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Genetic Risk Assessment for Cancer Education and Empowerment (GRACE) Project

Not Applicable
Completed
Conditions
Breast Cancer
Ovarian Cancer
Interventions
Behavioral: Mailed Targeted Print (TP)
Other: Usual Care (UC)
Behavioral: Telephone Counseling & Navigation (TCN)
Registration Number
NCT03326713
Lead Sponsor
Rutgers, The State University of New Jersey
Brief Summary

GRACE is a randomized 3-arm trial to determine the comparative effectiveness of two remote cancer communication interventions: 1) a targeted generic print (TP) or 2) a tailored telephone-based counseling and navigation intervention (TCN). Post-award, the target sample size was revised to (n=642) with NIH permission.

Detailed Description

There is increasing evidence that activated and engaged patients who are equipped with necessary skills and information are more likely to follow through with recommended care and have better health outcomes at reduced costs. Identification of individuals at increased risk of hereditary breast and ovarian cancer (HBOC) is crucial for cancer survivors and their families to benefit from biomedical advances in cancer prevention, early detection, treatment and survivorship. The primary purpose of this study is to assess the feasibility and acceptability of two remote interventions aimed at promoting cancer genetic risk assessment (CGRA) for HBOC. The randomized controlled trial will have 3 arms: usual care (UC) vs. targeted generic print (TP) vs. tailored telephone counseling and navigation intervention (TCN).

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
668
Inclusion Criteria

Breast Cancer

  • Hispanic or non-Hispanic

  • Female

  • 21 years of age or older

  • English-speaking

  • Breast cancer history

    • breast cancer at the age of 50 or younger OR
    • triple-negative breast cancer OR
    • two or more primary breast cancers

Ovarian Cancer

  • Hispanic or non-Hispanic
  • Female
  • 21 years of age or older
  • English-speaking
  • History of ovarian, fallopian, or peritoneal cancer diagnosed at any age
Exclusion Criteria

Have had prior genetic counseling or testing for hereditary breast and/or ovarian cancer

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mailed Targeted Print (TP)Mailed Targeted Print (TP)Mailed Targeted Print
Usual Care (UC)Usual Care (UC)Control
Telephone Counseling & Navigation (TCN)Telephone Counseling & Navigation (TCN)Telephone Counseling
Primary Outcome Measures
NameTimeMethod
Cancer Genetic Risk Assessment (Genetic Counseling) CGRA1 month, 6 months, and 12 months

Questionnaire: Participants will be asked whether they have had CGRA, the provider who conducted the CGRA, and the provider's genetics training. CGRA will be medical record verified delivered by the 6-month follow-up.

Secondary Outcome Measures
NameTimeMethod
HBOC Genetic Testing IntentionBaseline; 1 month; 6 months; or 12 months

Questionnaire: One item will measure future intention to get genetic testing for HBOC. In follow up surveys, this will only be asked if participant does not report uptake of genetic testing

Cancer Genetic Risk Assessment IntentionBaseline; 1 month; 6 months; or 12 months

Questionnaire: One item will measure future intention to get cancer genetic risk assessment. In follow up surveys, this will only be asked if participant does not report uptake of CGRA

HBOC Genetic Testing Uptake1 month; 6 months; or 12 months

Questionnaire: Participants will be asked if they received the intervention brochure and had telephone coaching. If yes, they will be asked questions regarding their reaction to the intervention.

Decisional conflict for CGRA: SURE Scale1 month; 6 months; or 12 months

Questionnaire: Decisional conflict associated with the CGRA decision will be measured separately with 4 items using the SURE Scale. Range from 0-4, with 0 indicating high decisional conflict.

CGRA and HBOC Genetic Testing FacilitatorsBaseline; 1 month; 6 months; or 12 months

Questionnaire: Facilitators include but are not limited to: help from family, desire to reduce risk of second cancers, and help/referrals from medical professionals.

Decisional conflict for HBOC genetic testing: Low Literacy Decisional Conflict Scale (DCS) SURE Scale6 months; or 12 months

Questionnaire: Decisional conflict associated with the HBOC gene test decision will be measured separately with 4 items using the SURE SCALE. Sum the four responses. Range from 0-4, with 0 indicating high decisional conflict.

Decisional satisfaction with CGRA: Satisfaction with Decision Instrument6 months; or 12 months

Questionnaire: Decisional satisfaction will be assessed using the Satisfaction with Decision Instrument. Five questions assess their personal satisfaction with their decision and two additional items assess how they feel about their CGRA decision in relation to their family. Satisfaction Score: Range 5-25, with 25 indicating high decisional satisfaction. Family Score: Range 2-10, with 10 indicating high consistency with personal values.

Decision Regret Scale6 months; or 12 months

Questionnaire: Five items will ask about regret regarding the decision to have or not have CGRA. Range from 0-100, with 100 indicating high decisional regret.

Cost Data6 Months and 12 months

Questionnaire: Several items will be used to conduct a cost analysis in terms of costs to participants. These questions were developed for the purpose of this study and include out-of-pocket costs.

Physician/Health Care Provider Recommendation and CommunicationBaseline; 1 month; 6 months; or 12 months

Questionnaire: Will assess whether healthcare providers have discussed participant's risk of HBOC and CGRA, and how participants feel discussing genetic testing with health care provider.

Trial Locations

Locations (1)

Rutgers University

🇺🇸

New Brunswick, New Jersey, United States

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