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Multicenter Study
. 2021 Aug:58:80-87.
doi: 10.1016/j.breast.2021.04.008. Epub 2021 Apr 22.

Effect of a health literacy training program for surgical oncologists and specialized nurses on disparities in referral to breast cancer genetic testing

Jeanine A M van der Giessen  1 , Sandra van Dulmen  2 , Mary E Velthuizen  1 , Maria E T C van den Muijsenbergh  3 , Klaartje van Engelen  4 , Margriet Collée  5 , Thijs van Dalen  6 , Cora M Aalfs  7 , Maartje J Hooning  8 , Peter M M Spreeuwenberg  9 , Mirjam P Fransen  10 , Margreet G E M Ausems  11
Affiliations
Multicenter Study

Effect of a health literacy training program for surgical oncologists and specialized nurses on disparities in referral to breast cancer genetic testing

Jeanine A M van der Giessen et al. Breast. 2021 Aug.

Abstract

Background: There is an underuse of genetic testing in breast cancer patients with a lower level of education, limited health literacy or a migrant background. We aimed to study the effect of a health literacy training program for surgical oncologists and specialized nurses on disparities in referral to genetic testing.

Methods: We conducted a multicenter study in a quasi-experimental pre-post (intervention) design. The intervention consisted of an online module and a group training for surgical oncologists and specialized nurses in three regions in the Netherlands. Six months pre- and 12 months post intervention, clinical geneticists completed a checklist with socio-demographic characteristics including the level of health literacy of each referred patient. We conducted univariate and logistic regression analysis to evaluate the effect of the training program on disparities in referral to genetic testing.

Results: In total, 3179 checklists were completed, of which 1695 were from hospital referrals. No significant differences were found in educational level, level of health literacy and migrant background of patients referred for genetic testing by healthcare professionals working in trained hospitals before (n = 795) and after (n = 409) the intervention. The mean age of patients referred by healthcare professionals from trained hospitals was significantly lower after the intervention (52.0 vs. 49.8, P = 0.003).

Conclusion: The results of our study suggest that the health literacy training program did not decrease disparities in referral to genetic testing. Future research in a more controlled design is needed to better understand how socio-demographic factors influence referral to breast cancer genetic testing and what other factors might contribute.

Keywords: Access to care; Breast cancer genetic testing; Communication; Health literacy; Referral; Training program.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Study design health literacy training program.
See this image and copyright information in PMC

References

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