Communication Analysis of BRCA1 Genetic Counseling

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. 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. Trained coders will analyze 180 audio tapes (90 from each kindred) of BRAC1 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., clinical and breast self-exam, prophylactic surgery, etc.) and psychosocial adjustment (e.g., cancer-specific distress) for one week and four months post-testing. Predicator variables of participant adjustment include: sociodemographics, communication factors (e.g., medical information), kindred, pre-test distress levels, and carrier status. The two studies used as data sources provide extensive psychosocial and behavioral data on participants' pre and post testing. These data will allow the investigators to examine the relationship between BRCA1 genetic counseling communication patterns and longitudinal outcomes. Specifically, it 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.