Table.1.

Content and process of the PCS and PeACE peer coaching protocols

	Goals/Content
Call	PCS	PeACE
1	• Clarifying potential communication choices that mothers have (e.g., share all, some, or no information with their children). • Identifying how values may be derived from multiple sources, including maternal psychological stress reactions/responses to their genetic testing, concern for family communication and well-being, extent to which they value input from spouses/partners, friends. • Addressing how maternal values and preferences may manifest in decision making needs, including family-of-origin beliefs, cultures, systems.	• Introduction and orientation to the program and working with a peer supporter. • Recognizing emotional, cognitive, and behavioral sources of hereditary cancer stress. • Presentation and practicing of problem solving approaches and the content of improving communication, making decisions, and managing distress. • Navigating the use of the participant workbook to apply problem-solving. • Assign homework that applies problem-solving techniques.
2	• Exploring issues and needs in communicating genetic test results to children and managing stress: o Patient types (previvor, newly diagnosed, survivor) o Implications of risk o How to assess children’s readiness to learn about hereditary risk o Communicating risk to children based on child age/gender o Pros/cons of communicating risk o Considerations for parents who choose not to communicate with children about BRCA • Using interactive decision guide worksheets to explore decision making.	• Review of homework problem-solving techniques. • Reinforce coping strategies: o Focusing on ways of enhancing coping and decreasing distress o Identifying healthy and unhealthy coping strategies o Assess information needs o Apply cognitive problem-solving training to hereditary cancer risk • Assign homework that applies problem-solving techniques.
3	• Discussing risk with children if/when the time is right, emphasizing if/how plans meet preferences/values. • Reviewing communication strategies/conversations that may occur–including consideration of vocabulary and terminology, explaining inheritance, risks, and management options, genetic testing in adulthood, psychological concerns. • Assessing children’s reactions, helping them cope with/assimilate hereditary risk. • Referencing useful websites and books. • Reviewing completed worksheets.	• Enhancing risk comprehension, decision making and managing emotions. • Specific steps to take to gain information and support about hereditary cancer risk, working with how to anticipate their thoughts and feelings, making plans for next steps. • Use of vignettes/role-playing techniques, problem-solving, communication, decision making skills training, managing emotions, reinforce resource utilization.