Health beliefs associated with readiness for genetic counseling among high risk breast cancer survivors

Breast J. 2019 Jan;25(1):117-123. doi: 10.1111/tbj.13165. Epub 2018 Nov 28.


We used the Health Belief Model (HBM) to explore factors associated with readiness for genetic counseling among breast cancer survivors. Breast cancer survivors meeting NCCN genetic counseling referral criteria completed questionnaires capturing demographic and clinical information and factors guided by the HBM, including health beliefs, psychosocial variables, and cues to action. Using logistic regression, we examined whether the above variables differed based on readiness group (pre-contemplators, who did not plan to make a genetic counseling appointment, and contemplators, who planned to make a genetic counseling appointment in the next 1-6 months). Of 111 participants, 57% were pre-contemplators and 43% were contemplators. Higher cancer worry was associated with increased odds of being a contemplator (OR = 2.99; 95% CI = 1.37-6.54) and higher perceived barriers to genetic counseling were associated with decreased odds of being a contemplator (OR = 0.31; 95% CI = 0.11-0.85). Those who reported a family member encouraged them to get tested were more likely to be contemplators (OR = 3.57; 95% CI = 1.19-10.70). Our results suggest key factors for predicting genetic counseling readiness include cancer worry, perceived barriers, and family influence. There is need for increased genetic counseling awareness. Better understanding of factors related to survivors' decisions about counseling can inform tailored interventions to improve uptake and ultimately reduce cancer recurrence risk.

Keywords: breast cancer; genetic counseling; health behavior; health belief model; stages of change.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Attitude to Health*
  • Breast Neoplasms / psychology*
  • Cancer Survivors / psychology*
  • Female
  • Genetic Counseling / psychology*
  • Genetic Predisposition to Disease / psychology
  • Humans
  • Logistic Models
  • Middle Aged
  • Models, Theoretical
  • Risk Factors
  • United States