Randomized control trial comparing genetic counseling service delivery models in an underserved population.

Area of Science:

• Genetics
• Public Health
• Health Services Research

Background:

• Underserved and bilingual populations face barriers to accessing cancer genetic counseling.
• Telehealth models offer potential solutions to improve healthcare accessibility.
• Comparing telephone and in-person genetic counseling is crucial for optimizing service delivery.

Purpose of the Study:

• To compare the effectiveness of telephone versus in-person genetic counseling models.
• To evaluate outcomes in underserved, bilingual patients referred for cancer genetic counseling.
• To assess genetics knowledge, satisfaction, informed choice, and testing completion rates.

Main Methods:

• A prospective, randomized controlled trial involving 201 participants across two county hospital cancer genetics clinics.
• Comparison of pre- and post-counseling genetics knowledge (MMIC), satisfaction (GCSS), and empowerment (GOS).
• Analysis of genetic testing attitudes, informed choice, and completion/cancellation rates using linear regression.

Main Results:

• No significant differences were found in genetics knowledge, attitude, empowerment (GOS), or satisfaction (GCSS) between telephone and in-person counseling.
• Telephone counseling showed a trend towards higher informed choice regarding genetic testing (52.5% vs. 39.0%).
• Genetic testing completion rates were significantly lower in the telephone group (74%) compared to the in-person group (100%).

Conclusions:

• Telephone genetic counseling appears comparable to in-person counseling for underserved populations regarding knowledge, satisfaction, and empowerment.
• The higher informed choice and significantly lower testing completion rates in the telephone arm require further research.
• Telehealth models show promise but necessitate strategies to ensure follow-through with genetic testing decisions.