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.
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