Facilitating Well-Informed Decisions for BRCA Testing

This study (N=300) of women at high familial risk for breast and ovarian cancer aims to develop and assess a core intervention, based on state-of-the-art theory and research, to facilitate well-informed decisions for BRCA1/2 testing. In this procedure the genetic cancer testing candidate is helped to cognitively and emotionally anticipate scenarios about alternative potential outcomes of testing outlined in the informed consent process. The goal is to enable the individual to vividly imagine the personal and social impact on herself and her future, in the context of a brief, structured supportive counseling session. The utility of the Cognitive-Affective Preparation (CAP) procedure will be evaluated systematically, in a randomized controlled trial, with General Health Information (GHI) serving as a control condition. Outcome measures include: the depth, complexity and accuracy of information processing; decisions about, and evaluation of, participation in genetic testing; and adjustment and adherence to recommended cancer-protective behaviors. Assessments will be obtained at baseline, after standard care, after CAP or GHI, after pre-disclosure and disclosure of results, and at 1-2 week and 6-month follow-up intervals. (Informed Consent RFA)