title: Attitudes Towards Prenatal Genetic Counseling, Prenatal Genetic Testing, and Termination of Pregnancy among Southeast and East Asian Women in the United States.
abstract: Recognizing the heterogeneity of the Asian population with regards to acculturation, education, health awareness, and cultural values is vital for tailoring culturally sensitive and appropriate care. Prior studies show that cultural values influence perceptions of genetics within Asian populations. The reputation of the family unit factors into decisions such as pregnancy termination and disclosure of family medical history, and the nondirective model of American genetic counseling may conflict with the historical Asian model of paternalistic health care. Previous studies also provide conflicting evidence regarding correlations between education, acculturation, age, and awareness and perceptions of genetic testing. The aims of this study were to describe attitudes towards prenatal genetics among Southeast and East Asian women living in the United States for varying amounts of time and to explore sociocultural factors influencing those attitudes. Twenty-three Asian women who were members of Asian cultural organizations in the United States were interviewed via telephone about their attitudes towards prenatal genetic counseling, prenatal genetic testing, and termination of pregnancy. Responses were transcribed and coded for common themes using a thematic analysis approach. Four major themes emerged. In general, participants: (1) had diverse expectations for genetic counselors; (2) tended to weigh risks and benefits with regards to genetic testing decisions; (3) had mixed views on termination for lethal and non-lethal genetic conditions; and (4) identified cultural factors which influenced testing and termination such as lack of available resources, societal shame and stigma, and family pressure. These findings may allow prenatal genetic counselors to gain a richer, more nuanced understanding of their Asian patients and to offer culturally tailored prenatal genetic counseling.
authors.affiliation: Genetic Counseling Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA. gingertsai@gmail.com.|Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA. gingertsai@gmail.com.
authors.forename: Ginger J
authors.initials: GJ
authors.lastname: Tsai
authors.affiliation: Department of Epidemiology, Division of OVP, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Cameron
authors.affiliation: Genetic Counseling Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA.|Department of Obstetrics, Gynecology, and Reproductive Services, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Czerwinski
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Services, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Hector
authors.initials: H
authors.lastname: Mendez-Figueroa
authors.affiliation: Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Peterson
authors.affiliation: Genetic Counseling Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA.|Department of Obstetrics, Gynecology, and Reproductive Services, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Sarah Jane
authors.initials: SJ
authors.lastname: Noblin
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D000072117:Counselors; D003466:Cultural Characteristics; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000523:psychology*; D014481:United States
keywords: Asian; Asian-American; Genetic counseling; Genetic testing; Interviews; Pregnancy termination; Prenatal genetics; Qualitative