Uptake of Genetic Research Results and Patient-Reported Outcomes with Return of Results Incorporating Web-Based Predisclosure Education

Madison Kilbride, Brian L. Egleston, Wendy K. Chung, Olufunmilayo Olopade, Kara N. Maxwell, Payal Shah, Jane E. Churpek, Linda Fleisher, Mary Beth Terry, Dominique Fetzer, Jill Bennett Gaieski, Jessica Bulafka, Aileen Espinal, Kelsey Karpink, Sarah Walser, Davone Singleton, Monica Palese, Ilona Siljander, Amanda Brandt, Dana ClarkCarrie Koval, Julia Wynn, Jessica M. Long, Danielle McKenna, Jacquelyn Powers, Sarah Nielsen, Susan M. Domchek, Katherine L. Nathanson, Angela R. Bradbury

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSEWe developed a web-based education intervention as an alternative to predisclosure education with a genetic counselor (GC) to reduce participant burden and provider costs with return of genetic research results.METHODSWomen at three sites who participated in 11 gene discovery research studies were contacted to consider receiving cancer genetic research results. Participants could complete predisclosure education through web education or with a GC. Outcomes included uptake of research results, factors associated with uptake, and patient-reported outcomes.RESULTSOf 819 participants, 178 actively (21.7%) and 167 passively (20.4%) declined return of results; 474 (57.9%) were enrolled. Most (60.3%) received results although this was lower than the 70% uptake we hypothesized. Passive and active decliners were more likely to be Black, to have less education, and to have not received phone follow-up after the invitation letter. Most participants selected web education (88.5%) as an alternative to speaking with a GC, but some did not complete or receive results. Knowledge increased significantly from baseline to other time points with no significant differences between those who received web versus GC education. There were no significant increases in distress between web and GC education.CONCLUSIONInterest in web-based predisclosure education for return of genetic research results was high although it did not increase uptake of results. We found no negative patient-reported outcomes with web education, suggesting that it is a viable alternative delivery model for reducing burdens and costs of returning genetic research results. Attention to attrition and lower uptake of results among Black participants and those with less formal education are important areas for future research.

Original languageEnglish
Pages (from-to)4905-4915
Number of pages11
JournalJournal of Clinical Oncology
Volume41
Issue number31
DOIs
StatePublished - Nov 1 2023

Keywords

  • Educational Status
  • Female
  • Genetic Research
  • Humans
  • Internet
  • Patient Reported Outcome Measures
  • Telephone

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