Traditional Counseling Research Articles

Blood and body fluids exposure, post-exposure prophylaxis, and HIV self-testing among healthcare workers in northern Nigeria

Introduction In high-HIV burden settings, such as Nigeria, HIV self-testing and post-exposure prophylaxis (PEP) are often recommended, but not widely practiced. This study aims to identify the predictors of PEP utilization and preferences for HIV self-testing among healthcare workers in Nigeria. Methods A total of 403 healthcare workers from a tertiary hospital in Nigeria completed questionnaires. Adjusted odds ratios were derived from logistic regression models. Results Among the respondents, 141 (35.0%) reported experiencing at least one workplace exposure incident, with 72 (51.1%) of them receiving PEP. The majority of healthcare workers (n = 354, 87.8%) expressed a preference for HIV self-testing over traditional HIV testing and counseling. The occurrence of exposure incidents was predicted by the respondent’s sex (adjusted odds ratio [aOR] = 1.25; 95% confidence interval [CI]: 1.15-3.08, female vs. male), age (aOR = 0. 16; 95% CI: 0.03-0.92, >40 vs. <30 years), profession (aOR = 1.88; 95% CI: 1.18-4.66, nurse/midwife vs. physician), work unit (aOR = 0.06; 95% CI: 0.02-0.23, obstetrics/gynecology vs. surgery), and previous HIV testing and counseling (aOR = 0.01; 95% Cl: 0.004-0.03, no vs. yes). Respondent’s profession, work unit, and previous HIV testing and counseling independently predicted a preference for HIV self-testing. Conclusion Further exploration of the feasibility of implementing HIV self-testing as an alternative to traditional HIV testing and counseling for workplace exposures is warranted.

Modeling and comparison of costs and high-risk variant detection between a genetic counseling chatbot and a traditional genetic counseling pathway (169)

Modeling and comparison of costs and high-risk variant detection between a genetic counseling chatbot and a traditional genetic counseling pathway (169)

Investigation of germline variants in Bahraini women with breast cancer using next-generation sequencing based-multigene panel.

Germline variants in BRCA1 and BRCA2 (BRCA1/2) genes are the most common cause of hereditary breast cancer. However, a significant number of cases are not linked to these two genes and additional high-, moderate- and low-penetrance genes have been identified in breast cancer. The advent of next-generation sequencing (NGS) allowed simultaneous sequencing of multiple cancer-susceptibility genes and prompted research in this field. So far, cancer-predisposition genes other than BRCA1/2 have not been studied in the population of Bahrain. We performed a targeted NGS using a multi-panel covering 180 genes associated with cancer predisposition to investigate the spectrum and frequency of germline variants in 54 women with a positive personal and/or family history of breast cancer. Sequencing analysis revealed germline variants in 29 (53.7%) patients. Five pathogenic/likely pathogenic variants in four DNA repair pathway-related genes were identified in five unrelated patients (9.3%). Two BRCA1 variants, namely the missense variant c.287A>G (p.Asp96Gly) and the truncating variant c.1066C>T (p.Gln356Ter), were detected in two patients (3.7%). Three variants in non-BRCA1/2 genes were detected in three patients (1.85% each) with a strong family history of breast cancer. These included a monoallelic missense variant c.1187G>A (p.Gly396Asp) in MUTYH gene, and two truncating variants namely c.3343C>T (p.Arg1115Ter) in MLH3 gene and c.1826G>A (p.Trp609Ter) in PMS1 gene. Other variants of uncertain significance (VUS) were also detected, and some of them were found together with the deleterious variants. In this first application of NGS-based multigene testing in Bahraini women with breast cancer, we show that multigene testing can yield additional genomic information on low-penetrance genes, although the clinical significance of these genes has not been fully appreciated yet. Our findings also provide valuable epidemiological information for future studies and highlight the importance of genetic testing, and an NGS-based multigene analysis may be applied supplementary to traditional genetic counseling.

