Highlights
- •Women randomized to the intervention had greater knowledge of hereditary cancer and genetic counseling.
- •Women receiving the intervention were more likely to talk with their family about genetic counseling.
- •Women demonstrated greater self-efficacy in making a genetic counseling appointment.
- •Participants in both the intervention and control groups reported high utilization of genetic counseling services.
Abstract
Objective
Despite current guidelines recommending women with ovarian cancer receive genetic
risk evaluation by a genetic counselor, utilization has historically been low. We
sought to assess the feasibility and effectiveness of a week-long mobile Application
for Genetic Information on Cancer (mAGIC) intervention aimed to persuade women with
ovarian cancer to pursue genetic counseling.
Methods
The mobile application intervention was based on the Fogg Behavior Model, and consisted
of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing
triggers to action. The Health Belief Model was used to guide content development.
We conducted a prospective, randomized, controlled pilot trial among 104 untested
women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer
with the primary objective of increasing uptake of cancer genetic counseling services.
Results
Utilization of cancer genetic counseling services improved in both study arms over
historical controls, however there was no statistically significant difference between
them (intervention: 54.5% versus control: 38.6%; p = 0.14). However, compared to controls,
women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary
cancer (0–10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least
three months. Additionally, 96% of women in the intervention group reported they had
talked with their family about genetic counseling compared to 77% in the control group
(p = 0.01).
Conclusions
The mAGIC intervention did not result in increased uptake of genetic counseling, however
it provided significant secondary benefits, including increased participants' knowledge
about hereditary ovarian cancer, self-efficacy, and their reported communication with
family members.
ClinicalTrials.gov Identifier: NCT02877862
Keywords
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Article info
Publication history
Published online: February 01, 2019
Accepted:
January 22,
2019
Received in revised form:
January 17,
2019
Received:
October 4,
2018
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
