Enabling family communication about cancer - Do you know your Kin Facts?

尽管医学和技术取得了进步，但在预防方面，癌症健康差距仍在继续， 诊断和结果。家族健康史(FH)是已知的癌症(CA)最强的预测因素之一 是对遗传性CA风险最强大、最公开的筛查。填补实际干预中的空白 对于必要的家庭沟通，我们建议开发和评估临床综合干预措施，以 加强患者与家人之间关于CA风险和预防的沟通。使用Kin Fact计划(保留 关于家庭癌症调整计划的信息)，研究助理(RA)将与245名成年人进行一对一的工作 从VCU妇女健康诊所每年的妇科就诊中招募的妇女，历时2年 在随机试验中。RA将帮助参与者绘制家谱，识别亲缘关系，并记录 关于患有乳腺癌(BC)或结肠癌(CC)的亲生家庭的信息。在这20-30分钟内 在届会期间，助理将：(A)提供风险信息和适当的健康建议；(B)确定 完成FH所需的家庭信息；(C)指导妇女获得信息的沟通技能， 和(D)与她一起制定收集和落实这一数据收集工作的计划。另有245名女性 随机分配到控制组的患者将接受标准护理。我们将测试干预措施之间的差异 以及对照组关于CA的家庭沟通的主要结果。我们亦会评估 干预后1、6、14个月对CA相关遗传知识和降低风险行为的影响 干预，使用书面基线调查和结构化的后续电话采访。大约45%的人 VCU妇女健康诊所的患者是非裔美国人，约三分之一的人保险不足。通过集成 在城市妇女健康安全网诊所内的模式，该项目致力于癌症控制和预防 种族多样性、包容性实践和临床翻译的研究挑战。我们的长期目标 目的是：通过最大限度地进行遗传风险评估，改善公众健康，特别是与BC和CC有关的健康 通过FH收集和沟通，消除在谁受益于家庭风险信息方面的差异， 并确定成功的方法，使妇女成为有效的FH和癌症预防传播者。 具体目标：1.评估Kin FACT项目对BCS和CCS跳频沟通的影响。我们 将调查种族/民族和教育作为影响因素。2.评估变化差异(干预与 控制)在报告的家庭沟通环境中，及其对沟通结果的中介效应。3. 评估CA相关遗传信息关键知识的变化差异(干预与对照) (一般了解癌症的遗传成分，以及具体的个体风险和能力 以识别资源)。4.作为次要目标，我们将检查健康行为差异(干预与 控制)(例如，临床乳房检查、乳房X光检查、结肠镜检查、USPSTF实践等)对于的子集 这些筛选行为适用的参与者。

Despite medical and technological advances, cancer health disparities continue to occur in prevention, diagnosis, and outcomes. Family health history (FH) is among the strongest known predictors of cancer (CA) and is the most powerful, publicly accessible screen for genetic CA risk. To fill the gap in practical interventions for necessary family communication, we propose to develop and evaluate a clinically integrated intervention to improve patient-family communication about CA risk and prevention. Using the Kin Fact Program (Keeping Information about Family Cancer Tune-up Program), a research assistant (RA) will work 1-on-1 with 245 adult women, recruited over the course of 2 years from annual gynecology visits at the VCU Women's Health Clinic within a randomized trial. The RA will help participants draw a family tree, identify biological kin, and document information about biological family who have had breast cancer (BC) or colon cancer (CC). In this 20-30 minute session, the assistant will: (a) provide risk information and appropriate health recommendations; (b) identify family information needed to complete the FH; (c) coach woman in communication skills to obtain information, and (d) develop, with her, a plan for collection and follow-up on this data gathering. Another 245 women randomized to the control arm will receive standard care. We will test for differences between the intervention and control groups on the primary outcome of family communication about CA. We will also assess the intervention impact on CA-related genetic knowledge and risk-reduction behaviors at 1, 6, and 14 months after the intervention, using written baseline surveys and structured follow-up phone interviews. About 45% of the VCU Women's Health Clinic patients are African-American and about 1/3 are under-insured. By integrating the model within an urban women's health safety-net clinic, this project addresses cancer control and prevention research challenges of racial diversity, inclusive practices, and clinical translation. Our long-term objectives are to: improve public health, specifically related to BC and CC, by maximizing genetic risk assessment through FH collection and communication, eliminate disparities in who benefits from familial risk information, and identify successful methods for enabling women to be effective FH and cancer prevention communicators. Specific aims: 1. Assess the effect of the Kin Fact program on communication about FH of BCs and CCs. We will investigate race/ethnicity and education as effect modifiers. 2. Assess change differences (intervention vs. control) in reported family communication contexts and their mediator effects on communication outcomes. 3. Assess change differences (intervention vs. control) in critical knowledge about CA-related genetic information (knowledge of the genetic component to cancer, in general and also their specific individual risks and capacity to identify resources). 4. As a secondary aim we will examine health behavior differences (intervention vs. control) (e.g. clinical breast exams, mammograms, colonoscopy, USPSTF practices, etc.) for the subset of participants to whom these screening behaviors apply.