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. 2022 Jul 18;12(7):800-809.
doi: 10.1093/tbm/ibac018.

Motivating cascade testing for familial hypercholesterolemia: applying the extended parallel process model for clinician communication

Gemme Campbell-Salome  1   2 , Nicole L Walters  1 , Ilene G Ladd  1 , Amanda Sheldon  3 , Catherine Davis Ahmed  3 , Andrew Brangan  1 , Megan N McMinn  1 , Alanna K Rahm  1 , Marci L B Schwartz  1 , Eric Tricou  1 , Carla L Fisher  2 , Amy C Sturm  1   4
Affiliations

Motivating cascade testing for familial hypercholesterolemia: applying the extended parallel process model for clinician communication

Gemme Campbell-Salome et al. Transl Behav Med. .

Abstract

Motivating at-risk relatives to undergo cascade testing for familial hypercholesterolemia (FH) is critical for diagnosis and lifesaving treatment. As credible sources of information, clinicians can assist in family communication about FH and motivate cascade testing uptake. However, there are no guidelines regarding how clinicians should effectively communicate with probands (the first person diagnosed in the family) and at-risk relatives. Individuals and families with FH can inform our understanding of the most effective communications to promote cascade testing. Guided by the extended parallel process model (EPPM), we analyzed the perspectives of individuals and families with FH for effective messaging clinicians can use to promote cascade testing uptake. We analyzed narrative data from interviews and surveys collected as part of a larger mixed-methods study. The EPPM was used to identify message features recommended by individuals and families with FH that focus on four key constructs (severity, susceptibility, response efficacy, self-efficacy) to promote cascade testing. Participants included 22 individuals from 11 dyadic interviews and 98 survey respondents. Participants described prioritizing multiple messages that address each EPPM construct to alert relatives about their risk. They illustrated strategies clinicians could use within each EPPM construct to communicate to at-risk relatives about the importance of pursuing diagnosis via cascade testing and subsequent treatment for high cholesterol due to FH. Findings provide guidance on effective messaging to motivate cascade testing uptake for FH and demonstrates how the EPPM may guide communication with at-risk relatives about genetic risk and motivate cascade testing broadly.

Keywords: Cascade testing; Familial hypercholesterolemia; Genetic testing; Health communication; Risk communication; extended parallel process model.

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Figures

Fig. 1
Fig. 1
Key themes for applying the EPPM to clinicians’ risk communication.
See this image and copyright information in PMC

References

    1. Abul-Husn NS, Manickam K, Jones LK, et al. Genetic identification of familial hypercholesterolemia within a single US health care system. Science 2016;354(6319):aaf7000. - PubMed
    1. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):e285–e350. - PubMed
    1. Khera AV, Won HH, Peloso GM, et al. Diagnostic yield and clinical utility of sequencing familial hypercholesterolemia genes in patients with severe hypercholesterolemia. J Am Coll Cardiol. 2016;67(22):2578–2589. - PMC - PubMed
    1. Luirink IK, Wiegman A, Kusters DM, et al. 20-Year follow-up of statins in children with familial hypercholesterolemia. N Engl J Med. 2019;381(16):1547–1556. - PubMed
    1. Nordestgaard BG, Chapman MJ, Humphries SE, et al. ; European Atherosclerosis Society Consensus Panel . Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. Eur Heart J. 2013;34(45):3478–390a. - PMC - PubMed

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