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Systematic development of a training program for healthcare professionals to improve communication about breast cancer genetic counseling with low health literate patients.

Giessen, J.A.M. van der, Ausems, M.G.E.M., Muijsenbergh, M.E.T.C. van den, Dulmen, S. van, Fransen, M.P. Systematic development of a training program for healthcare professionals to improve communication about breast cancer genetic counseling with low health literate patients. Familial Cancer: 2020, 19(4), 281-290
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Background
There is a disproportionate underuse of genetic testing in breast cancer patients from lower education or migrant background. Within these groups, communication about referral to genetic counseling appears challenging due to limited health literacy and cultural barriers.

Aim
Our aim was to develop and evaluate a training program for healthcare professionals (breast surgeons and specialized nurses), to increase effective communication.

Method
We systematically developed a blended training program based on patients’ and healthcare professionals’ needs and preferences. Prior to the training, we assessed awareness, knowledge and self-efficacy of healthcare professionals. Acceptability and usefulness of the training program were assessed directly after the training.

Findings
Healthcare professionals (n = 65) from 17 hospitals showed moderate to high awareness and knowledge about the prevalence and impact of limited health literacy. They were aware of cultural factors that influence communication. However, they did not feel confident in recognizing limited health literacy and their self-efficacy to communicate effectively with these patients was low. The training program was rated as acceptable and useful.

Conclusions
Healthcare professionals lack confidence to effectively communicate with patients with limited health literacy or migrant background. The training program offers opportunities to improve communication about referral to breast cancer genetic counseling.