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PubMed1993

A study of the dietary counseling practices among Oregon dental hygienists.

PURPOSE: The purpose of the study was to identify the dietary counseling practices of Oregon dental hygienists. Factors which affect the extent of dietary counseling were examined, including the dental hygienists' attitude, confidence, personal dietary practices, and perception of practice constraints. METHODS: A 25-item survey was mailed in summer 1989 to a random sample of 300 Oregon licensed dental hygienists. Likert-scaled statements were used to measure the extent of dietary counseling activities and the factors which affect their extent. Multiple-choice questions measured nutrition knowledge and quality of dietary counseling. Descriptive statistics were computed for each variable. Data were analyzed at the p<.05 significance level. Hypotheses testing included Pearson product-moment correlation, one-way analysis of variance (ANOVA), and chi-square. RESULTS: Of the 212 respondents (72% adjusted response rate), 52% reported providing dietary counseling. Ninety-six percent reported that they did not obtain dietary intake records and 82% did not evaluate their patients' diets for nutritional adequacy. A significant positive relationship (r=.19) was found between the hygienists' nutrition knowledge and quality of dietary counseling. Extent of counseling and the dental hygienist's confidence in nutrition knowledge and dietary counseling skills were found to be significantly related (r=-.31). A significant negative relationship (r= -.29) was found between extent of counseling and the dental hygienist's perception of practice constraints, most notably lack of time and cost-effectiveness. CONCLUSIONS: Dietary counseling is provided to a limited extent by dental hygienists in Oregon oral healthcare practices. Dental hygienists should provide this service based on patients' needs and, when necessary, refer patients to nutrition professionals. Further study could assess the nutrition and dietary counseling content and application in dental hygiene curricula.

Attitude of Health Personnel↗
PubMedDate not supplied

Correlates of physician counseling associated with obesity and smoking.

BACKGROUND: Patient, physician, and consultation variables associated with overweight and smoking counseling in general practice consultations were examined. METHODS: A random sample of full-time general practitioners was used. The sample consisted of 7,160 patients from 230 GPs who attended for consultations on consecutive days, and self-reported information from the doctor and the patient was collected via questionnaire. The aim of this paper is to identify variables associated with the doctor's identification of overweight and smoking status and with the occurrence of counseling for these two behavioral risk factors. RESULTS: Forty percent of patients were overweight (BMI > 24) and 25% were self-reported smokers. Doctors identified 59% of overweight patients and 66% of smokers. Doctors only counseled patients identified as having the risk factor, counseling 36% of identified overweight patients and 49% of identified smokers. Identification of overweight was associated with being female, being heavier, having been previously counseled, being less well educated, presenting with an associated condition, and visiting a doctor who is younger and knows the patient's medical history well. Counseling for overweight was associated with being younger, being previously counseled, presenting with an associated condition, presenting for a routine checkup, visiting a GP who generally has longer consultations, having BP measured in the consultation, visiting an older doctor and visiting a doctor who considers identification of risk behaviors important. Identification of smokers was associated with being a heavier smoker, with those who had been previously counseled, with marital status other than single or married, with a BP measurement being taken in the consultation, and with a doctor who believed it possible to influence lifestyle change. Counseling for smoking was associated with younger patients, longer consultations, previous counseling, BP measurement, presenting with an associated condition, and not presenting frequently. CONCLUSIONS: We have identified factors associated with counseling about behavioral risk factors which provide a framework for planning education programs to increase the level of primary preventive activities within general practice.

Adult↗
PubMed2006

Counselling and knowledge about contraceptive mode of action among married women; a cross-sectional study.

