Abstract
There is a disproportionate underuse of genetic testing in breast cancer patients from lower education or migrant background. Within these groups, communication about referral to genetic counseling appears challenging due to limited health literacy and cultural barriers. Our aim was to develop and evaluate a training program for healthcare professionals (breast surgeons and specialized nurses), to increase effective communication. We systematically developed a blended training program based on patients’ and healthcare professionals’ needs and preferences. Prior to the training, we assessed awareness, knowledge and self-efficacy of healthcare professionals. Acceptability and usefulness of the training program were assessed directly after the training. Healthcare professionals (n = 65) from 17 hospitals showed moderate to high awareness and knowledge about the prevalence and impact of limited health literacy. They were aware of cultural factors that influence communication. However, they did not feel confident in recognizing limited health literacy and their self-efficacy to communicate effectively with these patients was low. The training program was rated as acceptable and useful. Healthcare professionals lack confidence to effectively communicate with patients with limited health literacy or migrant background. The training program offers opportunities to improve communication about referral to breast cancer genetic counseling.
Highlights
Referral to genetic counseling for breast cancer patients at risk of carrying a mutation is crucial and should preferably be offered early after diagnosis to guide treatment decisions
A total of 73 healthcare professionals were included in the training program
In this paper we described the systematic development, pilotimplementation and acceptability of a blended training program for breast surgeons and specialized nurses to improve communication about referral to breast cancer genetic counseling
Summary
Referral to genetic counseling for breast cancer patients at risk of carrying a mutation is crucial and should preferably be offered early after diagnosis to guide treatment decisions. Genetic counseling is clinically relevant for all eligible high-risk patients with breast cancer, there’s still a disproportionate underuse of it in patients with a lower educational background and in migrant patients [4,5,6,7]. These patients seem to have poorer access to cancer-related genetic counseling [7, 8]. Patients need to understand the benefits, limitations and risks of genetic
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