성별 소수자에 대한 상담이론별 개입 실제

This study is driven by the recognition of a lack of research on counseling interventions andpractices tailored to gender minority clients, despite the prevalence of such clients in real-lifecounseling settings. As a result, this study aims to explore and summarize studies on theoreticalcounseling approaches for gender minority clients based on overseas research. To achieve thisresearch goal, this study summarizes results of studies published in academic journals from 2012to 2022. Research on counseling interventions for gender minority clients can be broadlycategorized into two main groups: affirmative counseling and traditional counseling theoriesculturally adapted to gender minority clients. This study presents the specifics of interventionsbased on the classification of affirmative counseling and traditional counseling theories. Finally,implications for counseling for gender minority clients are provided.

집단상담자의 화상회의 집단상담 경험에 관한 질적연구

Purpose: Whilst traditional counseling has been conducted in-person, videoconferencing counseling modality was widely adopted during COVID-19. This study aims to explore the group counselors’ experiences of videoconferencing group therapy by focusing on coping experiences. Method: Participants of the study were six group counselors. They had more than three videoconferencing group therapy experiences with masters or doctoral degree in the field of counseling, and had more than 5 years of counseling experiences. In-depth interviews were conducted once or twice per participant, and were recorded and transcribed. Data were analyzed using the Constant Comparative Analysis Method. Results: Results of the study are as follows; Efforts outside of videoconferencing group therapyg, Having control over group members and groups, Utilizing technology to facilitate interaction, Intervene in difficult group members and situations, and Positive attitude toward videoconferencing group therapy. Participants' experiences of were summarized as 'understanding the pros and cons of videoconferencing group therapy and creatively coping with difficulties arising inside and outside of the group by using technology and expertise'. Conclusion: Suggestions were proposed for future videoconferencing group therapy. Finally, the implications and limitations of the study were discussed.

Same day service: A genetic testing station model to improve germline genetic testing in patients with ovarian cancer

ObjectiveGenetic testing for ovarian cancer (OC) patients is essential to consideration of PARP inhibitor therapy. To improve access, we piloted a Genetic Testing Station (GTS) allowing patients to have a same-day genetic testing visit facilitated by Genetic Counselor Assistants (GCAs) under the supervision of Genetic Counselors (GCs). MethodsThe GTS was implemented December 2018 and operated through February 2020. Gynecologic Oncologists offered ovarian cancer patients a same-day GTS visit with a GCA. The patient received education via videos designed by GCs and then provided consent, a brief family history, and a sample for a standardized 133-gene panel. Results were provided by a GC. Patients were retrospectively identified by querying the medical record for OC patients seen 12 months prior to and 18 months after GTS implementation. ResultsA total of 482 patients pre-GTS were compared to 625 patients post-GTS. Genetic testing increased from 68.5% to 75.4% (p = 0.012) after implementation, primarily in patients with epithelial histologies (80% vs 89% in pre-GTS vs post-GTS, p = 0.005). Time from referral for genetic testing to obtaining results was evaluated in the post-GTS cohort, comparing patients who had traditional counseling to those who utilized the GTS. Time to obtaining results was 21 days in the GTS group (95% CI [10, 34]) compared to 56 days (95% CI [41,76]) in the traditional genetic counseling group. ConclusionsThe GTS reduces barriers to care and facilitates discussion of precision treatment within a timely fashion while optimizing GC clinic time. Access improvement remains integral to improving uptake of genetic testing.

ASO Visual Abstract:A Randomized Trial Comparing the Effectiveness of Pre-test Genetic Counseling Using an Artificial Intelligence Automated Chatbot and Traditional In-person Genetic Counseling in Women Newly Diagnosed with Breast Cancer.

ASO Visual Abstract:A Randomized Trial Comparing the Effectiveness of Pre-test Genetic Counseling Using an Artificial Intelligence Automated Chatbot and Traditional In-person Genetic Counseling in Women Newly Diagnosed with Breast Cancer.

