Skip to main content
Top
Published in: Journal of Genetic Counseling 6/2016

Open Access 01-12-2016 | Original Research

Design and Feasibility of an Intervention to Support Cancer Genetic Counselees in Informing their At-Risk Relatives

Authors: Eveline de Geus, Willem Eijzenga, Fred H. Menko, Rolf H. Sijmons, Hanneke C. J. M. de Haes, Cora M. Aalfs, Ellen M. A. Smets

Published in: Journal of Genetic Counseling | Issue 6/2016

Login to get access

Abstract

Cancer genetic counselees receive individualized information regarding heightened risks and medical recommendations which is also relevant for their at-risk relatives. Unfortunately, counselees often insufficiently inform these relatives. We designed an intervention aimed at improving counselees’ knowledge regarding which at-risk relatives to inform and what information to disclose, their motivation to disclose, and their self-efficacy. The intervention, offered by telephone by trained psychosocial workers, is based on the principles of Motivational Interviewing. Phase 1 of the intervention covers agenda setting, exploration, and evaluation, and phase 2 includes information provision, enhancing motivation and self-efficacy, and brainstorming for solutions to disseminate information within the family. Fidelity and acceptability of the intervention were assessed using recordings of intervention sessions and by counselee self-report. A total of 144 counselees participated. Psychosocial workers (n = 5) delivered the intervention largely as intended. Counselees highly appreciated the content of the intervention and the psychosocial workers who delivered the intervention. In the sessions, psychosocial workers provided additional and/or corrective information, and brainstorming for solutions was performed in 70 %. These results indicate that this intervention is feasible and warrants testing in clinical practice. For this, a randomized controlled trial is currently in progress to test the intervention’s efficacy.
Literature
go back to reference Albada, A., van Dulmen, S., Ausems, M. G., & Bensing, J. M. (2012). A Pre-Visit Website with Question Prompt Sheet for Counselees Facilitates Communication in the First Consultation for Breast Cancer Genetic Counseling:Findings from a Randomized Controlled Trial. Genetics in Medicine, 14, 535–542.CrossRefPubMed Albada, A., van Dulmen, S., Ausems, M. G., & Bensing, J. M. (2012). A Pre-Visit Website with Question Prompt Sheet for Counselees Facilitates Communication in the First Consultation for Breast Cancer Genetic Counseling:Findings from a Randomized Controlled Trial. Genetics in Medicine, 14, 535–542.CrossRefPubMed
go back to reference Broers, S., Smets, E. M. A., Bindels, P., Bennebroek Evertsz, F., Calff, M., & de Haes, C. J. M. (2005). Training General Practitioners in Behavior Change Counseling to Improve Asthma Medication Adherence. Patient Education and Counseling, 58, 279–287.CrossRefPubMed Broers, S., Smets, E. M. A., Bindels, P., Bennebroek Evertsz, F., Calff, M., & de Haes, C. J. M. (2005). Training General Practitioners in Behavior Change Counseling to Improve Asthma Medication Adherence. Patient Education and Counseling, 58, 279–287.CrossRefPubMed
go back to reference Chivers Seymour, K., Addington-Hall, J., Lucassen, A., & Foster, C. L. (2010). What Facilitates or Impedes Family Communication Following Genetic Testing for Cancer Risk? A Systematic Review and Meta-Analyses of Primary Qualitative Research. Journal of Genetic Counseling, 19, 330–342.CrossRefPubMed Chivers Seymour, K., Addington-Hall, J., Lucassen, A., & Foster, C. L. (2010). What Facilitates or Impedes Family Communication Following Genetic Testing for Cancer Risk? A Systematic Review and Meta-Analyses of Primary Qualitative Research. Journal of Genetic Counseling, 19, 330–342.CrossRefPubMed
