Examining the Effectiveness of Genetic Counselors’ Communication of Variant of Uncertain Significance Results of Breast Cancer Genes

ABSTRACT

Receiving a variant of uncertain significance (VUS) result is quite common for individuals who undergo genetic testing. Because VUS results are often unexpected and necessarily complex, they are challenging for genetic counselors to deliver. The current research sought to examine how three specific message features (risk estimate formats, establishment of a future plan, and linguistic agency), and message receivers’ intolerance of uncertainty, influenced the effectiveness of genetic counselors’ communication of a VUS result. A series of MANCOVAs and multiple regressions suggested that these message features affected message receivers’ perception of a genetic counselor’s credibility and receivers’ uncertainty appraisal and information-seeking intentions. Specifically, establishing a future plan and assigning agency to a VUS result enhanced perceived counselor credibility. When results were presented in a numeric format, assigning agency to counselors resulted in heightened danger appraisal and greater information-seeking intentions. Individuals’ intolerance of uncertainty moderated the association between risk formats and uncertainty appraisal. These results have both theoretical and practical implications for communication of uncertainty in the context of genetic counseling.

Disclosure of potential conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Notes

1. To address the focal information in each condition, the attention check questions were framed by the same message features used in each condition. For example, participants in conditions with a numeric risk format were asked to answer the question: “What is the risk of developing breast cancer for the general public?” by selecting one of the three choices that were expressed in a numeric format (“13%”, “46%”, “87%”). By comparison, participants in conditions with a verbal risk format were asked to answer the question: “What is the risk of developing breast cancer if one is tested positive for the gene mentioned in the scenario?” by choosing one of the three options that were worded in a verbal format (“above average,” “below average,” “about average”).

2. The majority of participants (n = 530) answered all three attention check questions correctly, followed by 149 participants who answered two questions right and 41 who answered one question right. Including those who answered one or two questions correctly in the sample for data analysis did not change the study results, thus we only excluded participants who answered all three attention check questions wrong (n = 9).

Additional information

Funding

This research received grant support from the Health Communication Scholars Program, sponsored by Center for Health Communication, Moody College of Communication, University of Texas at Austin.