GENETIC COUNSELING STRATEGIES WITH MEXICAN-ORIGIN WOMEN

虽然对大多数妇女来说，基因筛查现在是产前护理的标准，但少数民族和移民妇女比其他人接受检测的可能性要小。复杂技术信息的有效沟通是提供产前遗传学服务的一个重要方面。研究人员报告说，产前护理提供者可能会调整遗传信息的呈现，以适应他们对客户理解复杂遗传信息的能力的看法，特别是当客户受教育程度低或英语技能差时。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。采用定性和定量相结合的方法，提出的研究将探讨临床医生在加利福尼亚和德克萨斯州向墨西哥裔客户传达产前遗传学信息和服务选择的策略，在那里，墨西哥裔妇女在产前护理中所占的比例很大，而且还在不断增长。该研究将重点关注具有不同专业背景的临床医生，他们在不同的实践环境中工作，在不同的监管环境中工作。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择策略的社会文化因素；2)确定临床医生认为影响他们向这些客户传达产前遗传学信息和服务选择策略的制度、实际、经济和专业因素；3)对比加州和德克萨斯州为低收入的墨西哥裔妇女提供产前遗传学服务的临床医生的经验和观点，加州和德克萨斯州对此类服务有法律授权，而德克萨斯州没有这样全面的法律授权。

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.