Communicating genetic test results to the family: a six-step, skills-building strategy.

As the availability of tests to identify hereditary predisposition to chronic diseases continues to grow, a need has arisen to prepare individuals receiving genetic test results to share this highly sophisticated and value-laden information with other at-risk family members. Responding to this need, a communication skills-building intervention, based on Buckman's model of "Breaking Bad News," was developed for use in the setting of genetic testing for BRCA1 and BRCA2 mutations. Outcomes will include knowledge, attitudes, and health behavior on the part of both the proband and her first-degree relatives.

A self-help intervention for African American smokers: tailoring cancer information service counseling for a special population.

BACKGROUND: African Americans remain a critically underserved group for smoking cessation interventions. This study tested the effectiveness of a tailored, culturally sensitive intervention for African American smokers who called the NCI Cancer Information Service (CIS) for help to quit smoking. METHODS: This paper presents results of a 2-year study of tailored counseling strategies among African American smokers (n = 1,422) who called four regional CIS offices in response to a radio-based media campaign in 14 communities. Callers were randomly assigned to receive either the standard CIS quit smoking counseling and guide (Clearing the Air) or counseling and a guide (Pathways to Freedom) tailored to the quitting needs and barriers of African American smokers. Callers were predominantly female (63.6%). ages 20-49 (88%), with a high school education or more (84%). Median smoking history was 17 years; median smoking rate was 20 cigarettes/day. Standard (n = 689) and Tailored (n = 733) group subjects did not differ on most baseline measures. RESULTS: On most measures, Standard and Tailored counseling/guides received similar ratings, but the Tailored guide was rated as having more appealing photos (P = 0.001) and as being more appropriate for family members (P = 0.003). Six-month follow-up with 893 subjects (response rates were 63% Standard, 62% Tailored, ns) showed significantly more quit attempts (P = 0.002) and greater use of prequitting strategies (P < 0.05) among Tailored than among Standard subjects, but no differences in self-reported 1-week abstinence (14.4% Standard, 16.2% Tailored) (ns). An opportunistic 12-month follow-up of subjects recruited in the last year of the study (n = 445) (response rates were 57% Standard, 60% Tailored, ns) showed a significantly higher quit rate (15.4% Standard, 25.0% Tailored) for Tailored subjects (P = 0.034). CONCLUSIONS: Results show promise for tailored approaches to boost quit attempts and success rates among African American smokers.

Quit Today! A targeted communications campaign to increase use of the cancer information service by African American smokers.

BACKGROUND: African Americans have traditionally made little use of the Cancer Information Service (CIS), an information and education program of the National Cancer Institute, for smoking cessation assistance. This study evaluated whether a targeted communications campaign utilizing strategically placed radio and television advertisements in combination with community outreach could lead more adult African American smokers to call the CIS for smoking cessation information and materials. METHODS: Fourteen communities, served by four CIS regional offices, were carefully matched on demographic variables and then randomly assigned to either an experimental or a control group. Six radio advertisements targeting African American smokers to call the CIS for help in quitting smoking were developed and pretested for three different black-oriented formats. One television spot also was produced and pretested. The audio portion of the television ad was utilized as a seventh radio spot for the general programming formats. These advertisements were placed on selected radio and television stations reaching predominantly African American adult audiences. Also, copies of a videotape designed to motivate African American smokers to quit and to call the CIS for help in quitting were widely disseminated through community-based organizations in each experimental market. The aim was to increase the number and proportion of quitting-related calls to the CIS from African Americans within experimental communities. RESULTS: The call volume from African American smokers was significantly higher in the experimental communities than in the control communities (P < 0.008). The call rate from African American men was higher than typically observed. Overall, African Americans in the experimental communities reported radio more often than television as the way they heard about the CIS. CONCLUSION: The results suggest that paid targeted advertising, using radio as a primary channel, is an effective method of reaching an underserved population at risk. Future research directions are discussed.