Creating a bereavement memorial protocol using art therapy: Reflecting on two case studies

Art therapy in South Africa has focused on counselling and grief work but not on modelling a persistent complex bereavement memorial protocol as a viable alternative to traditional bereavement counselling. This article addresses this gap in practice and literature in the following ways: Investigating an organically modelled and observed bereavement process reflected in the form of interviews. Analysing the literature that will support this hypothesis, consider how this art-based therapeutic bereavement memorial protocol can provide a viable alternative to traditional bereavement counselling. Investigating how the use of art materials in the form of clay-work in this research can support healing and a safe place to process persistent complex grief processing. The methodology of this article is a qualitative arts-based inquiry extracting the information of an organically modelled process observing two bereavement case studies of two mothers processing persistent complex grief through the action of using the clay processing to the attachment onto a surface, creating bereavement artworks as memory capsules to support their unique mourning processes. The time frame of two years of observing, recording and creating a thematic analysis and synthesis is likened to the mourning process of persistent complex grief. Using a supporting psychodynamic investigation from an extensive literature review enables a unique art therapy bereavement protocol that could be used as an alternative to traditional grief and bereavement counselling. Furthermore, through the action of clay-work with an extension to paper collage to ‘piece together’ memories integrating the loss of a loved one into a life without them.

Evidence Based Nursing Penatalaksanaan Stroke melalui Penggunaan Mobile Health Terhadap Pengendalian Paska Stroke

This study aims to analyze the effectiveness of using the mHealth application in stroke patients in post-stroke control. The method used is an article search using electronic databases such as the Cochrane Library, Ebsco, Pubmed, Sage Journals, and Science Direct. The study results show that an indicator of effectiveness is that mHealth can prevent secondary strokes in stroke patients and prevent disability in post-stroke patients. Were 199 articles found, and then nine were selected for criticism/analysis. Among the nine articles found in this study, the patient characteristics were almost the same, and it was found that mHealth was effective in post-stroke control, namely secondary stroke prevention and post-stroke disability management. In conclusion, mHealth is the best tool for post-stroke control compared to traditional health counseling, community essential health services, conventional daily programs, or classic pamphlets.&#x0D; &#x0D; Keywords: Cellular Health, Disability Management, Secondary Prevention, Stroke

1065-P: Utilizing a Novel Telemedicine Clinic for Managing Patients with Type 2 Diabetes

Objective: To examine whether a new Diabetes Telemedicine (DT) clinic can lead to improved glycemic control compared to standard of care (SoC). Design: Pilot RCT of patients with type 2 diabetes (T2D) randomized to DT clinic or SoC. DT intervention comprised of continuous glucose monitoring, “connected” insulin pens/caps, telecommunication systems (i.e. video conferencing, online messaging and telephone) and promoting physical activity (PA) by providing brief counseling and exercise physiologist consultation. SoC was managed using point of care glucometer, traditional insulin pens, in-person visits and provider counseling on PA. Primary outcome was change in HbA1c. Secondary outcomes were time in range (TIR) 70-180 mg/dl, time above range (TAR)&amp;gt;180 mg/dl and time below range (TBR)&amp;lt; 70 mg/dl. Patients also completed senior fitness test, assessed by Hedge’s g effect size. Results: A total of 18 patients (17 male) have been recruited, 11 patients were black and 7 white, all non-Hispanic. 14 completed 90 days in the trial. Non statistically significant differences were seen. DT had an 1.6% (mean SE 0.60) HbA1c reduction vs 0.4 (0.69) in SoC [difference -1.2% (0.92), p=0.19]. TIR 70-180 mg/dl increased 8.5% (13.6) (DT) vs 4.4% (15.8) (SoC) [difference +4.1% (20.8), p=0.84]. DT had a decrease in TAR&amp;gt;180 mg/dl of 8.7% (13.7) compared to 4.4% (15.8) in SoC [difference -4.3% (21.0), p=0.85] and TBR&amp;lt;70 mg/dl 0.16% (0.60) (DT) vs 0.13% (0.69) (SoC) [difference of 0.03% (0.92), p=0.97]. DT had improved aerobic capacity (6-minute walk test 402±62 to 418±69m, g=0.53) and strength in the lower- (30-second chair stand 9.0±2.6 to 11.5±2.6 stands, g=0.91) and upper-body (30-second weighted arm curl 17.4±5.3 to 21.0±6.3 curls, g=0.72). SoC had no meaningful changes in aerobic capacity or lower/upper-body strength (g=-0.05 to 0.18). Conclusion: Patients with T2D managed with DT had a non-statistically significant improvement of glucose control and improved physical fitness performance compared to patients in SoC. Disclosure F.Sotomayor: None. I.Spanakis: Research Support; Dexcom, Inc. C.Gothong: None. R.Hernandez: None. G.I.Ash: None. W.H.Scott: None. L.Pinault: None. F.Gomez-peralta: Advisory Panel; Abbott Diabetes, Insulcloud S.L., Speaker's Bureau; A. Menarini Diagnostics, Boehringer Ingelheim and Eli Lilly Alliance, Lilly Diabetes, Novartis, Novo Nordisk. L.G.Singh: None. J.D.Sorkin: None.

