Improving care for marginalized populations at risk for hereditary cancer syndromes: Innovations that expanded genomic services’ reach in the CHARM study.

Access to genomic health services generally relies on primary care clinicians and specialists recognizing patients’ clinical needs and either offering genomic testing directly or referring to genetics professionals. However, this approach is not equitable as it relies on individual clinicians’ knowledge of genomic services and ignores variation in individual patients’ barriers to access these services. The recently completed Cancer Health Assessments Reaching Many (CHARM) study, conducted at Kaiser Permanente Northwest and Denver Health, evaluated the feasibility and acceptability of innovations designed to improve reach and address inequities in cancer genetics services for adults.
This panel will explore three key innovations used in CHARM: digital materials and remote technologies, relationship-oriented communication strategies, and health-system embedded multilevel interventions. The discussion will consider lessons from CHARM and further research needed to expand the reach of genomic health care, particularly to marginalized populations across other clinical contexts, such as for children with neurodevelopmental delay or adults making reproductive plans.

Authors: Benjamin Wilfond, Seattle Childrens Research Institute; Stephanie Kraft, Seattle Childrens Research Institute; Marian Gilmore, Kaiser Permanente – Center for Health Research; Sarah Knerr, University of Washington School of Public Health