Author ORCID Identifier
https://orcid.org/0000-0003-3850-5525
Date of Graduation
5-2023
Document Type
Thesis (MS)
Program Affiliation
Genetic Counseling
Degree Name
Masters of Science (MS)
Advisor/Committee Chair
Claire N. Singletary
Committee Member
Jennifer Czerwinski
Committee Member
Erica Bednar
Committee Member
Syed S. Hashmi
Committee Member
Carla McGruder
Committee Member
Hector Mendez-Figueroa
Abstract
Pregnant Black/African American patients have faced systematic racism in the U.S. healthcare system embodied in the high maternal morbidity and mortality rates. Patients have the desire to feel heard and connected with their healthcare providers. Prenatal genetic counselors are not only trained to provide education to individuals, couples, and families who may be seeking genetic counseling, but also to use psychosocial skills with patients. Previous studies with majority of White participants have described how psychosocial skills build patient trust. Therefore, this study aimed to determine what factors made pregnant Black/African American patients feel heard and trustful with their prenatal genetic counselors, and to compare their experiences with prenatal genetic counseling to other healthcare appointments. Of the 54 survey respondents recruited from approved UTHealth Houston prenatal clinics (IRB HSC-DB-22-0498) that completed the initial survey recruitment request, 25 participated in a semi-structured recorded telephone interview. Transcripts were coded for themes using inductive conventional content analysis in Atlas.ti. Generally, participants shared positive feedback about their prenatal genetic counseling experiences that fell into three themes: Felt Heard, Educational, and Comfortable Environment. Core psychosocial skills of genetic counseling such as active listening and tailoring were pronounced in Felt Heard where the domains of attentive, tailoring, and answered questions were found. Participants described how the counselor being personable (rapport), iv patient, reassuring, and open built a comfortable environment where they felt like they could ask questions and the counselor checked in with them. This provided the foundation for receiving education from a provider they had confidence in. The intersection of these themes created trust in the genetic counseling relationship. This model may be viewed as the patient version of the Reciprocal Engagement Model of Genetic Counseling. The findings from this study suggest that genetic counselors who incorporate these skills when providing care to their Black/African American patients are likely to make them feel comfortable, cared for, and heard. Future studies should explore whether other healthcare providers can incorporate these skills in an effort to build trust.
Keywords
Genetic counseling, family history, psychosocial, tailoring, informed decision-making