Defining critical educational components of informed consent for genetic testing: views of US-based genetic counselors and medical geneticists.

The Clinical Genome Resource (ClinGen) Consent and Disclosure Recommendation (CADRe) framework proposes that key components of informed consent for genetic testing can be covered with a targeted discussion for many conditions rather than a time-intensive traditional genetic counseling approach. We surveyed US genetics professionals (medical geneticists and genetic counselors) on their response to scenarios that proposed core informed consent concepts for clinical genetic testing developed in a prior expert consensus process. The anonymous online survey included responses to 3 (of 6 possible) different clinical scenarios that summarized the application of the core concepts. There was a binary (yes/no) question asking respondents whether they agreed the scenarios included the minimum necessary and critical educational concepts to allow an informed decision. Respondents then provided open-ended feedback on what concepts were missing or could be removed. At least one scenario was completed by 238 respondents. For all but one scenario, over 65% of respondents agreed that the identified concepts portrayed were sufficient for an informed decision; the exome scenario had the lowest agreement (58%). Qualitative analysis of the open-ended comments showed no consistently mentioned concepts to add or remove. The level of agreement with the example scenarios suggests that the minimum critical educational components for pre-test informed consent proposed in our prior work is a reasonable starting place for targeted pre-test discussions. This may be helpful in providing consistency to the clinical practice of both genetics and non-genetics providers, meeting patients' informational needs, tailoring consent for psychosocial support, and in future guideline development.

Technology-enhanced acceleration of germline evaluation for therapy (TARGET): Results of a randomized controlled trial of a pretest patient-driven webtool vs. genetic counseling for prostate cancer germline testing.

