Project overview: The GRAMM Project is an innovative study aimed at bridging the gap in breast cancer-related health disparities. At a juncture when patients are actively engaged in their breast cancer screening care, all patients presenting for a routine screening mammogram at the Ypsilanti Health Center were offered a risk assessment utilizing a software tool called InheRET. This tool gathers information about personal and family cancer history based on genetic testing criteria from the National Comprehensive Cancer Network, with the goal of identifying those who meet criteria for testing. For those with a positive screen, a direct referral was placed for them to meet with a genetic counselor. Those patients were then followed over time to observe how many followed up with genetic counseling, chose to complete genetic testing, and received their results. A voluntary quantitative survey was offered to all who participated in the risk assessment to gauge the acceptability of the intervention, patient understanding of cancer risk, and possible barriers to testing. Throughout the study, educational events were held with an emphasis on community outreach and trust building around genetics and cancer risk. Patients were also invited to participate in a qualitative component to further evaluate the intervention and explore barriers to care.
Project data: To date, the GRAMM study has recruited 106 participants, with 54 participants screening positive in the risk assessment. Of those who screened positive, 33 participants made an appointment with genetic counselors, and 18 participants completed testing.
79 participants completed the quantitative survey, with 78 participants expressing satisfaction with the risk assessment. For 74 participants, this was their first time being offered a breast cancer risk assessment.
Qualitative Component: The second phase of this study includes a qualitative component to explore facilitators and barriers to genetic counseling, testing, and appointments. This will involve interviewing the participants who screened positive during the risk assessment. The interviews will be separated into two parts, with the first cohort containing those who identified as African American/Black. 10-15 participants will be interviewed from each cohort, with a maximum of 30 participants in total. Each interview will last no more than an hour and will occur via Zoom. Each interview will be recorded, with the transcripts retained, de-identified, and analyzed. Participants will be compensated for completing their interview via a gift card.