Research has shown that African Americans are less likely than other racial groups to engage in genetic testing for hereditary cancer syndromes, which can uncover genetic mutations that increase cancer risk. African Americans also have lower rates of cancer cascade testing, a process for providing genetic counseling and testing for relatives of African Americans who are known carriers of specific cancer-related genetic mutations. As clinical genetic testing becoming increasingly available, it is critically important to design interventions to reach all populations, especially those that have been traditionally underserved. Tailored strategies are particularly useful for increasing intervention access and uptake where health disparities exist. This career development award provides Dr. Ellis the opportunity to develop and test a family-tailored intervention to increase cancer cascade testing among African Americans. This award focuses on strengthening the investigator’s skills in intervention research and cancer genetics. Her long-term career goal is to become an independent investigator with expertise in conducting family-based intervention research to improve cancer outcomes among African Americans. Dr. Ellis’ graduate-level training in public health (health behavior and education) and social work (interpersonal practice with individuals and families), and postdoctoral training in cancer health disparities, puts her in a unique position to develop interventions that attend to both the psychosocial and behavioral aspects of cancer genetic testing for African American families. The career development goals and mentoring plan include courses and workshops; guided mentoring, including directed readings with mentors; experiential learning, including shadowing in a cancer genetics clinic and intervention development, testing, and evaluation; tailored health messaging development; attendance and participation at professional conferences; and, manuscript and grant writing and submissions. These activities support the execution of the specific aims, which are to: (1) Identify intrapersonal and interpersonal facilitators and barriers to African American family communication about genetic testing and cascade testing through eight focus groups; (2) Develop a tailored, eHealth intervention for African American families that encourages uptake of recommended cascade genetic testing by improving communication about genetic testing results and targeting drivers of and barriers to behavior change (e.g., knowledge, attitudes, skills for communication and testing); (3) Conduct a pilot test of the intervention with 30 families to evaluate intervention feasibility, acceptability and engagement and explore its potential impact on cascade testing. Dr. Ellis’ mentoring team has expertise in each of her key developmental areas. At the completion of this K01 award, Dr. Ellis will have the expertise to become an independent investigator who conducts family-based intervention research to improve cancer outcomes with African American families with increased cancer risk.

PROJECT NARRATIVE African Americans are less likely to receive genetic testing to determine if they have a genetic mutation associated with increased risk for certain cancers. When testing is done, it is important to share information with relatives to help them determine whether or not they too would benefit from testing; however, it can be difficult to share this information within families. This project will develop and test an intervention specifically tailored for African American families to support their communication about cancer genetic testing results, communication about behaviors that can reduce their cancer risk, and future decisions about whether or not to complete cancer genetic testing.