BACKGROUND: Family planning counselling which covers knowledge transfer about contraceptive mode of action, by enabling informed choice, improves compliance to and efficiency of contraceptive methods. The objective of this study was to investigate associations between family planning counselling, counsellor and correct knowledge about mode of action of modern contraceptive methods among married women. METHODS: For this cross-sectional study, stratified (according to current modern contraceptive method in use) random sampling was performed from the registries of two primary health care centres. Main outcomes were; prevalence of family planning counselling, professional background of the counsellor and correct knowledge about mode of action. A semi-structured questionnaire developed by the researchers was applied via face-to-face interview. The answers about mode of action were categorized as correct vs. incorrect by consensus rating. RESULTS: Prevalence of counselling and correct knowledge about mode of action was 49.0% and 39.3%, respectively. Higher educated women were significantly more likely to know the mode of action (p < 0.001). Being counselled by a physician (54.1%, n = 120) was not associated with correct knowledge about mode of action (p = 0.79). Non-barrier method users were less educated (p = 0.001), more often counselled (60.8% vs. 8.0%) and less knowledgeable (p < 0.001) about mode of action of their contraceptive method, compared to condom users. Nevertheless, counselled non-barrier method users were significantly more likely to know the correct mode of action of their chosen method (p = 0.021) than counselled condom users. CONCLUSION: The beneficial effect of counselling on knowledge about mode of action of the more complicated, medical (non-barrier) contraceptive methods suggests that the use of family planning counselling services in primary health care should be promoted; furthermore, counselling strategies and content should be re-structured for better efficacy.

Journal Article↗
PubMed1994

Preferences for religious or nonreligious counseling and psychotherapy.

Religious values in counseling and preferences for religious or secular counseling were investigated in two geographic areas. Over-all, 164 respondents distinguished religious from secular counseling and endorsed the importance of religious issues and the availability of counseling which can deal with religious issues. 51 preferred religious counseling. Small minorities expressed biases against religious or nonreligious counseling. Counseling preferences were based on the type of problem: religious counseling was preferred for marriage and family problems, and nonreligious counseling was preferred for mental illness and addiction, but religious and nonreligious counseling were equally chosen for depression. Frequency of church attendance was broadly related to preferences for religious and nonreligious counseling.

Adult↗
PubMed1992

Improving smoking cessation counseling by family practice residents.

BACKGROUND: While programs to train residents in smoking cessation counseling skills have been devised, few have assessed trainee behavioral changes in practice settings where residents were blind to the evaluation of their behavior. This study assessed the effectiveness of a training program in smoking cessation counseling and chart-prompting system in increasing the frequency and quality of counseling by residents at three clinic sites. METHODS: Twenty-eight residents participated in a training program that included epidemiology, discussion of attitudes, counseling techniques, videotaped examples, and small group role play. The chart-prompting system was implemented at two clinics 1 month after training. Patient exit interviews, during which information on resident counseling on smoking cessation was obtained, were conducted before training, after training, at 3-month follow-up, and at 6-month follow-up. Questionnaires assessing knowledge, attitudes, and self-perceived counseling behaviors were completed by residents at pretraining, posttraining, and 6-month follow-up periods. RESULTS: Interviews with 517 smokers were analyzed. Results showed an increase in counseling at 3-month follow-up but a regression toward baseline at 6 months. Counseling improved at clinics where chart prompting was initiated. The number of counseling behaviors decreased when the number of patients seen increased. Whether a patient received counseling was positively associated with prior contact with the physician. There was no correlation between resident self-perception and patient report. CONCLUSIONS: A training program in smoking cessation counseling and a chart-prompting system did not result in a lasting change in resident behavior. System factors may play an important role in long-term behavior change.

Clinical Competence↗
PubMed1994

Pharmacists' perceptions of patients' needs for counseling.

Pharmacists in Wisconsin were surveyed about their assessment of patients' needs for medication counseling and factors that hinder or facilitate counseling. Pharmacists attending regional meetings for a state board of pharmacy project completed the survey. The questionnaire was pretested on pharmacists from one area and refined; the study population then included pharmacists from all areas except this one. Questions were asked about criteria for determining the amount and content of oral counseling, the importance of oral versus written counseling, and factors that impede or facilitate counseling. Responses concerning criteria, barriers, and facilitators were grouped by two judges trained in content analysis. Information was collected about years spent in practice, counselor role orientation (scored on responses to eight statements), type of practice setting and position, and use of technicians and daily prescription volume in that setting. Of 708 pharmacists asked to complete the survey 697 (98%) provided usable responses. Seventy percent of respondents were in community practice; 63% were managing pharmacists; 74% of their practice sites used technicians, and 40% averaged 76-150 prescriptions per day. Patient motivation was the most frequently cited determinant of the amount and type of counseling, followed by type of medication, patient abilities, and time available for counseling. Sixty-one percent of respondents indicated that it was important to give both oral and written counseling. Pharmacists in different practice settings and positions reported different barriers to and facilitators of counseling. Pharmacists in this survey said patient-oriented criteria and type of medication determined the amount and content of counseling given to patients. They said it was important to provide both oral and written counseling.

