Prenatal screening and testing technologies using genetic methods are rapidly expanding, offering increasing amounts of genetic information about the fetus. However, research shows that women from underserved populations are less likely to receive or accept prenatal genetic services, leading to discordant birth outcomes. We propose to explore the barriers to access and acceptance of prenatal genetic care among women from underserved populations.

The objectives of this group research project are to extend the analysis of ethical and social questions raised by the Human Genome Initiative by utilizing insights and methodology recently developed in 4 new subfields of women's studies: feminist ethics, medical ethics, science analysis, and technology studies. The project will use these new approaches in an expressly collaborative methodology, to focus on hopes of, concerns of, and implications for women, especially by seeking and valuing input from potential end-users of HGI discoveries and from groups marginalized by society.

Using a combined qualitative-quantitative approach, this renewal project will explore clinicians strategies for communicating prenatal genetics information and service options to Mexican-origin clients in California and Texas, where Mexican-origin women constitute a large and growing proportion of women in prenatal care. The study will focus on clinicians with different professional backgrounds working in diverse practice settings within distinct regulatory contexts.

This project will study the role of patient preferences and other factors in choices regarding use of prenatal screening for and diagnosis of chromosomal disorders in a racially/ethnically diverse population. The study will collect detailed information regarding the distribution of individual preferences for test characteristics and outcomes by racial/ethnic group, as well as other factors which may be related to choices regarding the use of these tests.

This prospective, longitudinal study will examine decision-making about pre-surgery BRCA1/2 testing and the medical, psychosocial, and economic outcomes of testing among newly-diagnosed breast cancer patients who are at high risk for having a BRCA1/2 mutation. The theoretical framework for this investigation is derived from Expected Utility Theory.