10598 Background: Germline genetic testing is important for prostate cancer management, clinical trial eligibility and hereditary cancer risk assessment. Despite this, genetic testing is underutilized and there is a shortage of genetic counselors. To address these gaps, we designed a webtool to provide patient-driven genetic education and conducted a randomized non-inferiority trial to compare it with traditional pre-test genetic counseling. Methods: TARGET is a multi-center randomized controlled trial comparing standard pre-test genetic counseling versus web-based genetic education (intervention) (NCT04447703). The study protocol was previously published (PMID 35710085). Briefly, patients with prostate cancer who met criteria for germline testing (based on tumor features, ancestry or family history) were randomized to pre-test genetic education through genetic counseling vs a 9-module webtool created by the study team and Prostate Cancer Foundation. The primary endpoint was non-inferiority in reducing decisional conflict between the webtool and genetic counseling by a margin of 4 (set in advance) on the validated Decision Conflict Scale. Analysis of covariance was used to compare decisional conflict between groups. All participants opting for testing received a 51-gene Invitae panel, with results delivered to the patient and their provider. Results: 346 patients with prostate cancer with a mean age of 63.7 years were randomized to genetic counseling (n=174) or web-based genetic education (n=172). Compared to baseline, there were reductions in decisional conflict in both arms following pre-test genetic education (Table). Adjusting for study site and baseline decisional conflict, the test of non-inferiority in reducing decisional conflict between arms was statistically significant (difference = -0.04, 95% CI: -∞ to 1.95, p&lt;0.001). Overall 265 (76.6%) participants underwent genetic testing, including 146 (83.9%) in the genetic counseling and 119 (69.2%) in webtool arm, with the following results: negative (49.4%), variant of uncertain significance (35.5%) and pathogenic variant (15.1%). Conclusions: Delivery of pre-test genetic education through a webtool was non-inferior to genetic counseling in reducing decisional conflict. These results support a new standard of care for the use of patient-driven digital webtools for expanding access to pretest genetic education and informed decision-making for prostate cancer genetic testing. Clinical trial information: NCT04447703 . [Table: see text]

Patient decision support resources inform decisions about cancer susceptibility genetic testing and risk management: a systematic review of patient impact and experience.

Patients with genetic cancer susceptibility are presented with complex management options involving difficult decisions, for example about genetic testing, treatment, screening and risk-reducing surgery/medications. This review sought to explore the experience of patients using decision support resources in this context, and the impact on decision-making outcomes. Systematic review of quantitative, qualitative and mixed-methods studies involving adults with or without cancer who used a decision support resource pre- or post-genetic test for any cancer susceptibility. To gather a broad view of existing resources and gaps for development, digital or paper-based patient resources were included and not limited to decision aids. Narrative synthesis was used to summarise patient impact and experience. Thirty-six publications describing 27 resources were included. Heterogeneity of resources and outcome measurements highlighted the multiple modes of resource delivery and personal tailoring acceptable to and valued by patients. Impact on cognitive, emotional, and behavioural outcomes was mixed, but mainly positive. Findings suggested clear potential for quality patient-facing resources to be acceptable and useful. Decision support resources about genetic cancer susceptibility are likely useful to support decision-making, but should be co-designed with patients according to evidence-based frameworks. More research is needed to study impact and outcomes, particularly in terms of longer term follow-up to identify whether patients follow through on decisions and whether any increased distress is transient. Innovative, streamlined resources are needed to scale up delivery of genetic cancer susceptibility testing for patients with cancer in mainstream oncology clinics. Tailored patient-facing decision aids should also be made available to patients identified as carriers of a pathogenic gene variant that increases future cancer risks, to complement traditional genetic counselling. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020220460, identifier: CRD42020220460.

Genetic Testing for Familial Hypercholesterolemia in Clinical Practice.

Genetic testing has proven utility in identifying and diagnosing individuals with FH. Here we outline the current landscape of genetic testing for FH, recommendations for testing practices and the efforts underway to improve access, availability, and uptake. Alternatives to the traditional genetic testing and counseling paradigm for FH are being explored including expanding screening programs, testing in primary care and/or cardiology clinics, leveraging electronic communication tools like chatbots, and implementing direct contact approaches to facilitate genetic testing of both probands and at-risk relatives. There is no consensus on if, when, and how genetic testing or accompanying genetic counseling should be provided for FH, though traditional genetic counseling and/or testing in specialty lipid clinics is often recommended in expert statements and professional guidelines. More evidence is needed to determine whether alternative approaches to the implementation of genetic testing for FH may be more effective.

