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The impact of genetic counseling on patient engagement and health behavior

Leifeste, Claire (2018) The impact of genetic counseling on patient engagement and health behavior. Master's Thesis, University of Pittsburgh. (Unpublished)

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Patient engagement, or active participation and involvement in one’s health care, has been beneficially related to health outcomes and lower health care costs. The purpose of this study was to elucidate the relationship between patient engagement, pursuing lifestyle behavior changes (weight loss and tobacco cessation), and the impact of receiving genetic information for hereditary cancer syndromes. We hypothesized that higher baseline engagement scores and receiving a pathogenic variant result would be associated with positive behavior changes. It was also expected that receiving pathogenic variant results would be associated with increased engagement scores. Patients seen in the UPMC Hereditary GI Tumor Program were verbally administered the Altarum Consumer Engagement (ACE) Measure survey to assess patient engagement prior to their initial appointment. Participants were then contacted via phone three to five months after their initial appointment to repeat the ACE measure, as well as a Lifestyle Questionnaire if applicable. A total of 195 participants were included in the analyses, 51 of whom were overweight at their initial appointment and 15 of whom were current smokers at their initial appointment. Two sample T-tests, linear and logistic models, and Fisher’s exact test were used to test associations. It was found that having a higher baseline Navigation score within the ACE measure was associated with an individual being less likely to lose weight. Tobacco cessation was not associated with baseline total engagement (ACE). A pathogenic variant result did not make an individual more or less engaged in their health, lose weight, or quit smoking compared to those with no pathogenic variant. Additionally, participants were found to have significantly greater engagement levels after receiving genetic counseling. Genetic counseling may be an effective healthcare intervention to increase patient engagement, and thus ultimately lead to improved public health, decreased healthcare dollars, and beneficial patient outcomes.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Leifeste, Claireclaireleifeste@gmail.comcel66
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBrand,
Committee MemberDudley,
Committee MemberGrubs,
Committee MemberDurst,
Committee MemberShaffer,
Date: 28 June 2018
Date Type: Publication
Defense Date: 3 April 2015
Approval Date: 28 June 2018
Submission Date: 27 April 2018
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 111
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Human Genetics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: genetic counseling, patient engagement, health behavior changes
Article Type: Research Article
Date Deposited: 28 Jun 2018 20:09
Last Modified: 01 May 2019 05:15


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