An interactive computer program can effectively educate patients about genetic testing for breast cancer susceptibility

As genetic testing for susceptibility to breast cancer becomes more widespr ead, alternative methods for educating individuals prior to testing will be needed. Our objective was to compare face-to-face education and counseling by a genetic counselor with education by an interactive computer program, assessing the effects of each on knowledge of breast cancer genetics and in tent to undergo genetic testing. We used a randomized, controlled trial. Se venty-two self-referred women with a first-degree relative with breast canc er received outpatient education and counseling at the Clinical Center of t he National Institutes of Health (NIH). Twenty-nine received individualized counseling from a genetic counselor (counseling group), 29 received educat ion from an interactive computer program followed by individualized counsel ing (computer group), and 14 were controls. Both pre- and postintervention assessment of knowledge about breast cancer genetics and intent to undergo genetic testing were measured. The control group participants correctly ans wered 74% of the knowledge questions; the counselor group, 92%; and the com puter group, 96% (P < .0001). Unadjusted mean knowledge scores were signifi cantly higher in the computer group than the counselor group (P =.048), but they were equivalent when adjusted for demographic differences (P = 0.34). Intent to undergo genetic testing was influenced by the interventions: pre intervention, a majority in all groups (69%) indicated that they were likel y (definitely and most likely) to undergo testing; after either interventio n coupled with counseling, only 44% indicated that they were likely to do s o (P =.0002; odds ratio = 2.8, 95% CI = 1.7-4.9). We concluded that a compu ter program can successfully educate patients about breast cancer susceptib ility, and, along with genetic counseling, can influence patients' intentio ns to undergo genetic testing. (C) 2001 Wiley-Liss, Inc.