A patient-centered mobile health application to motivate use of genetic counseling among women with ovarian cancer

A pilot randomized controlled trial

Rachel I Vogel, Kristin B Niendorf, Sue Petzel, Heewon Lee, Deanna G Teoh, Anne H Blaes, Peter A Argenta, Colleen Rivard, Boris J Winterhoff, Hee Yun Lee, Melissa A Geller

Research output: Contribution to journalArticle

Abstract

Objective: Despite current guidelines recommending women with ovarian cancer receive genetic risk evaluation by a genetic counselor, utilization has historically been low. We sought to assess the feasibility and effectiveness of a week-long mobile Application for Genetic Information on Cancer (mAGIC) intervention aimed to persuade women with ovarian cancer to pursue genetic counseling. Methods: The mobile application intervention was based on the Fogg Behavior Model, and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers to action. The Health Belief Model was used to guide content development. We conducted a prospective, randomized, controlled pilot trial among 104 untested women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer with the primary objective of increasing uptake of cancer genetic counseling services. Results: Utilization of cancer genetic counseling services improved in both study arms over historical controls, however there was no statistically significant difference between them (intervention: 54.5% versus control: 38.6%; p = 0.14). However, compared to controls, women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary cancer (0–10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least three months. Additionally, 96% of women in the intervention group reported they had talked with their family about genetic counseling compared to 77% in the control group (p = 0.01). Conclusions: The mAGIC intervention did not result in increased uptake of genetic counseling, however it provided significant secondary benefits, including increased participants’ knowledge about hereditary ovarian cancer, self-efficacy, and their reported communication with family members. ClinicalTrials.gov Identifier: NCT02877862

Original languageEnglish (US)
Pages (from-to)100-107
Number of pages8
JournalGynecologic oncology
Volume153
Issue number1
DOIs
StatePublished - Apr 1 2019

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Mobile Applications
Telemedicine
Genetic Counseling
Ovarian Neoplasms
Randomized Controlled Trials
Genetic Services
Neoplasms
Fallopian Tube Neoplasms
Self Efficacy
Communication
Guidelines
Control Groups
Health

Keywords

  • BRCA
  • Communication
  • Genetic counseling
  • Mobile application
  • Ovarian cancer

Cite this

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title = "A patient-centered mobile health application to motivate use of genetic counseling among women with ovarian cancer: A pilot randomized controlled trial",
abstract = "Objective: Despite current guidelines recommending women with ovarian cancer receive genetic risk evaluation by a genetic counselor, utilization has historically been low. We sought to assess the feasibility and effectiveness of a week-long mobile Application for Genetic Information on Cancer (mAGIC) intervention aimed to persuade women with ovarian cancer to pursue genetic counseling. Methods: The mobile application intervention was based on the Fogg Behavior Model, and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers to action. The Health Belief Model was used to guide content development. We conducted a prospective, randomized, controlled pilot trial among 104 untested women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer with the primary objective of increasing uptake of cancer genetic counseling services. Results: Utilization of cancer genetic counseling services improved in both study arms over historical controls, however there was no statistically significant difference between them (intervention: 54.5{\%} versus control: 38.6{\%}; p = 0.14). However, compared to controls, women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary cancer (0–10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least three months. Additionally, 96{\%} of women in the intervention group reported they had talked with their family about genetic counseling compared to 77{\%} in the control group (p = 0.01). Conclusions: The mAGIC intervention did not result in increased uptake of genetic counseling, however it provided significant secondary benefits, including increased participants’ knowledge about hereditary ovarian cancer, self-efficacy, and their reported communication with family members. ClinicalTrials.gov Identifier: NCT02877862",
keywords = "BRCA, Communication, Genetic counseling, Mobile application, Ovarian cancer",
author = "Vogel, {Rachel I} and Niendorf, {Kristin B} and Sue Petzel and Heewon Lee and Teoh, {Deanna G} and Blaes, {Anne H} and Argenta, {Peter A} and Colleen Rivard and Winterhoff, {Boris J} and Lee, {Hee Yun} and Geller, {Melissa A}",
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TY - JOUR

T1 - A patient-centered mobile health application to motivate use of genetic counseling among women with ovarian cancer

T2 - A pilot randomized controlled trial

AU - Vogel, Rachel I

AU - Niendorf, Kristin B

AU - Petzel, Sue

AU - Lee, Heewon

AU - Teoh, Deanna G

AU - Blaes, Anne H

AU - Argenta, Peter A

AU - Rivard, Colleen

AU - Winterhoff, Boris J

AU - Lee, Hee Yun

AU - Geller, Melissa A

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objective: Despite current guidelines recommending women with ovarian cancer receive genetic risk evaluation by a genetic counselor, utilization has historically been low. We sought to assess the feasibility and effectiveness of a week-long mobile Application for Genetic Information on Cancer (mAGIC) intervention aimed to persuade women with ovarian cancer to pursue genetic counseling. Methods: The mobile application intervention was based on the Fogg Behavior Model, and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers to action. The Health Belief Model was used to guide content development. We conducted a prospective, randomized, controlled pilot trial among 104 untested women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer with the primary objective of increasing uptake of cancer genetic counseling services. Results: Utilization of cancer genetic counseling services improved in both study arms over historical controls, however there was no statistically significant difference between them (intervention: 54.5% versus control: 38.6%; p = 0.14). However, compared to controls, women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary cancer (0–10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least three months. Additionally, 96% of women in the intervention group reported they had talked with their family about genetic counseling compared to 77% in the control group (p = 0.01). Conclusions: The mAGIC intervention did not result in increased uptake of genetic counseling, however it provided significant secondary benefits, including increased participants’ knowledge about hereditary ovarian cancer, self-efficacy, and their reported communication with family members. ClinicalTrials.gov Identifier: NCT02877862

AB - Objective: Despite current guidelines recommending women with ovarian cancer receive genetic risk evaluation by a genetic counselor, utilization has historically been low. We sought to assess the feasibility and effectiveness of a week-long mobile Application for Genetic Information on Cancer (mAGIC) intervention aimed to persuade women with ovarian cancer to pursue genetic counseling. Methods: The mobile application intervention was based on the Fogg Behavior Model, and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers to action. The Health Belief Model was used to guide content development. We conducted a prospective, randomized, controlled pilot trial among 104 untested women with a history of epithelial ovarian, primary peritoneal or fallopian tube cancer with the primary objective of increasing uptake of cancer genetic counseling services. Results: Utilization of cancer genetic counseling services improved in both study arms over historical controls, however there was no statistically significant difference between them (intervention: 54.5% versus control: 38.6%; p = 0.14). However, compared to controls, women randomized to the mAGIC intervention demonstrated greater knowledge of hereditary cancer (0–10 scale; 9.4 ± 1.0 vs. 7.1 ± 1.5; p < 0.0001), which persisted for at least three months. Additionally, 96% of women in the intervention group reported they had talked with their family about genetic counseling compared to 77% in the control group (p = 0.01). Conclusions: The mAGIC intervention did not result in increased uptake of genetic counseling, however it provided significant secondary benefits, including increased participants’ knowledge about hereditary ovarian cancer, self-efficacy, and their reported communication with family members. ClinicalTrials.gov Identifier: NCT02877862

KW - BRCA

KW - Communication

KW - Genetic counseling

KW - Mobile application

KW - Ovarian cancer

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