TACT - TESTING AND COUNSELING EDUCATION

TACT - 测试和咨询教育

• 批准号: 7380536
• 负责人: HEIDDIS VALDIMARSDOTTIR
• 金额: $ 0.7万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-17 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7380536
• 关键词: attitude; breast neoplasms; culture; decision making; education; emotions; family; gene mutation; genetic counseling; neoplasm /cancer

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The possibility that culture-specific attitudes and beliefs affect BRCA-decision making among African-American women has been raised by several studies. Mistrust of the medical community, fear of stigmatization and fatalistic attitudes towards cancer have been cited as barriers to testing among African American women. However, standard genetic counseling does not specifically address these culture-specific concerns. This may explain why standard genetic counseling has been less effective for African American women than for Caucasian women. In addition, little is known about the impact of genetic counseling on BRCA decision-making among African American breast cancer patients. It is important to understand which factors affect BRCA counseling/testing decisions among breast cancer patients. First, testing affected family members first may be beneficial for other family members as negative BRCA results in an unaffected family member can only be considered true negative when a mutation has been detected in an affected family member. It is clinically incorrect to assign average risk status to an unaffected person if a mutation has not been identified because the increased breast cancer risk in the family may be due to other, as yet unknown, susceptibility genes. Second, patients with a BRCA mutation are at increased risk for developing contralateral breast cancer and/or ovarian cancer, genetic test results may help patients with decision-making regarding options for surveillance and/or prevention for second primary cancers. The goal of this project is to develop and evaluate the impact of culturally tailored genetic counseling on patient decision-making regarding BRCA testing and subsequent cognitive, emotional, and behavioral outcomes. We propose a randomized trial among African American women with newly diagnosed breast cancer with a family history of breast cancer suggestive of hereditary disease in which we will compare standard genetic counseling (SGC) to culturally tailored genetic counseling CT-GC.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。几项研究提出了特定文化的态度和信念影响非裔美国妇女的BRCA决策的可能性。医学界的不信任，对污名化和对癌症的宿命论态度的恐惧被认为是非裔美国人妇女测试的障碍。但是，标准的遗传咨询并不能特别解决这些特定文化的关注。这可以解释为什么标准的遗传咨询对非裔美国妇女的效果不如白人妇女有效。此外，关于遗传咨询对非裔美国乳腺癌患者BRCA决策的影响知之甚少。重要的是要了解哪些因素会影响乳腺癌患者的BRCA咨询/测试决策。 首先，对受影响的家庭成员进行测试可能对其他家庭成员有益，因为负面的BRCA导致未受影响的家庭成员只有在受影响的家庭成员中发现突变时才能被视为真正的负面。如果未发现突变，则在临床上为未受影响的人分配平均风险状态是不正确的，因为家族的乳腺癌风险增加可能是由于其他尚不清楚的敏感性基因所致。其次，患有BRCA突变的患者患有对侧乳腺癌和/或卵巢癌的风险增加，基因测试结果可能会帮助对第二个原发性癌症进行监测和/或预防的决策患者进行决策。 该项目的目的是开发和评估文化量身定制的遗传咨询对有关BRCA测试以及随后的认知，情感和行为结果的患者决策的影响。我们提出了一项新诊断的乳腺癌的非洲裔美国妇女的随机试验，该乳腺癌具有乳腺癌的家族病史，提示遗传性疾病，我们将将标准遗传咨询（SGC）与文化量身定制的遗传咨询CT-GC进行比较。