Attitude of Health Personnel↗
PubMed2001

Genetic counseling and risk communication services of newborn screening programs.

OBJECTIVES: Newborn screening test results labeled "positive" can have uncertain implications for parents, especially when false-positive results occur or when heterozygous infants are detected using molecular tests for sickle cell hemoglobinopathy or cystic fibrosis. This study surveyed communication services across state newborn screening programs. METHODS: We surveyed newborn screening programs to identify current communication practices and the methods used for quality assessment. Two successive survey instruments with fixed-answer and free-answer questions were distributed to screening program follow-up coordinators or similar designated officials associated with 52 states and territories. RESULTS: Replies from 46 respondents (89% response rate) revealed that regional newborn screening programs vary widely in their approaches to counseling. Of the 46 respondents, 35 (76%) answered that they "routinely" provide counseling services to families of affected infants. Depending on the disease, an average of approximately one-half that number provide counseling after false-positive results or for heterozygous infants. Most respondents advocate nondirective counseling more than direct advice. Most programs reported that counseling was usually done by subspecialist physicians or specially trained nurses and counselors. Respondents reported a perception that the "quality" of counseling by these professionals is better than counseling by primary care physicians. Few programs reported systems for assessing quality assurance of counseling. CONCLUSIONS: Newborn screening programs in the United States vary widely with regard to counseling practices, and no best practices are currently evident. Few programs provide counseling quality assurance. Further study and advocacy is needed to optimize communication services, preferably before implementation of molecular tests arising as a result of the Human Genome Project.

Communication↗
PubMed2006

The Genetic Counseling Video Project (GCVP): models of practice.

Genetic counseling is conceptualized as having both "teaching" and "counseling" functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pre-test counseling to simulated clients (SCs). One hundred and seventy-seven GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. One hundred and fifty-two videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor's affective demeanor, and the counselor's use of non-verbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction, affective demeanor, and nonverbal effectiveness.

Adult↗
PubMed1997

Pediatric injury prevention. Preparing residents for patient counseling.

OBJECTIVES: To describe counseling practices on injury prevention and barriers to patient counseling by pediatric residents and determine whether education about injury prevention or use of educational aids promotes this activity in resident ambulatory practices. DESIGN: Cross-sectional mail survey. SETTING: Accredited US pediatric residency programs. PARTICIPANTS: Pediatric chief residents. MAIN OUTCOME MEASURE: Reported frequencies of patient counseling performed on various injury prevention topics. RESULTS: All residents reported that they were expected to educate patients and families about injury prevention in the continuity clinic setting. Almost all residents (98.5%) reported that they counseled on at least 1 injury prevention topic. On all topics except for poisoning prevention, residents were most likely to counsel patients and families on those topics about which they had received education. Additionally, those residents familiar with the American Academy of Pediatrics The Injury Prevention Program included more injury prevention topics in their counseling repertoire (P = .01). The most frequently identified barriers to counseling included lack of information about the topic and lack of time in the visit. CONCLUSIONS: Most pediatric residents counsel their patients and families on a variety of injury prevention topics. This activity is promoted by the education offered during residency training. Focused efforts should be made to educate residents about those injury topics not being taught and to address counseling barriers with educational interventions that promote prevention counseling during patient visits.

Age Factors↗
PubMed2006

Effectiveness and cost effectiveness of counselling in primary care.

