An interactive computer program can effectively educate patients about genetic testing for breast cancer susceptibility

Authors

  • Michael J. Green,

    Corresponding author
    1. Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania
    2. Section of General Internal Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
    • Department of Humanities, H134, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033.
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  • Barbara B. Biesecker,

    1. Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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  • Aideen M. McInerney,

    1. Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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  • David Mauger,

    1. Department of Health Evaluation Sciences, Penn State College of Medicine, Hershey, Pennsylvania
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  • Norman Fost

    1. Department of Pediatrics, University of Wisconsin, Madison, Wisconsin
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  • This publication was supported by grant number 1R03 CA 70638 from the National Cancer Institute (NCI), and grant number 1 R01 CA84770 from NCI and the National Human Genome Research Institute (NHGRI). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCI or NHGRI.

Abstract

As genetic testing for susceptibility to breast cancer becomes more widespread, alternative methods for educating individuals prior to testing will be needed. Our objective was to compare face-to-face education and counseling by a genetic counselor with education by an interactive computer program, assessing the effects of each on knowledge of breast cancer genetics and intent to undergo genetic testing. We used a randomized, controlled trial. Seventy-two self-referred women with a first-degree relative with breast cancer received outpatient education and counseling at the Clinical Center of the National Institutes of Health (NIH). Twenty-nine received individualized counseling from a genetic counselor (counseling group), 29 received education from an interactive computer program followed by individualized counseling (computer group), and 14 were controls. Both pre- and postintervention assessment of knowledge about breast cancer genetics and intent to undergo genetic testing were measured. The control group participants correctly answered 74% of the knowledge questions; the counselor group, 92%; and the computer group, 96% (P < .0001). Unadjusted mean knowledge scores were significantly higher in the computer group than the counselor group (P = .048), but they were equivalent when adjusted for demographic differences (P = 0.34). Intent to undergo genetic testing was influenced by the interventions: preintervention, a majority in all groups (69%) indicated that they were likely (definitely and most likely) to undergo testing; after either intervention coupled with counseling, only 44% indicated that they were likely to do so (P = .0002; odds ratio = 2.8, 95% CI = 1.7–4.9). We concluded that a computer program can successfully educate patients about breast cancer susceptibility, and, along with genetic counseling, can influence patients' intentions to undergo genetic testing. © 2001 Wiley-Liss, Inc.

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