Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial.
Understanding cancer genetic risk assessment motivations in a remote tailored risk communication and navigation intervention randomized controlled trial.
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DOI：
10.1080/21642850.2022.2150623
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发表时间：
2022
影响因子：
2.7
通讯作者：
中科院分区：
文献类型：
--
作者：
国家指南建议对遗传性乳腺癌和卵巢癌 (HBOC) 风险较高的女性进行癌症遗传风险评估 (CGRA)（即基因检测前的遗传咨询）。不到一半的符合资格的女性获得 CGRA，导致数千名女性及其家人无法获得可能挽救生命的癌症预防干预措施。癌症教育和赋权项目遗传风险评估 (GRACE) 解决了这一转化差距，测试了定制咨询和导航 (TCN) 干预与有针对性的印刷手册与常规护理对 CGRA 意图的效果。选定的行为变量被理论化以调节 CGRA 意图。从三个州癌症登记处招募符合基于指南的 CGRA 标准的乳腺癌和卵巢癌幸存者 (N = 654)，完成基线调查并进行随机分组。 TCN 和目标印刷部门收到了小册子； TCN 还参加了基于扩展并行流程模型和渥太华决策支持框架的定制的、基于电话的决策指导和导航会议。参与者完成了为期一个月的评估。使用逻辑回归来比较 CGRA 意向率。使用混合模型分析计算 CGRA 意图和理论中介评分（连续水平变量）。 TCN (53.2%) 与定向打印 (26.7%) 相比 (OR = 3.129; 95% CI: 2.028, 4.827, p< .0001) 和 TCN 与常规护理 (23.1%) (OR = 3.778, CI: 2.422) 相比，CGRA 意向有所增加5.894，p < .0001)。 TCN 中感知风险 (p = 0.023) 和自我效能 (p = 0.035) 介导 CGRA 意图。 CGRA 意图和理论调解因素的改进支持在 HBOC 风险增加的女性中使用量身定制的沟通干预措施。 （ClinicalTrials.gov：NCT03326713。）试验注册：。
National guidelines recommend cancer genetic risk assessment (CGRA) (i.e. genetic counseling prior to genetic testing) for women at increased risk for hereditary breast and ovarian cancer (HBOC). Less than one-half of eligible women obtain CGRA, leaving thousands of women and their family members without access to potentially life-saving cancer prevention interventions. The Genetic Risk Assessment for Cancer Education and Empowerment Project (GRACE) addressed this translational gap, testing the efficacy of a tailored counseling and navigation (TCN) intervention vs. a targeted print brochure vs. usual care on CGRA intentions. Selected behavioral variables were theorized to mediate CGRA intentions. Breast and ovarian cancer survivors meeting criteria for guideline-based CGRA were recruited from three state cancer registries (N = 654), completed a baseline survey, and were randomized. TCN and targeted print arms received the brochure; TCN also participated in a tailored, telephone-based decision coaching and navigation session grounded in the Extended Parallel Process Model and Ottawa Decision Support Framework. Participants completed a one-month assessment. Logistic regression was used to compare the rate of CGRA intentions. CGRA intentions and theorized mediator scores (continuous level variables) were calculated using mixed model analysis. CGRA intentions increased for TCN (53.2%) vs. targeted print (26.7%) (OR = 3.129; 95% CI: 2.028, 4.827, p < .0001) and TCN vs. usual care (23.1%) (OR = 3.778, CI: 2.422, 5.894, p < .0001). Perceived risk (p = 0.023) and self-efficacy (p = 0.035) mediated CGRA intentions in TCN. Improvements in CGRA intentions and theorized mediators support the use of a tailored communication intervention among women at increased HBOC risk. (Clinicaltrials.gov: NCT03326713.) Trial registration: .
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DOI：
10.6004/jnccn.2017.0003
发表时间：
2017-01-01
影响因子：
13.4
作者：
Daly, Mary B.;Pilarski, Robert;Darlow, Susan
通讯作者：
Darlow, Susan
影响因子：
3.6
作者：
Birmingham, Wendy C.;Hung, Man;Kinney, Anita Y.
通讯作者：
Kinney, Anita Y.
影响因子：
3.8
作者：
Boonyasiriwat, Watcharaporn;Hung, Man;Kinney, Anita Y.
通讯作者：
Kinney, Anita Y.
影响因子：
3.8
作者：
Brumbach, Barbara H.;Birmingham, Wendy C.;Kinney, Anita Y.
通讯作者：
Kinney, Anita Y.
影响因子：
1.9
作者：
Flores, Kristina G.;Steffen, Laurie E.;Kinney, Anita Y.
通讯作者：
Kinney, Anita Y.