Developing and Optimizing Best Practice Solutions for Implementation of Population Based Cancer Genetic Services in Federally Qualified Health Centers

What this Trial Is About

Researchers are evaluating two different models of cancer genetic service delivery to improve access for patients at risk for hereditary breast or colon cancer syndromes in urban Federally Qualified Health Centers (FQHCs). This study compares a mainstream genetic testing model (MGT), where primary care providers directly offer genetic testing, with an enhanced standard of care model (SOC+) that includes patient navigation support alongside referrals to genetic counseling. The goal is to identify which approach leads to higher uptake of genetic testing and to understand barriers and facilitators in these community health settings. The study involves four community health clinics within an FQHC network, each assigned to use either the MGT or SOC+ model. In the MGT model, primary care providers educate, counsel, and order genetic tests directly, referring patients to genetics specialists only if abnormal results occur. The SOC+ model enhances the usual referral process by adding universal electronic hereditary cancer risk assessment and patient navigation to address barriers like financial concerns. Data such as patient demographics, referrals, testing completion, and timing will be collected, and interviews with patients, providers, and staff will explore their experiences with each model. Participants will be adults aged 25 and older who are English-speaking and eligible for genetic testing based on established criteria. The study will collect information from medical records over two years to measure uptake and timing of genetic testing. Qualitative interviews will assess acceptability, feasibility, and sustainability of each service model. This research aims to provide evidence for scalable, equitable genetic services in underserved primary care settings, with participant involvement lasting up to two years.

Implementation of Population Cancer Genetic Services in Federally Qualified Health Centers (FQHC)