Analysis of Advantages, Limitations, and Barriers of Genetic Counseling Service Delivery Models
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Previous studies on genetic counseling service delivery models (SDMs) have shown that genetic counselors (GCs) are incorporating alternate models to address growing service demand and improve access to genetic services. This study sought to identify barriers, limitations and advantages to previously identified genetic counseling SDMs. A qualitative research design was employed, in which 20 practicing GCs who utilize a variety of SDMs were interviewed using an email interview format. Interview transcripts were analyzed using a thematic analysis to identify themes related to implementation and utilization of SDMs. Factors that led GCs to implement SDMs other than in-person genetic counseling included: 1) travel distance, 2) wait time and 3) convenience. Logistical issues such as billing and reimbursement, equipment set up, making arrangements for genetic testing and the inability to see the patient are major limitations to alternative genetic counseling SDMs in clinical practice. However, GCs interviewed stated that the convenience to the patient and genetic counselor of alternative SDMs outweighed these limitations. More research is needed to assess the outcomes of SDMs in practice to demonstrate an impact on the identified barriers of travel distance, wait time and convenience.
KeywordsService delivery models Genetic counseling Access
Thanks to the NSGC Service Delivery Model Task Force for input on the design of this study and to thesis committee members Elizabeth A. Gettig, MS, CGC and Jessica Burke, PhD, MHS.
Compliance with ethical standards
Conflict of Interest
Authors Stephanie A. Cohen, Rachelle C. Huziak and Robin E. Grubs declare they have no conflict of interest.
Author Shanna Gustafson declares she is employed by a private company which uses telephone genetic counseling and owns shares in the company.
Human Studies and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.
No animal studies were carried out by the authors for this article.
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