go back to reference Claes, E., Evers-Kiebooms, G., Boogaerts, A., Decruyenaere, M., Denayer, L., & Legius, E. (2003). Communication with Close and Distant Relatives in the Context of Genetic Testing for Hereditary Breast and Ovarian Cancer in Cancer Patients. American Journal of Medical Genetics A, 116, 11–19.CrossRef Claes, E., Evers-Kiebooms, G., Boogaerts, A., Decruyenaere, M., Denayer, L., & Legius, E. (2003). Communication with Close and Distant Relatives in the Context of Genetic Testing for Hereditary Breast and Ovarian Cancer in Cancer Patients. American Journal of Medical Genetics A, 116, 11–19.CrossRef
go back to reference Geus de, E., Aalfs, C. M., Verdam, M. G., de Haes, H. C., & Smets, E. M. (2014). Informing Relatives about their Hereditary or Familial Cancer Risk: Study Protocol for a Randomized Controlled Trial. Trials, 15, 86.CrossRef Geus de, E., Aalfs, C. M., Verdam, M. G., de Haes, H. C., & Smets, E. M. (2014). Informing Relatives about their Hereditary or Familial Cancer Risk: Study Protocol for a Randomized Controlled Trial. Trials, 15, 86.CrossRef
go back to reference Forrest, L. E., Burke, J., Bacic, S., & Amor, D. J. (2008). Increased Genetic Counseling Support Improves Communication of Genetic Information in Families. Genetics in Medicine, 10, 167–172.CrossRefPubMed Forrest, L. E., Burke, J., Bacic, S., & Amor, D. J. (2008). Increased Genetic Counseling Support Improves Communication of Genetic Information in Families. Genetics in Medicine, 10, 167–172.CrossRefPubMed
go back to reference Geus de, E., Aalfs, C. M., Menko, F. H., Sijmons, R. H., Verdam, M. G. E., Haes de, H. C. J. M., & Smets, E. M. A. (2015). Development of the Informing Relatives Inventory (IRI): Assessing Index Patients’ Knowledge, Motivation and Self-Efficacy Regarding the Disclosure of Hereditary Cancer Risk Information to Relatives. International Journal of Behavioral Medicine, 22, 551–560.CrossRef Geus de, E., Aalfs, C. M., Menko, F. H., Sijmons, R. H., Verdam, M. G. E., Haes de, H. C. J. M., & Smets, E. M. A. (2015). Development of the Informing Relatives Inventory (IRI): Assessing Index Patients’ Knowledge, Motivation and Self-Efficacy Regarding the Disclosure of Hereditary Cancer Risk Information to Relatives. International Journal of Behavioral Medicine, 22, 551–560.CrossRef
go back to reference Godard, B., Hurlimann, T., Letendre, M., & Egalite, N. (2006). Guidelines for Disclosing Genetic Information to Family Members: from Development to Use. Familial Cancer, 5, 103–116.CrossRefPubMed Godard, B., Hurlimann, T., Letendre, M., & Egalite, N. (2006). Guidelines for Disclosing Genetic Information to Family Members: from Development to Use. Familial Cancer, 5, 103–116.CrossRefPubMed
go back to reference Hayat, R. A., Lampic, C., Ingvoldstad, C., Askmalm, M. S., Bjorvatn, C., Rosenquist, R., et al. (2012). What Information Do Cancer Genetic Counselees Prioritize? Journal of Genetic Counseling, 21, 510–526.CrossRef Hayat, R. A., Lampic, C., Ingvoldstad, C., Askmalm, M. S., Bjorvatn, C., Rosenquist, R., et al. (2012). What Information Do Cancer Genetic Counselees Prioritize? Journal of Genetic Counseling, 21, 510–526.CrossRef
go back to reference Hodgson, J., & Gaff, C. (2013). Enhancing Family Communication about Genetics: Ethical and Professional Dilemmas. Journal of Genetic Counseling, 22, 16–21.CrossRefPubMed Hodgson, J., & Gaff, C. (2013). Enhancing Family Communication about Genetics: Ethical and Professional Dilemmas. Journal of Genetic Counseling, 22, 16–21.CrossRefPubMed
