Optimizing communication strategies and designing a comprehensive program to facilitate cascade testing for familial hypercholesterolemia

BMC Health Serv Res. 2023 Apr 5;23(1):340. doi: 10.1186/s12913-023-09304-y.

Abstract

Background: This project aimed to optimize communication strategies to support family communication about familial hypercholesterolemia (FH) and improve cascade testing uptake among at-risk relatives. Individuals and families with FH provided feedback on multiple strategies including: a family letter, digital tools, and direct contact.

Methods: Feedback from participants was collected via dyadic interviews (n = 11) and surveys (n = 98) on communication strategies and their proposed implementation to improve cascade testing uptake. We conducted a thematic analysis to identify how to optimize each strategy. We categorized optimizations and their implementation within the project's healthcare system using a Traffic Light approach.

Results: Thematic analysis resulted in four distinct suggested optimizations for each communication strategy and seven suggested optimizations that were suitable across all strategies. Four suggestions for developing a comprehensive cascade testing program, which would offer all optimized communication strategies also emerged. All optimized suggestions coded green (n = 21) were incorporated. Suggestions coded yellow (n = 12) were partially incorporated. Only two suggestions were coded red and could not be incorporated.

Conclusions: This project demonstrates how to collect and analyze stakeholder feedback for program design. We identified feasible suggested optimizations, resulting in communication strategies that are patient-informed and patient-centered. Optimized strategies were implemented in a comprehensive cascade testing program.

Keywords: Cascade testing; Chatbots; Direct contact; Familial hypercholesterolemia; Health communication; Implementation.

MeSH terms

  • Communication
  • Genetic Testing
  • Humans
  • Hyperlipoproteinemia Type II*
  • Patients