TeleNEwCARe: An Italian case-control telegenetics study in patients with Hereditary NEuromuscular and CARdiac diseases

Telemedicine provides healthcare services remotely and represents a fundamental resource for the management of rare and fragile patients. Tele-health implementation is a main objective of the European Reference Networks (ERNs) mission to accelerate diagnosis for rare diseases.TeleNewCARe is a pilot case-control project which evaluates the efficacy and satisfaction of telegenetics for neuromuscular and cardiac adult patients, compared to face-to-face genetic counselling. The virtual sessions were co-hosted by a medical geneticist and a neurologist/cardiologist. Specific questionnaires (Clinical Genetics Satisfaction Questionnaire (CGS), Telemedicine Satisfaction Questionnaire (TSQ) and a Satisfaction Questionnaire for medical geneticists) were used to assess the effectiveness and fulfilment of telecounselling, both for patients and health care providers.Satisfaction expressed for telegenetics did not significantly differ from face-to-face counselling. The virtually enrolled patients declared they had the possibility to relate confidentially with the specialists, to share information and to be informed in an exhaustive way about their disease. Almost all patients declared themselves willing to reuse the telecounselling in the future. The multidisciplinary care was perceived as a significant added value. No overt technical problems were reported although the need for digital skills and tools can limit patients’ compliance.Our experience supports telegenetics as a valid alternative to traditional genetic counselling in cardiac and neuromuscular patients. This innovative approach facilitates multidisciplinary care, grants a periodical follow up, without forcing patients to discomfortable travelling, and allows to maintain expert care. This result meets the ERNs needs to reduce patients’ burden to access and monitor their healthcare.

From traditional counselling to health-promoting conversations? Registered nurses' experiences of providing health counselling to people living with severe mental ill-health in supported housing.

People with severe mental ill-health have lower life expectancies than the rest of the population, partly due to unhealthy lifestyles. Counselling to help these people improve their health can also be complex, and registered nurses are key to its success. The aim of this study was to elucidate registered nurses' experiences of providing health counselling to people living with severe mental ill-health in supported housing. We conducted eight individual semi-structured interviews with registered nurses working in this context and subjected the responses to qualitative content analysis. The results show that registered nurses who counsel people with severe mental ill-health feel dispirited, but they defend their often fruitless endeavours and strive, through health counselling, to help these people meet healthier lifestyle goals. Shifting the focus from traditional health counselling to person-centred care using health-promoting conversations could strengthen registered nurses in their efforts towards improving lifestyles among people living with severe mental ill-health in supported housing. Therefore, to facilitate healthier lifestyles among this population, we recommend that community healthcare support registered nurses working in supported housing by educating them in the use of health-promoting conversations, including teach-back techniques.

Evaluating remote post-fitting support services for over-the-counter hearing devices

Over-the-counter (OTC) hearing aids are a more affordable and accessible option for many individuals with mild-to-moderate hearing loss. However, many clinicians and industry partners are apprehensive about how successful these new hearing aid (HA) users will be without the traditional support of audiologists. Much effort has gone into making the fitting and personalization of hearing aids accessible for OTC customers, but other post-fitting support services have not yet been translated to a remote format. Specifically, the individualized counseling audiologists traditionally provide is currently inaccessible to new HA users. The aim of this study is to explore ways of translating important aspects of audiologic counseling that contribute to satisfaction, use, and retention of HAs, to a format that is not dependent upon services provided within the clinic. Individuals with mild-to-moderate hearing loss were recruited and randomly assigned to one of three treatment groups: (1) a traditional clinical treatment model; (2) a model reflective of the typical “hands off” OTC experience; or (3) a non-clinical model with orientation and personalized counseling materials provided in a remote format. We hypothesize that individuals receiving personalized counseling remotely will be as successful as those receiving traditional clinical counseling, and more successful than typical OTC customers.

