Family Centered Approaches to Promoting Cascade Screening for Hereditary Cancer Syndromes among African Americans

Cancer cascade testing is a process for providing genetic counseling and testing for relatives of individuals who are known carriers of specific cancer-related genetic mutations. As clinical genetic testing becomes increasingly available, it is critically important to design interventions for families that improve cascade testing rates that take into account unique drivers of and barriers to behavior change (i.e., testing) for targeted populations. This career development award provides Dr. Ellis the opportunity to develop and test a family intervention to increase cancer cascade testing. This award focuses on strengthening the investigator’s skills in intervention research and cancer genetics. Her long-term career goal is to become an independent investigator with expertise in conducting family-based intervention research to improve cancer outcomes among target populations, including African Americans. Dr. Ellis’ graduate-level training in public health and social work, and postdoctoral training in cancer research, puts her in a unique position to develop interventions that attend to both the psychosocial and behavioral aspects of cancer genetic testing for families. The career development goals and mentoring plan include courses and workshops; guided mentoring, including directed readings with mentors; experiential learning, including shadowing in a cancer genetics clinic and intervention development, testing, and evaluation; tailored health messaging development; attendance and participation at professional conferences; and, manuscript and grant writing and submissions. These activities support the execution of the specific aims, which are to: (1) Identify intrapersonal and interpersonal facilitators and barriers to African American family communication about genetic testing and cascade testing through eight focus groups; (2) Develop a tailored, eHealth intervention for African American families that encourages uptake of recommended cascade genetic testing by improving communication about genetic testing results and targeting drivers of and barriers to behavior change (e.g., knowledge, attitudes, skills for communication and testing); (3) Conduct a pilot test of the intervention with 30 families to evaluate intervention feasibility, acceptability and engagement and explore its potential impact on cascade testing. Dr. Ellis’ mentoring team has expertise in each of her key developmental areas. At the completion of this K01 award, Dr. Ellis will have the expertise to become an independent investigator who conducts family-based intervention research to improve cancer outcomes among families from various target populations (e.g., African Americans, adolescent and young adult cancer survivors, rural populations, low-income).