Current Approaches to Cancer Genetic Counseling Services for Spanish-Speaking Patients

Augusto, Bianca; Kasting, Monica L.; Couch, Fergus J.; Lindor, Noralane M.; Vadaparampil, Susan T.

doi:10.1007/s10903-018-0772-z

Cited by 19 publications

(16 citation statements)

References 10 publications

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“…More recent literature has focused on general improvements for genetic testing and associated care to reduce the burden of anxiety and stress and to increase uptake from speci c groups such as Hispanic and Black/African American women at risk for BRCA1/2 mutations. Speci cally, current recommendations infer that culturally appropriate language and increasing the number of physicians who speak Spanish is imperative, as a larger proportion of Hispanic women have been tested when reporting to counselors or physicians in Spanish [55]. Increasing the knowledge of the bene ts of genetic testing via primary care physicians [56] and bilingual media may be helpful to increase awareness of hereditary cancer risk and genetic testing availability [42].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Dibble

Connor

2022

Support Care Cancer

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PurposeTo outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive United States (US) women to identify high-risk groups of mutation carriers from medically underserved backgrounds. Methods 211 BRCA1/2-positive women from medically underserved backgrounds were recruited through national Facebook support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% con dence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity, poverty status, and self-reported moderate-to-severe anxiety and depressive symptoms. ResultsWomen ranged in age (18-75, M = 39.5, SD = 10.6). Most women were non-Hispanic white (NHW) (67.2%) and were not impoverished (76.7%). Hispanic women with BRCA1/2 mutations were 6.11 times more likely to report moderate-to-severe anxiety (95% CI, 2.16-17.2, p = 0.001) and 4.28 times more likely to report moderate-to-severe depressive symptoms (95% CI, 1.98-9.60, p = < 0.001) than NHW women with BRCA1/2. Associations were not statistically signi cant among other minority women. Women living in poverty were signi cantly less likely to report moderate-to-severe depressive symptoms than women not in poverty (aOR, 0.42, 95% CI, 0.18-0.95, p = 0.04). ConclusionHispanic women with BRCA1/2 mutations from medically underserved backgrounds are an important population at increased risk for worse anxiety and depressive symptomology. Our ndings among Hispanic women with BRCA1/2 mutations add to the growing body of literature focused on ethnic disparities experienced across the cancer control continuum. impoverished women. Furthermore, the impact on mental health among BRCA1/2-positive women from racial/ethnic and impoverished groups remains relatively unknown, as past literature has targeted racial/ethnic minority women from one location due to di culty in recruitment [29,30].Objectives. The current study aims to outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive US women to identify high-risk groups of mutation carriers from medically underserved backgrounds. Women with BRCA1/2 mutations may experience adverse mental health symptomologies related to their mutations and ongoing care, and we hypothesize that racial/ethnic minority and impoverished women may face an even more heightened threat. Methods Study Design & Sample

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Section: Discussionmentioning

confidence: 99%

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Dibble

Connor

2022

Support Care Cancer

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“…Results from this study also highlight the potential of the video to target historically identified barriers that Latinas in the U.S face for reception of GCT, including language barriers and suboptimal referrals [16,21,47,69]. Few education materials are available in Spanish, and very few genetic counselors speak Spanish in the US [70,71]. Spanish-speaking Latinas diagnosed with breast cancer are almost five times more likely to report unmet needs for genetic testing discussion with their providers compared to their non-Latina counterparts [72].…”

Section: Discussionmentioning

confidence: 99%

Culturally Targeted Video Improves Psychosocial Outcomes in Latina Women at Risk of Hereditary Breast and Ovarian Cancer