go back to reference Hughes, C., Lerman, C., Schwartz, M., Peshkin, B. N., Wenzel, L., Narod, S., et al. (2002). All in the Family: Evaluation of the Process and Content of Sisters’ Communication about BRCA1 and BRCA2 Genetic Test Results. American Journal of Medical Genetics, 107, 143–150.CrossRefPubMed Hughes, C., Lerman, C., Schwartz, M., Peshkin, B. N., Wenzel, L., Narod, S., et al. (2002). All in the Family: Evaluation of the Process and Content of Sisters’ Communication about BRCA1 and BRCA2 Genetic Test Results. American Journal of Medical Genetics, 107, 143–150.CrossRefPubMed
go back to reference Kardashian, A., Fehniger, J., Creasman, J., Cheung, E., & Beattie, M. S. (2012). A Pilot Study of the Sharing Risk Information Tool (ShaRIT) for Families with Hereditary Breast and Ovarian Cancer Syndrome. Hereditary Cancer in Clinical Practice, 10, 4.CrossRefPubMedPubMedCentral Kardashian, A., Fehniger, J., Creasman, J., Cheung, E., & Beattie, M. S. (2012). A Pilot Study of the Sharing Risk Information Tool (ShaRIT) for Families with Hereditary Breast and Ovarian Cancer Syndrome. Hereditary Cancer in Clinical Practice, 10, 4.CrossRefPubMedPubMedCentral
go back to reference MacDonald, D. J., Sarna, L., van, S. G., Bastani, R., Giger, J. N., & Weitzel, J. N. (2007). Selection of Family Members for Communication of Cancer Risk and Barriers to this Communication before and after Genetic Cancer Risk Assessment. Genetics in Medicine, 9, 275–282.CrossRefPubMed MacDonald, D. J., Sarna, L., van, S. G., Bastani, R., Giger, J. N., & Weitzel, J. N. (2007). Selection of Family Members for Communication of Cancer Risk and Barriers to this Communication before and after Genetic Cancer Risk Assessment. Genetics in Medicine, 9, 275–282.CrossRefPubMed
go back to reference McGivern, B., Everett, J., Yager, G. G., Baumiller, R. C., Hafertepen, A., & Saal, H. M. (2004). Family Communication about Positive BRCA1 and BRCA2 Genetic Test Results. Genetics in Medicine, 6, 503–509.CrossRefPubMed McGivern, B., Everett, J., Yager, G. G., Baumiller, R. C., Hafertepen, A., & Saal, H. M. (2004). Family Communication about Positive BRCA1 and BRCA2 Genetic Test Results. Genetics in Medicine, 6, 503–509.CrossRefPubMed
go back to reference Menko, F. H., Aalfs, C. M., Henneman, L., Stol, Y., Wijdenes, M., Otten, E., et al. (2013). Informing Family Members of Individuals with Lynch Syndrome: a Guideline for Clinical Geneticists. Familial Cancer, 12, 319–324.CrossRefPubMed Menko, F. H., Aalfs, C. M., Henneman, L., Stol, Y., Wijdenes, M., Otten, E., et al. (2013). Informing Family Members of Individuals with Lynch Syndrome: a Guideline for Clinical Geneticists. Familial Cancer, 12, 319–324.CrossRefPubMed
go back to reference Miller, W. R. & Rollnick, S. (2002a). Motivational interviewing. Preparing people for change. (2nd ed.) The Guilford Press, NY/London. Miller, W. R. & Rollnick, S. (2002a). Motivational interviewing. Preparing people for change. (2nd ed.) The Guilford Press, NY/London.
go back to reference Miller, W. R., & Rollnick, S. (2002b). What is motivational interviewing? In W. R. Miller & S. Rollnick (Eds.), Motivational Interviewing. Preparing people for change. (pp. 33–42). The Guilford Press NY/London. Miller, W. R., & Rollnick, S. (2002b). What is motivational interviewing? In W. R. Miller & S. Rollnick (Eds.), Motivational Interviewing. Preparing people for change. (pp. 33–42). The Guilford Press NY/London.
