Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling

Deborah Cragun, Heather Zierhut

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, “Framework for Outcomes of Clinical commUnication Services” (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

Original languageEnglish (US)
Pages (from-to)33-58
Number of pages26
JournalJournal of Genetic Counseling
Issue number1
StatePublished - Feb 1 2018

Bibliographical note

Publisher Copyright:
© 2017, National Society of Genetic Counselors, Inc.


  • Cascade testing
  • Evaluation
  • Family communication
  • Genetic counseling
  • Genetic services
  • Patient communication
  • Patient outcomes


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