initials: JR
authors.lastname: Joines
authors.affiliation: Joan H. Marks Graduate Program in Human Genetics, Sarah Lawrence College, Yonkers, NY, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Davis
authors.affiliation: Center for Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Shelley R
authors.initials: SR
authors.lastname: McCormick
authors.affiliation: Familial Cancer Program, University of Vermont Cancer Center, Burlington, VT, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: McKinnon
authors.affiliation: Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.|Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
authors.forename: Kristi D
authors.initials: KD
authors.lastname: Graves
authors.affiliation: Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.|Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.affiliation: Center for Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Garber
authors.affiliation: Familial Cancer Program, University of Vermont Cancer Center, Burlington, VT, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Wood
authors.affiliation: Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Lina
authors.initials: L
authors.lastname: Jandorf
authors.affiliation: Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.|Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D015397:Program Evaluation; D057566:Self Report; D013689:Telephone
keywords: BRCA1/BRCA2; Genetic counseling; Patient satisfaction; Telephone counseling