Incorporating Traditional Games in Group Counseling: Its Impact on Social Intelligence

The present work explores the impact of incorporating Gorontalo traditional games in group counseling on the social intelligence of students. It employed a pre-experimental design with a one-group pre-test and post-test. Variable X and Y refer to traditional game-based group counseling and social intelligence, respectively. The subject involved 15 students of SMPN 1 Tapa, Bone Bolango Regency. All data were retrieved from questionnaires and were further analyzed using the T-test. The result of hypothesis testing reveals that tcount (18.917) &gt; ttable (2.98). In other words, Gorontalo traditional games in group counseling are significant to the social intelligence of the students.

Abstract P027: Interest and uptake rates for cancer risk genetic testing in the AHEAD early detection program

Abstract Genetic testing for hereditary breast and ovarian cancer syndrome (HBOC) and Lynch syndrome have both been defined as Tier 1 genomic applications for their significant potential for positive impact on public health, as early cancer interception could greatly reduce mortality among the millions of people at increased risk. However, the integration of this genetic screening into standard-of-care workflows has proven to be challenging due to factors such as clinical resources, patient access, cost and insurance, or patient education and perceptions. More recently, alternative care-delivery models such as tele genetics or “mainstreaming” genetic testing have been popularized as a route to providing more access and less burden that the traditional referral-based pre-test counseling model. This study analyzed the uptake of recommended genetic testing for hereditary cancer from the Adventist Health Early All-Around Detection (AHEAD) program, which is a system-wide initiative aimed at expanding access to genetic screening for cancer risk. The purpose of this analysis is to understand associations between the uptake of genetic testing, and factors such as population demographics, socioeconomics, or care-delivery models, in order to inform and improve the implementation design of the AHEAD program and similar efforts, ultimately improving care and outcomes for the whole patient population. A retrospective data analysis was performed from January 2021 to July 2022 of individuals from 48 clinical locations across California, Oregon, and Hawaii, who went through the AHEAD screening program. A total of 4,922 out of 19,258 individuals met NCCN criteria for HBOP and Lynch syndrome. Of these “high-risk” individuals, 2,666 (54.2%) were interested in genetic testing and of those, 2,313 (86.8%) underwent testing. The analysis demonstrated that interest in genetic testing differed among patient age groups (243, 49.4% in Under 30; 426, 58% in 30-40; 597, 60% in 40-50; 574, 56.7% in 50-60; 501, 50% in 60-70 and 325, 47.6% in 70 and above) and clinic types (1549, 62.5% RHC vs. 663, 52.5% non-RHC). Of patients that were interested, those who went through a single-appointment, point-of-care testing (POCT) model were more likely to follow through with testing than a multiple-appointment, non-POCT model (odds ratio of 1.5, 95% confidence interval of 1.18 to 1.91). The study results showed that interest and uptake of genetic testing may be influenced by demographic or socioeconomic factors, as well as care-delivery models. The difference in testing follow through may indicate that POCT could be a more effective model for increasing genetic testing in certain populations. These results from the AHEAD program suggest that alternative care-delivery models such as telegenetics or "mainstreaming" can provide patients access to genetic screening. Future work should focus on understanding barriers and attitudes among different groups and designing targeted strategies for increasing genetic testing uptake across all groups. Citation Format: Candace Theal Westgate. Interest and uptake rates for cancer risk genetic testing in the AHEAD early detection program. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P027.

Applications of Relational-Cultural Theory for Social Justice in Mental Health Counseling

A long-standing challenge in counseling practice is the application of multicultural and social justice competencies through traditional counseling paradigms, many of which uphold systems of oppression. Although contemporary standards for the profession emphasize the need for greater attention to systemic influences on clients’ lives, enacting frameworks such as the Multicultural and Social Justice Counseling Competencies (MSJCC) proposed by Ratts et al. without a complementary theoretical framework can be challenging for mental health counselors. Relational-cultural theory (RCT) offers such a framework to support counselors’ efforts to serve marginalized clients, as well as understand their own oppressed identities in the counseling room. Following an overview of RCT, the authors describe practical guidelines for enacting the MSJCC through RCT in clinical practice. A case study is provided to illustrate a workable application for mental health counselors.