Abstract B5: Development and evaluation of a cancer risk educational tool (CREdIT)

Introduction: Educational and decision tools for cancer risk genetic counseling have typically been developed and studied among educated white populations. The Cancer Risk Educational Intervention Tool (CREdIT) was developed in underserved women at high risk of Hereditary Breast and Ovarian Cancer (HBOC) at San Francisco General Hospital, where BRCA testing, counseling, and follow-up is provided at no cost to underserved women. The purpose of this study was to determine the impact of CREdIT on patient understanding of cancer genetics.

Methods: CREdIT was shaped into a story that employs simple language, non-scientific images, and analogies comparing genetic information to an instruction book. CREdIT is available as a 15 minute audio-visual powerpoint presentation in English and Spanish. Patient questionnaires before and after CREdIT addressed patient satisfaction, risk perception, anxiety, and knowledge of cancer genetics. Genetic counselor questionnaires before and after CREdIT addressed counselor satisfaction and timeflow.

Results: The 38 participants ranged from age 27 to 69 with a mean age of 49 and 29% have high school level of education or below. 89% were English speaking and 50% were non-white. 66% were employed either full time or part-time and 26% have had cancer. Patient responses to CREdIT showed that 100% of the participants responded positively that CREdIT improved understanding of cancer risk. 92% of the participants responded favorably that CREdIT improved understanding of cancer inheritance, while 79% answered that CREdIT did not increased worry about cancer. Genetic counselor reported that following CREdIT, there was an increased level of patient preparedness and increased overall counseling satisfaction with the counseling. Mean genetic counselor time decreased by 5.5 minutes after CREdIT.

Conclusions: CREdIT appeared to increase knowledge without increasing patient anxiety or cancer worry among underserved women. Genetic counselors reported increased satisfaction, increased patient preparedness, and decreased counseling time with CREdIT. Further studies should improve interface, tool delivery, and include specific ethnic group.