go back to reference Miller, W. R., & Rollnick, S. (2009). Ten Things that Motivational Interviewing Is not. Behavioural and Cognitive Psychotherapy, 37, 129–140.CrossRefPubMed Miller, W. R., & Rollnick, S. (2009). Ten Things that Motivational Interviewing Is not. Behavioural and Cognitive Psychotherapy, 37, 129–140.CrossRefPubMed
go back to reference Montgomery, S. V., Barsevick, A. M., Egleston, B. L., Bingler, R., Ruth, K., Miller, S. M., et al. (2013). Preparing Individuals to Communicate Genetic Test Results to their Relatives: Report of a Randomized Control Trial. Familial Cancer, 12, 537–546.CrossRefPubMedPubMedCentral Montgomery, S. V., Barsevick, A. M., Egleston, B. L., Bingler, R., Ruth, K., Miller, S. M., et al. (2013). Preparing Individuals to Communicate Genetic Test Results to their Relatives: Report of a Randomized Control Trial. Familial Cancer, 12, 537–546.CrossRefPubMedPubMedCentral
go back to reference Peterson, S. K., Watts, B. G., Koehly, L. M., Vernon, S. W., Baile, W. F., Kohlmann, W. K., et al. (2003). How Families Communicate about HNPCC Genetic Testing: Findings from a Qualitative Study. American Journal of Medical Genetics, 119C, 78–86.CrossRefPubMed Peterson, S. K., Watts, B. G., Koehly, L. M., Vernon, S. W., Baile, W. F., Kohlmann, W. K., et al. (2003). How Families Communicate about HNPCC Genetic Testing: Findings from a Qualitative Study. American Journal of Medical Genetics, 119C, 78–86.CrossRefPubMed
go back to reference Ratnayake, P., Wakefield, C. E., Meiser, B., Suthers, G., Price, M. A., Duffy, J., et al. (2011). An Exploration of the Communication Preferences Regarding Genetic Testing in Individuals from Families with Identified Breast/Ovarian Cancer Mutations. Familial Cancer, 10, 97–105.CrossRefPubMed Ratnayake, P., Wakefield, C. E., Meiser, B., Suthers, G., Price, M. A., Duffy, J., et al. (2011). An Exploration of the Communication Preferences Regarding Genetic Testing in Individuals from Families with Identified Breast/Ovarian Cancer Mutations. Familial Cancer, 10, 97–105.CrossRefPubMed
go back to reference Rollnick, S., Mason, P., & Butler, C. (1999). Health behavior change. A guide for practitioners. Churchill Livingstone,Edinburgh. Rollnick, S., Mason, P., & Butler, C. (1999). Health behavior change. A guide for practitioners. Churchill Livingstone,Edinburgh.
go back to reference Rollnick, S., Miller, W.R. & Butler, C. (2008). Motivational interviewing in health care. Helping patients change behavior. The Guilford Press, New York. Rollnick, S., Miller, W.R. & Butler, C. (2008). Motivational interviewing in health care. Helping patients change behavior. The Guilford Press, New York.
go back to reference Roshanai, A. H., Rosenquist, R., Lampic, C., & Nordin, K. (2009). Does Enhanced Information at Cancer Genetic Counseling Improve Counselees’ Knowledge, Risk Perception, Satisfaction and Negotiation of Information to At-Risk Relatives?–a Randomized Study. Acta Oncologica, 48, 999–1009.CrossRefPubMed Roshanai, A. H., Rosenquist, R., Lampic, C., & Nordin, K. (2009). Does Enhanced Information at Cancer Genetic Counseling Improve Counselees’ Knowledge, Risk Perception, Satisfaction and Negotiation of Information to At-Risk Relatives?–a Randomized Study. Acta Oncologica, 48, 999–1009.CrossRefPubMed
go back to reference Stichting Opsporing Erfelijke Tumoren & Vereniging Klinische Genetica Nederland Werkgroep Klinische Oncogenetica (2005). Erfelijke tumoren; richtlijnen voor diagnostiek en preventie. (3 ed.). Stichting Opsporing Erfelijke Tumoren & Vereniging Klinische Genetica Nederland Werkgroep Klinische Oncogenetica (2005). Erfelijke tumoren; richtlijnen voor diagnostiek en preventie. (3 ed.).
