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Healthcare (Basel). 2018 Sep 17;6(3). pii: E116. doi: 10.3390/healthcare6030116.

Provider's Perceptions of Barriers and Facilitators for Latinas to Participate in Genetic Cancer Risk Assessment for Hereditary Breast and Ovarian Cancer.

Author information

1
Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA. ahd28@georgetown.edu.
2
Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA. kdg9@georgetown.edu.
3
Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA. sg1328@georgetown.edu.
4
Department of Nursing, California State University, Sacramento, CA 95819-6096, USA. ltw7@georgetown.edu.
5
Nueva Vida, DC Office-Alexandria, 206 N. Washington St. Suite 300, Alexandria, VA 22314, USA. ccampos@nueva-vida.org.
6
Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, PA 19104, USA. chaevansc3@gmail.com.
7
Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA. ss4081@georgetown.edu.
8
Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA. qz66@georgetown.edu.
9
Capital Breast Cancer Center, 1000 New Jersey Ave, SE, Washington, DC 20003, USA. ng472@georgetown.edu.
10
Department of Health Behavior Policy, Virginia Commonwealth University, Richmond, VA 23219, USA. Vanessa.Sheppard@vcuhealth.org.

Abstract

The Comprehensive Cancer Network (NCCN) recommends genetic cancer risk assessment (GCRA) referral to women at high risk of hereditary breast and ovarian cancer. Latinas affected by breast cancer have the second highest prevalence of BRCA1/2 mutations after Ashkenazi Jews. Compared to non-Hispanic Whites, Latinas have lower GCRA uptake. While some studies have identified barriers for GCRA use in this population, few studies have focused on health care providers' perspectives. The purpose of the study was to examine providers' perceptions of barriers and facilitators for at-risk Latina women to participate in GCRA and their experiences providing services to this population. We conducted semi-structured interviews with 20 healthcare providers (e.g., genetic counselors, patient navigators) recruited nationally through snowballing. Interviews were transcribed. Two coders independently coded each interview and then met to reconcile the codes using Consensual Qualitative Research guidelines. Providers identified several facilitators for GCRA uptake (e.g., family, treatment/prevention decisions) and barriers (e.g., cost, referrals, awareness, stigma). Genetic counselors described important aspects to consider when working with at-risk Latina including language barriers, obtaining accurate family histories, family communication, and testing relatives who live outside the US. Findings from this study can inform future interventions to enhance uptake and quality of GCRA in at-risk Latina women to reduce disparities.

KEYWORDS:

Latinas; Provider’s perspectives; barriers; genetic counseling; genetic testing; hereditary breast and ovarian cancer

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