Journal of Genetic Counseling

, Volume 23, Issue 5, pp 838–848 | Cite as

Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk

  • Kimberly M. Kelly
  • Lee Ellington
  • Nancy Schoenberg
  • Parul Agarwal
  • Thomas Jackson
  • Stephanie Dickinson
  • Jame Abraham
  • Electra D. Paskett
  • Howard Leventhal
  • Michael Andrykowski
Original Research


Few studies have linked actual genetic counseling content to short-term outcomes. Using the Self-regulation Model, the impact of cognitive and affective content in genetic counseling on short-term outcomes was studied in individuals at elevated risk of familial breast-ovarian cancer. Surveys assessed dependent variables: distress, perceived risk, and 6 knowledge measures (Meaning of Positive Test; Meaning of Negative Test; Personal Behavior; Practitioner Knowledge; Mechanisms of Cancer Inheritance; Frequency of Inherited Cancer) measured at pre- and post-counseling. Proportion of participant cognitive and affective and counselor cognitive and affective content during sessions (using LIWC software) were predictors in regressions. Knowledge increased for 5 measures and decreased for Personal Behavior, Distress and Perceived Risk. Controlling for age and education, results were significant/marginally significant for three measures. More counselor content was associated with decreases in knowledge of Personal Behavior. More participant and less counselor affective content was associated with gains in Practitioner Knowledge. More counselor cognitive, and interaction of counselor cognitive and affective content, were associated with higher perceived risk. Genetic counselors dominate the content of counseling sessions. Therefore, their content is tied more closely to short term outcomes than participant content. A lack of patient communication in sessions may pose problems for understanding of complex concepts.


Cancer Oncology Breast cancer Genetic counseling Perceived risk Knowledge 



This work was supported by the National Cancer Institute at the National Institutes of Health (R03 CA128459-01A2 Kelly, PI).

Conflict of Interest

“The authors have no conflict of interest with the content of this manuscript.”

Informed Consent

“All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.”

“I confirm all patient/personal identifiers have been removed or disguised so the patient/person(s) described are not identifiable and cannot be identified through the details of the story.”


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Copyright information

© National Society of Genetic Counselors, Inc. 2014

Authors and Affiliations

  • Kimberly M. Kelly
    • 1
    • 2
    • 8
  • Lee Ellington
    • 3
  • Nancy Schoenberg
    • 4
  • Parul Agarwal
    • 1
  • Thomas Jackson
    • 5
  • Stephanie Dickinson
    • 5
  • Jame Abraham
    • 2
  • Electra D. Paskett
    • 6
  • Howard Leventhal
    • 7
  • Michael Andrykowski
    • 4
  1. 1.School of PharmacyWest Virginia UniversityMorgantownUSA
  2. 2.Mary Babb Randolph Cancer CenterWest Virginia UniversityMorgantownUSA
  3. 3.School of NursingUniversity of UtahSalt Lake CityUSA
  4. 4.Department of Behavioral ScienceUniversity of KentuckyLexingtonUSA
  5. 5.Department of StatisticsIndiana UniversityBloomingtonUSA
  6. 6.Comprehensive Cancer CenterThe Ohio State UniversityColumbusUSA
  7. 7.Department of PsychologyRutgers, the State University of New JerseyNew BrunswickUSA
  8. 8.School of Pharmacy and Mary Babb Randolph Cancer Center, Robert C. Byrd Health Sciences CenterWest Virginia UniversityMorgantownUSA

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