Providers’ Perceptions and Practices Regarding BRCA1/2 Genetic Counseling and Testing in African American Women

We examined healthcare providers’ perceptions of genetic counseling and testing in African American women at moderate to high‐risk of carrying a BRCA1/2 mutation. We conducted 20 in‐depth interviews with genetic counselors ( n  = 5), medical oncologists ( n  = 8), obstetrician/gynecologists ( n  = 2) and surgeons ( n  = 5). Interviews were audiotaped, transcribed and independently coded by two individuals using a content analysis approach. Seven themes emerged relevant to providers’ perceptions of African American women's use of BRCA1/2 genetic services: access factors, cultural beliefs and preferences, effects of testing, patient motivators for genetic counseling and testing, patient‐provider communication, reasons for provider referral, and reasons for patient refusal. Providers identified individual‐ and system‐level barriers to African American women's use of genetic services, including lack of follow‐up after referrals to genetic specialists and challenges to obtaining financial coverage for under‐ and uninsured high‐risk women. Results have implications for physician and patient education regarding appropriate referrals to and uptake of genetic services in at‐risk African American women.