Introduction: GCRA, which includes genetic counseling and testing, identifies individuals at hereditary cancer risk. Despite recognition of GCRA as standard-of- care, Latinas remain underrepresented in clinics and little is known about their experience. Our study examines the effect of an adapted motivational interviewing (AMI) telephone intervention on GCRA uptake. Perceived personal control (PPC) assesses cognitive, behavioral and decisional locus of control relative to the possibility of having a hereditary condition. Purpose: 1) Evaluate the effect of an AMI intervention on GCRA uptake 2) Explore baseline PPC and how it is affected by GCRA and AMI Procedures: English or Spanish speaking adult Latinas, who met NCCN criteria for BRCA testing were eligible and approached when scheduling their GCRA at two safety-net hospitals and one cancer center. Participants were randomized to an AMI intervention, time-and-attention control health habits (HH), or usual care (UC). The 9-item validated PPC instrument (scored 0-2, no PPC to full PPC) was administered in participants’ preferred language at baseline, pre- and post-GCRA. Results: Of the 478 Latinas who consented, 152 (32%) were randomized to both the AMI and UC arms, and the remaining 174 (36%) assigned to the HH arm. Spanish was the primary language for 76% (n=362). The majority had a history of cancer (79%, n=375) and most (64%, n=241) were undergoing treatment at the time of GCRA. There was no difference in the demographics of each arm (p>0.22). There was no difference in GCRA uptake by arm with 79% (n=379) keeping their appointment.
Baseline PPC: PPC scores were not different between the arms for total PPC (AMI = 1.36, HH = 1.36, UC = 1.37; p = 0.67). Domain scores were: cognitive = 1.22, behavioral = 1.32 and decisional = 1.54. Post-GRCA PPC: PPC increased 12% for the cohort and in the arms, with no difference in the magnitude of increase between arms (p>0.68). The greatest increase was observed in cognitive PPC (>17%) across the cohort. In the AMI arm, total PPC increased 11% for those with cancer (p=0.043) and English speakers had an increase of 20% compared to 11% for Spanish speakers. Behavioral PPC increased by 14% in both the AMI and UC arms (p=0.004). Decisional PPC increased 8.9% in the AMI arm (p=0.026). Conclusions: PPC scores increased post-GCRA, with no between-arm differences, suggesting that the shared exposure to GCRA may increase PPC for Latinas. AMI did not impact GCRA uptake, though we did observe an increase in PPC scores in this arm for English speakers and those with cancer. Therefore, the addition of AMI to GCRA may be particularly effective in increasing PPC for some patients. The most significant increases in post-GCRA PPC were observed in cognitive PPC, likely reflecting the educational focus of GCRA but also supports a need for focus on approaches to enhance decisional and behavioral control. This is further supported by our finding that an increase in decisional control was only seen in the AMI arm. This merits further exploration and study.
Citation Format: Charité Ricker, Bita Nehoray, Guadalupe M. Carvajal, Kathleen R. Blazer, Sharon Sand, Kimlin Ashing, April Vang, Kai Wang, Nancy Feldman, Jeffrey N. Weitzel. Genetic cancer risk assessment (GCRA) increases perceived personal control in Latinas at risk for hereditary breast and ovarian cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-049.