The long term goal of this project is to improve patient understanding about breast cancer risk and genetic testing. We have previously developed a patient-oriented CD-ROM called """"""""Counseling by Computer: Breast Cancer Risk and Genetic Testing ."""""""" The proposed research is to conduct a clinical trial to evaluate the effectiveness of the CD-ROM at educating women about breast cancer risk, and options and implications of genetic testing. This project will take 36 months to complete and involves two specific aims:
Specific Aim 1 : to evaluate the effectiveness of our CD-ROM at educating women about breast cancer risk, and the options and implications of genetic testing. We will complete this aim in two phases. During phase 1 we will obtain critical feedback on the CD-ROM and survey instruments from a diverse group of women in Central Pennsylvania. Forty women (at least 1/4 of whom are minorities) will be recruited from a general internal medicine clinic and breast cancer support group to evaluate the useability and effectiveness of the CD-ROM. The survey data will be used to refine the CD-ROM and study instruments in preparation for a randomized trial. Phase 2 will be to evaluate the impact of the CD-ROM on those actually considering genetic testing for breast cancer susceptibility, through a randomized, pretest-posttest control-group, crossover trial of 210 patients at three study sites. The effectiveness of computer-based education will be compared with one-on-one education for the impact on patients': risk perception; intent to receive genetic testing; knowledge about breast cancer risk and genetic testing; satisfaction with their decision about genetic testing; and decisional conflict. An assessment of the acceptability of each educational intervention will also be obtained.
Specific Aim 2 : to evaluate the impact of a prior computer-based educational session on subsequent interactions between patients and genetic counselors. As part of the randomized trial, we will study whether the addition of a computer-based educational program improves the interactions between patients and genetic counselors. Comparisons will be made between those educated by a genetic counselor alone, and those educated by a computer prior to their session with a genetic counselor, by measuring: the amount of time spent with a genetic counselor; the quality and quantity of questions directed to the genetic counselor; patient's and genetic counselor's satisfaction; and perceived effectiveness of the counseling session.
|Green, Michael J; Peterson, Susan K; Baker, Maria Wagner et al. (2005) Use of an educational computer program before genetic counseling for breast cancer susceptibility: effects on duration and content of counseling sessions. Genet Med 7:221-9|
|Green, Michael J; Peterson, Susan K; Baker, Maria Wagner et al. (2004) Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility: a randomized controlled trial. JAMA 292:442-52|
|Green, Michael J; Botkin, Jeffrey R (2003) ""Genetic exceptionalism"" in medicine: clarifying the differences between genetic and nongenetic tests. Ann Intern Med 138:571-5|
|Green, M J; Biesecker, B B; McInerney, A M et al. (2001) An interactive computer program can effectively educate patients about genetic testing for breast cancer susceptibility. Am J Med Genet 103:16-23|
|Green, M J; McInerney, A M; Biesecker, B B et al. (2001) Education about genetic testing for breast cancer susceptibility: patient preferences for a computer program or genetic counselor. Am J Med Genet 103:24-31|