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Predictors of Participation in Psychosocial Telephone Counseling following Genetic Testing for BRCA1 and BRCA2 Mutations

Departments of ¹ Psychiatry and Abramson Cancer Center and ² Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania; ³ Department of Medicine, Epidemiology Division, University of California-Irvine, Irvine, California; ⁴ Department of Oncology, Lombardi Cancer Center, Georgetown University, Washington, District of Columbia; ⁵ The Centre for Research in Women's Health, Women's College Hospital, Toronto, Canada; and ⁶ Center for Behavioral and Community Studies, AMC Cancer Research Center, Denver, Colorado

Requests for reprints: Chanita Hughes Halbert, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104. Phone: (215) 746-7144; Fax: (215) 746-7140. E-mail:chanita{at}mail.med.upenn.edu

Although adjunctive educational and psychosocial programs are now being developed for BRCA1 and BRCA2 (BRCA1/2) mutation carriers, limited information is available about whether mutation carriers will want to receive such programs or about the characteristics of individuals who participate. The goals of the present study were to describe rates of completing a psychosocial telephone counseling (PTC) intervention that was offered to female BRCA1/2 mutation carriers and to identify sociodemographic and psychological factors associated with decisions to complete the intervention. Subjects were 66 BRCA1/2 mutation carriers who were randomized to receive a PTC intervention following receipt of genetic test results. Sociodemographic and psychological factors were evaluated before notification of assignment to the PTC intervention. Completion of the intervention was determined from study records. Overall, 75.8% of subjects completed the PTC intervention. Compared to unaffected subjects, those affected with breast and/or ovarian cancer were 76% less likely to complete the intervention [odds ratio (OR) = 0.24, 95% confidence interval (CI) = 0.06, 0.98, P = 0.05]. In addition, subjects with higher levels of cancer-specific distress [OR = 4.74, 95% CI = 1.02, 22.03, P = 0.05] and those with greater perceptions of social support [OR = 5.81, 95% CI = 1.29, 26.16, P = 0.02] were also most likely to complete the intervention. The results of this study suggest that while most BRCA1/2 mutation carriers are likely to complete an adjunctive psycho-educational program, personal history of cancer, cancer-specific distress, and perceptions of social support are likely to influence participation.

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