A randomized controlled intervention to promote readiness to genetic counseling for breast cancer survivors
A randomized controlled intervention to promote readiness to genetic counseling for breast cancer survivors
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DOI：
10.1002/pon.5059
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发表时间：
2019-05-01
期刊：
影响因子：
3.6
通讯作者：
Vadaparampil, Susan T.
中科院分区：
文献类型：
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作者：
Kasting, Monica L.;Conley, Claire C.;Vadaparampil, Susan T.
目的乳腺癌（BC）幸存者与基因突变的后续癌症的风险较高，了解遗传风险状态可以帮助幸存者作出决定后续筛查。接受遗传咨询和检测（GC/GT），以确定BRCA状态是低的高风险BC幸存者。本研究评估的可行性，可接受性，和初步疗效的一个新开发的心理教育干预（PEI）GC/GT. Methods高风险BC幸存者（N = 119）完成了基线调查问卷，并随机干预（PEI视频/小册子）或控制（情况说明书）组。在基线后2周（T2）和T2后4个月（T3）完成随访问卷。我们分析了招募、保留（可行性）、参与者是否查看了研究材料（可接受性）、获得GC/GT的意图（疗效）和心理社会结局（例如，感知风险、事件影响量表[IES]）。t检验或卡方检验确定了基线时干预组之间的差异。混合模型研究了组、时间和组与时间相互作用的主要影响。结果各组的人口学特征相似（P >= .05）。在完成基线问卷的参与者中，91%的人完成了研究，92%的人查看了研究材料。干预组中更高比例的参与者转向GC/GT（28% vs 8%; P = 0.027）。混合模型显示感知风险（P = .029），IES（P = .027）和IES回避子量表（P = .012）的显著组与时间的相互作用。结论PEI是可行的，可接受的，有效的。妇女在干预组报告更大的意图，追求GC，更大的感知风险，并减少回避。今后的研究应首先设法查明系统一级的障碍和促进因素，然后再设法解决个人一级的障碍。
Objective Breast cancer (BC) survivors with a genetic mutation are at higher risk for subsequent cancer; knowing genetic risk status could help survivors make decisions about follow-up screening. Uptake of genetic counseling and testing (GC/GT) to determine BRCA status is low among high risk BC survivors. This study assessed feasibility, acceptability, and preliminary efficacy of a newly developed psychoeducational intervention (PEI) for GC/GT. Methods High risk BC survivors (N = 119) completed a baseline questionnaire and were randomized to the intervention (PEI video/booklet) or control (factsheet) group. Follow-up questionnaires were completed 2 weeks after baseline (T2), and 4 months after T2 (T3). We analyzed recruitment, retention (feasibility), whether the participant viewed study materials (acceptability), intent to get GC/GT (efficacy), and psychosocial outcomes (eg, perceived risk, Impact of Events Scale [IES]). t tests or chi-square tests identified differences between intervention groups at baseline. Mixed models examined main effects of group, time, and group-by-time interactions. Results Groups were similar on demographic characteristics (P >= .05). Of participants who completed the baseline questionnaire, 91% followed through to study completion and 92% viewed study materials. A higher percentage of participants in the intervention group moved toward GC/GT (28% vs 8%; P = .027). Mixed models demonstrated significant group-by-time interactions for perceived risk (P = .029), IES (P = .027), and IES avoidance subscale (P = .012). Conclusions The PEI was feasible, acceptable, and efficacious. Women in the intervention group reported greater intentions to pursue GC, greater perceived risk, and decreased avoidance. Future studies should seek to first identify system-level barriers and facilitators before aiming to address individual-level barriers.