Hurtado‐de‐Mendoza

Graves

Gómez‐Trillos

et al. 2019

IJERPH

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Latina women at risk of hereditary breast and ovarian cancer (HBOC) have lower awareness, knowledge, and use of genetic counseling and testing services (GCT) than non-Latina Whites. Few interventions have been developed to reduce these disparities among at-risk Latinas. This pilot study assessed the impact of a culturally targeted narrative video developed by our team. The study included 40 Latina immigrants living in the United States who were at risk of HBOC, including affected and unaffected women. We assessed pre-post differences in psychosocial outcomes. Participants were 47.35 years old on average (SD = 9.48). Most (70%) were unaffected with cancer, had an annual income of $40,000 or less (65%), an education of High School or less (62.5%), and were uninsured (77.5%). The video significantly enhanced knowledge (p < 0.001), positive attitudes (p < 0.05), anticipatory positive emotions (p < 0.05), and intentions to participate in counseling (p < 0.001). Importantly, the video also significantly reduced negative attitudes (p < 0.05), and attitudinal ambivalence (p < 0.001). The culturally targeted video shows preliminary evidence in improving psychosocial outcomes related to GCT uptake in Latinas at risk for HBOC. This intervention is a promising easily-disseminable strategy to address disparities in GCT utilization.

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“…Per the 2020 NSGC Professional Status Survey, ~5%–6% of GCs are bilingual in Spanish (NSGC Professional Status Survey: Service Delivery and Access to Care, 2020). Approximately 10% of cancer GCs speak Spanish, with only 6% counseling in Spanish (Augusto et al, 2019). Because of the limited number of practicing Spanish‐speaking GCs in the U.S., it is important to employ strategies that allow for these patients to be seen by bilingual GCs such as “telephone counseling in Spanish, [or] group education sessions” (Augusto et al, 2019), as previously suggested by one participant in the present study as well as by Spanish‐speaking patients in the literature (Garza et al, 2020; Thompson et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 10% of cancer GCs speak Spanish, with only 6% counseling in Spanish (Augusto et al, 2019). Because of the limited number of practicing Spanish‐speaking GCs in the U.S., it is important to employ strategies that allow for these patients to be seen by bilingual GCs such as “telephone counseling in Spanish, [or] group education sessions” (Augusto et al, 2019), as previously suggested by one participant in the present study as well as by Spanish‐speaking patients in the literature (Garza et al, 2020; Thompson et al, 2015). The benefit of group sessions for routine indications is to “normalize the genetic counseling process” and “have the perspectives of other individuals in a similar situation to their own and the opportunity to learn from others” (Thompson et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Perspectives on Spanish language concordant cancer genetic counseling sessions from the Spanish‐speaking population

Jimenez

Matthews

Darrah

et al. 2022

Journal of Genetic Counseling

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Genetic counselors (GCs) provide risk assessment, education, and counseling about the genetic contribution to disease. To do so, they must effectively communicate, build rapport, and help patients make the best decisions for themselves and their families. Language barriers add a complex layer to this patient-provider dynamic. While interpreters serve as a primary solution when a patient and GC speak different languages, issues have been documented with these sessions, such as misinterpreted genetic terminology (Gutierrez et al., 2017). Having a GC with concordant language skills may help address these barriers. The purpose of this study was to assess Spanishspeaking patients' perspectives on communication, decision-making, and the interpersonal relationship developed with a bilingual GC in language concordant cancer genetic counseling sessions. Spanish-speaking patients, ages 18 or older, seen by a Spanish-speaking GC at a California public, safety-net hospital were eligible to participate in this study. Nine participants were interviewed via telephone by the bilingual researcher using a semi-structured interview guide to assess three domains: communication, decision-making, and interpersonal relationship. Analyses of interview transcripts identified themes within these three areas of focus: (1) participants felt all explanations were clear and they were not afraid to ask questions in the session, (2) participants experienced preference-concordant decision making, and (3) participants felt empowered and supported by the GC. Participants suggested that GCs working with Spanish-speaking patients in the future should consider group counseling sessions, engaging in outreach efforts to educate the Spanish-speaking community about genetics, and increasing the number of GCs who speak Spanish. These results demonstrate the positive experiences of Spanish-speaking patients in language concordant cancer genetic counseling sessions and further support the need for recruitment of Spanish-speaking individuals into the profession. Future research should further assess the experience of Spanish-speaking patients in language concordant sessions and address the role of cultural concordance in sessions.

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Current Approaches to Cancer Genetic Counseling Services for Spanish-Speaking Patients

Cited by 19 publications

References 10 publications

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

Culturally Targeted Video Improves Psychosocial Outcomes in Latina Women at Risk of Hereditary Breast and Ovarian Cancer

Perspectives on Spanish language concordant cancer genetic counseling sessions from the Spanish‐speaking population

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