go back to reference Suthers, G. K., Armstrong, J., McCormack, J., & Trott, D. (2006). Letting the Family Know: Balancing Ethics and Effectiveness when Notifying Relatives about Genetic Testing for a Familial Disorder. Journal of Medical Genetics, 43, 665–670.CrossRefPubMed Suthers, G. K., Armstrong, J., McCormack, J., & Trott, D. (2006). Letting the Family Know: Balancing Ethics and Effectiveness when Notifying Relatives about Genetic Testing for a Familial Disorder. Journal of Medical Genetics, 43, 665–670.CrossRefPubMed
go back to reference van den Nieuwenhoff, H. W. P., Mesters, I., Gielen, C., & de Vries, N. K. (2007). Family Communication Regarding Inherited High Cholesterol: why and how Do Patients Disclose Genetic Risk? Social Science & Medicine, 65, 1025–1037.CrossRef van den Nieuwenhoff, H. W. P., Mesters, I., Gielen, C., & de Vries, N. K. (2007). Family Communication Regarding Inherited High Cholesterol: why and how Do Patients Disclose Genetic Risk? Social Science & Medicine, 65, 1025–1037.CrossRef
go back to reference Vos, J., Menko, F., Jansen, A. M., van Asperen, C. J., Stiggelbout, A. M., & Tibben, A. (2011). A Whisper-Game Perspective on the Family Communication of DNA-Test Results: a Retrospective Study on the Communication Process of BRCA1/2-Test Results between Proband and Relatives. Familial Cancer, 10, 87–96.CrossRefPubMed Vos, J., Menko, F., Jansen, A. M., van Asperen, C. J., Stiggelbout, A. M., & Tibben, A. (2011). A Whisper-Game Perspective on the Family Communication of DNA-Test Results: a Retrospective Study on the Communication Process of BRCA1/2-Test Results between Proband and Relatives. Familial Cancer, 10, 87–96.CrossRefPubMed
go back to reference Wiggers, L. C. W., Oort, F. J., Legemate, D. A., de Haes, J. C. J. M., & Smets, E. M. A. (2005). Quality assessment: process evaluation of the Minimal Intervention Strategy’s implementation. In Smoking cessation in patients with cardiovascular disease (pp. 95–106). (Unpublished doctoral dissertation). University of Amsterdam, the Netherlands. Wiggers, L. C. W., Oort, F. J., Legemate, D. A., de Haes, J. C. J. M., & Smets, E. M. A. (2005). Quality assessment: process evaluation of the Minimal Intervention Strategy’s implementation. In Smoking cessation in patients with cardiovascular disease (pp. 95–106). (Unpublished doctoral dissertation). University of Amsterdam, the Netherlands.
go back to reference Wilson, B. J., Forrest, K., van Teijlingen, E. R., McKee, L., Haites, N., & Matthews, E. (2004). Family Communication about Genetic Risk: the Little that Is Known. Community Genetics, 7, 15–24.PubMed Wilson, B. J., Forrest, K., van Teijlingen, E. R., McKee, L., Haites, N., & Matthews, E. (2004). Family Communication about Genetic Risk: the Little that Is Known. Community Genetics, 7, 15–24.PubMed
go back to reference Wiseman, M., Dancyger, C., & Michie, S. (2010). Communicating Genetic Risk Information within Families: a Review. Familial Cancer, 9, 691–703.CrossRefPubMed Wiseman, M., Dancyger, C., & Michie, S. (2010). Communicating Genetic Risk Information within Families: a Review. Familial Cancer, 9, 691–703.CrossRefPubMed
Metadata
Title
Design and Feasibility of an Intervention to Support Cancer Genetic Counselees in Informing their At-Risk Relatives
Authors
Eveline de Geus
Willem Eijzenga
Fred H. Menko
Rolf H. Sijmons
Hanneke C. J. M. de Haes
Cora M. Aalfs
Ellen M. A. Smets
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 6/2016
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-016-9948-7

Other articles of this Issue 6/2016

Journal of Genetic Counseling 6/2016 Go to the issue