BACKGROUND: The prevalence of mental health and psychosocial problems in primary care is high. This review examines the clinical and cost-effectiveness of psychological therapies provided in primary care by counsellors. OBJECTIVES: To assess the effectiveness and cost effectiveness of counselling in primary care by reviewing cost and outcome data in randomised controlled trials for patients with psychological and psychosocial problems considered suitable for counselling. SEARCH STRATEGY: To update the review, the following electronic databases were searched on 25-10-2005: MEDLINE, EMBASE, PsycLIT, CINAHL, the Cochrane Controlled Trials register and the Cochrane Collaboration Depression, Anxiety and Neurosis (CCDAN) trials registers. SELECTION CRITERIA: All controlled trials comparing counselling in primary care with other treatments for patients with psychological and psychosocial problems considered suitable for counselling. Trials completed before the end of June 2005 were included in the review. DATA COLLECTION AND ANALYSIS: Data were extracted using a standardised data extraction sheet. Trials were rated for quality using CCDAN criteria, to assess the extent to which their design and conduct were likely to have prevented systematic error. Continuous measures of outcome were combined using standardised mean differences. An overall effect size was calculated for each outcome with 95% confidence intervals (CI). Continuous data from different measuring instruments were transformed into a standard effect size by dividing mean values by standard deviations. Sensitivity analyses were undertaken to test the robustness of the results. Economic analyses were summarised in narrative form. MAIN RESULTS: Eight trials were included in the review. The analysis found significantly greater clinical effectiveness in the counselling group compared with usual care in the short-term (standardised mean difference -0.28, 95% CI -0.43 to -0.13, n = 772, 6 trials) but not the long-term (standardised mean difference -0.09, 95% CI -0.27 to 0.10, n = 475, 4 trials). Levels of satisfaction with counselling were high. There was some evidence that the overall costs of counselling and usual care were similar. AUTHORS' CONCLUSIONS: Counselling is associated with modest improvement in short-term outcome compared to usual care, but provides no additional advantages in the long-term. Patients are satisfied with counselling. Although some types of health care utilisation may be reduced, counselling does not seem to reduce overall healthcare costs.

Cost-Benefit Analysis↗
PubMed1984

Genetic counseling and reproductive uncertainty.

Of 836 fertile women seeking genetic counseling, 544 (65%) reported that their major reason for doing so was to obtain information to help in deciding if they should have a child. Thirty-four percent of these 836 women entered counseling uncertain about undertaking a pregnancy in the next 2 years. After counseling, 28% of the 836 had uncertain pregnancy intentions. These included 66% of those who were uncertain and 11% of those who were reproductively certain before counseling. Stepwise logistic regression identified the following as independently and significantly associated with reproductive uncertainty after counseling: 1) uncertainty before counseling; 2) uncertainty about ideal family size; 3) concern about the effects of an affected child on the client's social life; 4) perceived serious problems caring for a child with a birth defect now living at home; and 5) new concerns raised in counseling. Reproductive uncertainty after counseling was not related to characteristics of the risked birth defect, level of risk, treatment potential, or client learning of medical and genetic facts. These data suggest that genetic counseling will not eliminate reproductive uncertainty for many clients, because this uncertainty is related to factors mainly outside the usual scope of counseling.

Adolescent↗
PubMed1995

Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners.

BACKGROUND: Previous surveys have shown that there is a disparity between physicians' beliefs about the importance of diet and nutrition in health maintenance and disease prevention and the actual delivery of nutrition counseling. The primary objective of this study was to assess the current attitudes, practice behavior, and barriers to the delivery of nutrition counseling by primary care physicians. METHODS: A random-sample-mailed questionnaire was sent to 2,250 primary care physicians selected from the AMA masterfile from general practice, internal medicine, and pediatrics, representing self-employed, group, hospital, and HMO practices. Participants were stratified by age, gender, geographical region, and present employment. The main outcome measures were to determine time spent by physicians providing and percentage of patients receiving dietary counseling and to identify barriers to the delivery of nutrition counseling. RESULTS: A 49% response rate (n = 1,103) was obtained. Results are presented for the 1,030 physicians (70% private practice) with complete data. Over two-thirds of physicians provide dietary counseling to 40% or less of patients and spend 5 or fewer min discussing dietary changes. Despite this pattern, nearly three-quarters of respondents feel that dietary counseling is important and is the responsibility of the physician. Ranking of perceived barriers to delivery of dietary counseling were lack of time, patient noncompliance, inadequate teaching materials, lack of counseling, training, lack of knowledge, inadequate reimbursement, and low physician confidence. CONCLUSIONS: This survey suggests that multiple barriers exist that prevent the primary care practitioner from providing dietary counseling. A multifaceted approach will be needed to change physician counseling behavior.

