Communication Analysis of BRCA1 Genetic Counseling

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DESCRIPTION: (Applicant's Abstract): The primary goal of this pilot project is to examine the relationship between BRCA1 genetic counseling communication patterns and cancer-related health behaviors and psychosocial adjustment of an ethnically and culturally diverse sample. This project will provide the first detailed examination of the communication process of BRCA1 genetic counseling sessions. Data for this project are derived from two NCI-funded studies on the psychosocial and behavioral outcomes of BRCA1 testing. Audio-taped genetic counseling sessions of a Utah-based Caucasian kindred (K2082) and a large African American kindred (K2099) will be analyzed using a widely used provider-patient communication analysis system, Roter Interaction Analysis System (RIAS) adapted for this study. The two studies used as data sources provide extensive psychosocial and behavioral data on participants pre and post testing. These data allow us to examine the relationship between BRCA1 genetic counseling communication patterns and longitudinal outcomes. Specifically, we will examine individuals who are at risk for adverse psychosocial effects of genetic testing and how their communication process varies according to their level of distress. This project is an opportunity to examine BRCA1 communication patterns of two culturally and ethnically diverse kindreds with similar family histories of cancer. Experts in the fields of genetic counseling and patient communication will meet to operationalize and achieve consensus on adaptations to the existing RIAS for genetic counseling sessions. Trained coders will analyze 180 audio tapes (90 from each kindred) of BRCA1 pre-test genetic counseling sessions using the adapted version of RIAS. These communication variables will be merged within the larger data sets of baseline and outcome measures on health behaviors (e.g., cancer-specific distress) for one week and four months post-testing. Predictor variables of participant adjustment include: sociodemographics, communication factors (e.g., medical information), kindred, pre-test distress levels, and carrier status.