Table II.
Identified Themes and Sample Quotes
| Theme | Providers (N = 20) | References to Theme (n = 227 total references) | Sample Quote | ||
|---|---|---|---|---|---|
| # mentioning theme | % mentioning theme | # of references | % of total references | ||
| Access Factors | n = 10 | 50% | n = 21 | 9.3% | “Many African Americans don’t have access to care. Money and cost issues keep them from obtaining the test.” Obstetrician/Gynecologist |
| Cultural Beliefs and Preferences | n = 8 | 40% | n = 15 | 6.6% | “There may be more cultural beliefs and values that [make African American women] less likely to be interested in genetic counseling and undergoing genetic testing. I think the African American community is more historically well-known for atrocities, for instance, Tuskegee…[or] not getting referred for a particular procedure they needed. That may cause people to be a little more distrustful.” Genetic Counselor |
| Effects of Testing | n = 20 | 100% | n = 52 | 22.9% | Beneficial: “It empowers people to find out [their risk of a BRCA1/2 mutation] and alleviate fears. It allows them to play an active role in their health by giving them something to cling to.” Obstetrician/Gynecologist Harmful: “It can certainly raise a person’s anxiety knowing that if they test positive [for a BRCA1/2 mutation] they are at an increased risk for breast cancer. It can make choices at times when they are otherwise healthy difficult, and it could be confounded, for example, if they don’t have good medical care or insurance.” Medical Oncologist |
| Patient Motivators for Genetic Counseling and Testing | n = 19 | 95% | n = 34 | 15% | “I think women are motivated by the fact that there is some degree of clarity on whether or not they should have risk reducing surgery or more intensive screenings, MRI,[or] breast exams.” Medical Oncologist |
| Reasons for Provider Referral | n = 19 | 95% | n = 29 | 12.8% | “Basically if women are [diagnosed with breast cancer] under fifty, you should consider it.” Medical Oncologist |
| Patient Provider Communication | n = 15 | 75% | n = 43 | 18.9% | “[There may be a] disconnect to how information [about genetic counseling and testing] is presented. [Is it done in a] culturally sensitive manner or is it not conveyed adequately to minorities?” Obstetrician/Gynecologist |
| Reasons for Patient Refusal | n = 17 | 85% | n = 33 | 14.5% | “I remember one [patient] who told me I don’t want anybody to peek into my private life. [Another patient] said, I think if I find out I have BRCA1 then…I won’t get health insurance because of discrimination.” Medical Oncologist |
Note: References indicate the number of times providers mentioned each theme/subdomain. Exemplar quotes were selected to highlight key ideas for each theme.