Acceptability of Telemedicine and Other Cancer Genetic Counseling Models of Service Delivery in Geographically Remote Settings
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This work examined acceptability of cancer genetic counseling models of service delivery among Maine residents at risk for hereditary cancer susceptibility disorders. Pre-counseling, participants ranked characteristics reflecting models of care from most to least important including: mode-of-communication (in-person versus telegenetics), provider level of training (genetic specialty versus some training/experience), delivery format (one-on-one versus group counseling), and location (local versus tertiary service requiring travel). Associations between models of care characteristic rankings and patient characteristics, including rural residence, perceived cancer risk, and perceived risk for a hereditary cancer risk susceptibility disorder were examined. A total of 149/300 (49.7 % response rate) individuals from 11/16 Maine counties responded; 30.8 % were from rural counties; 92.2 % indicated that an important/the most important model of care characteristic is provider professional qualifications. Among other characteristics, 65.1 % ranked one-on-one counseling as important/the most important. In-person and local counseling were ranked the two least important characteristics (51.8 % and 52.1 % important/the most important, respectively). Responses did not vary by patient characteristics with the exception of greater acceptance of group counseling among those at perceived high personal cancer risk. Cancer telegenetic services hold promise for access to expert providers in a one-on-one format for rurally remote clients.
KeywordsCancer genetic counseling Disparities Models of service delivery Telegenetics Rural
We thank Norma Albrecht, Kathy J. Goodwin, Roxanne M. Kenerson, Cynthia K. McDonough, and Heather M. Smith for their technical assistance. This project was funded in whole or in part with Federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
Disclosure of Interest
The authors have no actual or potential conflict of interest. They have full control of all primary data and agree to allow the journal to review their data, if requested.
- Bluman, L. G., Rimer, B. K., Berry, D. A., Borstelmann, N., Iglehart, J. D., Regan, K., & Winer, E. P. (1999). Attitudes, knowledge, and risk perceptions of women with breast and/or ovarian cancer considering testing for BRCA1 and BRCA2. Journal of Clinical Oncology, 17(3), 1040–1046.PubMedGoogle Scholar
- Bureau of Economic Analysis, U.S. Department of Commerce. (2012). State Personal Income 2011 (released March 28, 2012). Retrieved July 16, 2012, 2012, from http://www.bea.gov/newsreleases/regional/spi/2012/spi0312.htm
- Calzone, K. A., Prindiville, S. A., Jourkiv, O., Jenkins, J., DeCarvalho, M., Wallerstedt, D. B., & Kirsch, I. R. (2005). Randomized comparison of group versus individual genetic education and counseling for familial breast and/or ovarian cancer. Journal of Clinical Oncology, 23(15), 3455–3464. doi: 10.1200/JCO.2005.04.050.PubMedCrossRefGoogle Scholar
- Coelho, J. J., Arnold, A., Nayler, J., Tischkowitz, M., & MacKay, J. (2005). An assessment of the efficacy of cancer genetic counselling using real-time videoconferencing technology (telemedicine) compared to face-to-face consultations. European Journal of Cancer, 41(15), 2257–2261. doi: 10.1016/j.ejca.2005.06.020.PubMedCrossRefGoogle Scholar
- Cohen, S. A., Gustafson, S. L., Marvin, M. L., Riley, B. D., Uhlmann, W. R., Liebers, S. B., & Rousseau, J. A. (2012). Report from the National Society of Genetic Counselors service delivery model task force: a proposal to define models, components, and modes of referral. Journal of Genetic Counseling, 21(5), 645–651. doi: 10.1007/s10897-012-9505-y.PubMedCrossRefGoogle Scholar
- Committee on Evaluating Clinical Applications of Telemedicine, Institute of Medicine. (1996). A Guide to Assessing Telecommunications for Health Care. Washington: The National Academies Press.Google Scholar
- d’Agincourt--Canning, L., McGillivray, B., Panabaker, K., Scott, J., Pearn, A., Ridge, Y., & Portigal-Todd, C. (2008). Evaluation of genetic counseling for hereditary cancer by videoconference in British Columbia. BC Medical Journal, 50, 554–559. http://www.bcmj.org/article/evaluation-genetic-counseling-hereditary-cancer-videoconference-british-columbia.Google Scholar
- Elliott, A. M., Mhanni, A. A., Marles, S. L., Greenberg, C. R., Chudley, A. E., Nyhof, G. C., & Chodirker, B. N. (2012). Trends in telehealth versus on-site clinical genetics appointments in Manitoba: a comparative study. Journal of Genetic Counseling, 21(2), 337–344. doi: 10.1007/s10897-011-9406-5.PubMedCrossRefGoogle Scholar
- Garrett, C. C., Hocking, J., Chen, M. Y., Fairley, C. K., & Kirkman, M. (2011). Young people’s views on the potential use of telemedicine consultations for sexual health: results of a national survey. BMC Infectious Diseases, 11, 285. doi: 10.1186/1471-2334-11-285.PubMedCentralPubMedCrossRefGoogle Scholar
- Hill, J. H., Burge, S., Haring, A., Young, R. A., Network, R. R., & Residency Research Network of Texas, Investigators. (2012). Communication technology access, use, and preferences among primary care patients: from the Residency Research Network of Texas (RRNeT). Journal of the American Board Family Medicine, 25(5), 625–634. doi: 10.3122/jabfm.2012.05.120043.CrossRefGoogle Scholar
- Lerman, C., Narod, S., Schulman, K., Hughes, C., Gomez-Caminero, A., Bonney, G., & Lynch, H. (1996). BRCA1 testing in families with hereditary breast-ovarian cancer. A prospective study of patient decision making and outcomes. The Journal of the American Medical Association, 275(24), 1885–1892.CrossRefGoogle Scholar
- Lerman, C., Biesecker, B., Benkendorf, J. L., Kerner, J., Gomez-Caminero, A., Hughes, C., & Reed, M. M. (1997). Controlled trial of pretest education approaches to enhance informed decision-making for BRCA1 gene testing. Journal of the National Cancer Institute, 89(2), 148–157.PubMedCrossRefGoogle Scholar
- Office of Management and Budget. (2005). List of Rural Counties and Designated Eligible Census Tracts in Metropolitan Counties. Retrieved August 9, 2012, 2012, from ftp://ftp.hrsa.gov/ruralhealth/eligibility2005.pdf
- United States Census Bureau. (2010). Census 2000 Summary File 1, Matrices H1 and H3. Retrieved August 9, 2012 Retrieved from http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk.
- Wideroff, L., Freedman, A. N., Olson, L., Klabunde, C. N., Davis, W., Srinath, K. P., & Ballard-Barbash, R. (2003). Physician use of genetic testing for cancer susceptibility: results of a national survey. Cancer Epidemiology, Biomarkers& Prevention, 12(4), 295–303.Google Scholar
- Zilliacus, E. M., Meiser, B., Lobb, E. A., Kelly, P. J., Barlow-Stewart, K., Kirk, J. A., & Tucker, K. M. (2011). Are videoconferenced consultations as effective as face-to-face consultations for hereditary breast and ovarian cancer genetic counseling? Genetics in Medicine, 13(11), 933–941. doi: 10.1097/GIM.0b013e3182217a19.PubMedCrossRefGoogle Scholar