Adult↗
PubMed2000

Quality and correlates of physical activity counseling by health care providers in Israel.

BACKGROUND: The quantity and quality of physical activity counseling by the health care provider can have a profound impact on improving the physical activity of the older population. This study presents an estimate of the quality and quantity of physical activity counseling and tests the associations of different variables with physical activity. METHODS: A random telephone survey of 793 Israeli residents between the ages of 45 and 75 was conducted. Counseling by a health care provider was evaluated using a three-stage approach--assess, advise, and assist. RESULTS: Of those visiting a doctor in the last 3 months 22, 16, and 7% were assessed, advised, and assisted, respectively, regarding physical activity by a health care provider. At all three stages, receiving weight reduction counseling was a main variable correlated with receiving physical activity counseling (OR 3.38-2.43). Having a chronic disease was associated with being assessed; smoking and being a recent immigrant were associated with getting assistance on physical activity. Visiting a health care provider in the last 3 months, and being physically active were also associated with counseling. The dietitians and the physicians had the highest quality and rates of counseling in all three stages. CONCLUSION: It seems that a sedentary lifestyle is not regarded as an independent risk factor during counseling, but more as an important part of weight reduction. An evaluation of physical activity counseling by the three stages can be used to assess the quality of the counseling.

Aged↗
PubMed1993

Exercise counseling: how do general internists do?

OBJECTIVE: To assess how often physicians counsel patients about exercise and to identify which primary care internists infrequently counsel about it. DESIGN: Cross-sectional survey of a random sample of primary care internists in Massachusetts. Questions covered physicians' attitudes, beliefs, and practices with respect to counseling about exercise; physicians' perceived barriers to counseling about exercise; physicians' personal exercise frequency; and physician demographics. PARTICIPANTS: Of 1,000 physicians, 687 were eligible and 422 returned usable questionnaires (response rate 61%). RESULTS: Data describing physician demographics, practice setting, measures of personal fitness, and beliefs regarding exercise were entered into a logistic regression model. The characteristic that best identified physicians who infrequently counsel about exercise was their perceived lack of success at counseling (OR 22.83, 95% CI 8.36-62.31). Other independent predictors of infrequent counselling were physicians' lack of conviction that exercise is very important (OR 4.86, 95% CI 1.70-13.91), physician age < or = 40 years (OR 3.08, 95% CI 1.33-7.15), and higher physician resting heart rate (OR 3.45, 95% CI 1.46-8.18). CONCLUSIONS: Several factors were found to be independently associated with the likelihood of a physician's counseling about exercise. These included physician perceived success at counseling, physician belief that exercise is important, physician age, and physician resting heart rate. These results suggest possible strategies to improve physician's counseling efforts.

Adult↗
PubMed2006

Counselling of hearing aid users is highly cost-effective.

Hearing aids (HAs) are often left unused. Several investigations have shown that the use of HAs and the skills to use them can be significantly improved through counselling. Follow-up counselling is often restricted by increased cost. The objective of the study was to assess the cost and the effect of follow-up counselling on HA use. In a prospective pre-post design study, 98 first-time HA users were counselled 6 months after the fitting of a HA, and the use of and benefit from HAs were measured by means of an interview and the short form of the hearing handicap inventory for the elderly (HHIE-S) and the EuroQoL (EQ-5D) questionnaires. The results obtained before and 6 months after counselling were compared and the cost of counselling was calculated. After follow-up counselling, over half of the occasional users of a HA and as many as one third of the non-users became regular users. The number of regular users increased by 16 subjects, and non-users decreased from 29 subjects to 17. The HHIE-S results showed a significant positive change, but the EQ-5D results showed practically no change. The additional expense of follow-up counselling at home was approximately 8.8% (83 euro per visit) of the calculated 942 euro cost of fitting a HA. Bringing one unused HA into regular use required 508 euro. The results show that HA use and the consequent benefit can be significantly increased through counselling. The expense caused by follow-up counselling at home is highly acceptable in addition to the cost of fitting a HA.

Aged↗
PubMed1994

Multiple factors affect dietitians' counseling practices for high blood cholesterol.

