GENETIC COUNSELING STRATEGIES WITH MEXICAN-ORIGIN WOMEN

虽然对大多数女性来说，基因筛查现在是产前护理的标准，但少数民族和移民女性接受检测的可能性比其他人小。有效地交流复杂的技术信息是提供产前遗传学服务的一个重要方面。研究人员报告称，产前护理提供者可能会调整遗传学信息的呈现方式，以适应他们对客户理解复杂遗传学信息的能力的看法，特别是在客户受教育程度较低或英语语言技能较差的情况下。然而，到目前为止，还没有研究专门关注这种适应的性质或背景。利用定性和定量相结合的方法，拟议的研究将探索临床医生向加利福尼亚州和德克萨斯州的墨西哥裔客户传达产前遗传学信息和服务选择的策略，在这两个州，墨西哥裔妇女在产前护理中占女性的比例很大，而且比例不断上升。这项研究将侧重于具有不同专业背景的临床医生，他们在不同的监管背景下，在不同的执业环境中工作。我们的具体目标是1)确定临床医生报告的影响他们向低收入墨西哥裔客户提供产前遗传学信息和服务选项的策略的社会文化因素，2)确定临床医生认为影响他们向此类客户传达产前遗传学信息和服务选项的策略的机构、实用、经济和专业因素，以及3)对比临床医生向低收入墨西哥裔妇女提供产前遗传学服务的经验和观点，加利福尼亚州和德克萨斯州有管理此类服务的法律授权，而德克萨斯州没有此类全面的法律授权。

While for most women genetics screening is now standard in prenatal care, ethnic minority and immigrant women are less likely than others to be tested. Effective communication of complex technical information is an essential aspect of providing access to prenatal genetics services. Researchers report that prenatal care providers may tailor the presentation of genetics information to fit their perceptions of clients capacity to understand complex genetics information, especially when clients have little education or poor English language skills. However, as yet no research has focused specifically on the nature or context of such adaptations. Using a combined qualitative-quantitative approach, the proposed research will explore clinicians strategies for communicating prenatal genetics information and service options to Mexican- origin clients in California and Texas, where Mexican-origin women constitute a large and growing proportion of women in prenatal care. The study will focus on clinicians with different professional backgrounds working in diverse practice settings within distinct regulatory contexts. Our specific aims our 1) to identify the sociocultural factors which clinicians report affect their strategies for providing prenatal genetics information and service options to low income Mexican-origin clients, 2) to identify the institutional, practical, economic, and professional factors clinicians perceive as affecting their strategies for communicating prenatal genetics information and service options to such clients, and 3) to contrast the experiences and perspectives of clinicians providing prenatal genetics services to low income Mexican-origin women in California, which has a legal mandate regulating such services and Texas, which has no such comprehensive legal mandate.