OBJECTIVE: To examine the association of factors from social cognitive theory with dietitians' counseling practices for high blood cholesterol. DESIGN: A cross-sectional mail survey of 1,500 dietitians that included a 67-item, specially designed questionnaire to collect data. SUBJECTS: The sample comprised clinical dietitians and dietitians in consulting and private practice who were members of The American Dietetic Association and were practicing in Pennsylvania; Delaware; Washington, DC; Maryland; North Carolina; and Virginia (N = 1,500). Questionnaires were returned by 1,011 (67%) respondents; the 508 respondents (50%) who counseled adults for high blood cholesterol completed the entire questionnaire. STATISTICAL ANALYSES PERFORMED: Statistical analyses proceeded in three steps: descriptive statistics on questionnaire items, calculation of composite index scores, and bivariate and multivariate analyses. RESULTS: Of the key hypothesized factors, greater self-efficacy, higher levels of outcome efficacy, and greater adherence expectations significantly correlated with compliance-enhancing counseling practices. Outpatient dietitians used more compliance-enhancing counseling practices than did inpatient dietitians. Stepwise multiple regression analysis showed that the outpatient setting, a greater number of counseling sessions, follow-up counseling, and a charge to patients for counseling positively correlated with compliance-enhancing counseling practices. APPLICATIONS: Recommendations suggested by the findings include structuring professional training and continuing education programs for dietitians to strengthen self-efficacy, providing more feedback to improve perceived outcome efficacy, and changing the organization of the delivery of nutrition counseling services for prevention to allow more outpatient counseling.

Adult↗
PubMed2005

Factors that influence adolescent reports of counseling by physicians on risky behavior.

PURPOSE: To determine factors that affect whether low-income adolescents report that their doctor talked with them about risky behavior. METHODS: Random digit-dial survey of low-income adolescents in New York City asking about depression, smoking, alcohol use, and sexual activity and the screening and counseling they received on these risk factors and risks during health visits. RESULTS: Prevalence of counseling by physicians was low, according to adolescent reports, ranging from 17% of adolescents counseled about depression to 52% about sexually transmitted diseases. Older adolescents were more likely than younger to receive counseling about all topics. In bivariate and multivariate models, having the risk factor was strongly associated with physicians counseling for depression (adjusted [adj.] OR = 4.42; p < 0.001); for sexual activity and counseling about condom use (adj. OR = 4.06; p < 0.01), and birth control (adj. OR = 2.76; p < 0.03). Still, many adolescents at risk had not received counseling. Many adolescents have not had a private and confidential visit with their provider. Having a private and confidential visit was also associated with receipt of counseling. CONCLUSIONS: Adolescents are not receiving sufficient counseling about risks and risky behavior, according to their own reports. There is need to improve delivery of counseling and ensure that private and confidential visits are provided to youth.

Adolescent↗
PubMed2006

Satisfaction with genetic counseling for BRCA1 and BRCA2 mutations among African American women.

OBJECTIVE: The objective of this study was to evaluate satisfaction with genetic counseling for BRCA1 and BRCA2 (BRCA1/2) mutations among African American women. METHODS: Participants were 54 African American women at moderate and high risk for BRCA1/2 mutations who were offered genetic testing as part of a randomized clinical trial designed to compare the effects of culturally tailored genetic counseling (CTGC) and standard genetic counseling (SGC). Satisfaction with genetic counseling was evaluated using a self-administered questionnaire following culturally tailored or standard pre-test education and counseling. RESULTS: Overall, the majority of women (96%) were very satisfied with genetic counseling; however, only 26% reported that their worries were lessened and 22% reported that they were able to cope better. Women who received CTGC were significantly more likely than women who received SGC to report that their worries were lessened (p<0.05). In addition, women with household incomes less than US$ 35,000 were significantly more likely to report that the counselor lessened their worries compared to women with higher incomes (p<0.05). CONCLUSIONS: Most African American women were satisfied with genetic counseling; however, women who received culturally tailored genetic counseling were significantly more likely to strongly agree that their worries were lessened compared to women who received standard genetic counseling. PRACTICE IMPLICATIONS: Discussion of cultural beliefs and values during genetic counseling may be beneficial to African American women, especially those with low incomes.

Adult↗