P257 - EVALUATING THE IMPACT OF DIRECT VS. HEALTHCARE PROFESSIONAL FACILITATED COMMUNICATION OF POLYGENIC RISK SCORES ON CARDIOVASCULAR RISK PERCEPTION AND HEALTH BEHAVIOR: AN IMPLEMENTATION SCIENCE STUDY

Background: Cardiovascular diseases (CVD) remain a leading cause of global mortality, significantly influenced by genetic predispositions. A polygenic risk score (PRS) represents an aggregate of thousands to millions of single-nucleotide polymorphisms (SNPs) and offers a sophisticated approach to assessing genetic risk. However, the optimal method of communicating these scores—directly to patients or through healthcare professionals (HCPs)—requires further exploration. In this study we compared the impact of direct versus HCP-facilitated web tool communication of a PRS on patients' perceptions of CVD risk, the utility of genetic information, and attitudes toward genetic testing, utilizing an implementation science framework.

METHODS AND RESULTS: We enlisted first-degree relatives of premature CVD patients from a pre-established cohort. Participants were randomly assigned to receive PRS information directly via a custom-developed web tool or through HCP-mediated discussions facilitated by the same web tool. An implementation science framework informed the study design to ensure its practicality and applicability in real-world settings. We evaluated outcomes related to perceived CVD risk, PRS utility and disutility, genetic testing attitudes, psychosocial impacts, communication method satisfaction, PRS results confidence, PRS understanding, and intentions for health behavior modifications. The analysis revealed that while both HCP-mediated and direct web tool communication methods effectively increased participants' perceived utility of PRS and positively influenced their attitudes toward genetic testing, the HCP-mediated approach outperformed direct communication in fostering a deeper understanding of genetic risk. Participants receiving HCP-mediated communication reported higher satisfaction, a more nuanced comprehension of their PRS, and greater confidence in interpreting the results to inform health decisions. However, it is noteworthy that direct communication also demonstrated substantial benefits, particularly in terms of accessibility and immediacy of information. Both methods showed potential in encouraging participants to engage in preventive health behaviors, with HCP-mediated communication offering an advantage in personalizing the information and addressing individual concerns.

Conclusion: This study indicates that while HCP-mediated communication of PRS information via a web tool enhances patient comprehension and satisfaction, both methods play a critical role in disseminating genetic risk information. The nuanced differences suggest that personalization and direct engagement through HCPs can further amplify the positive impacts on patient understanding and psychosocial outcomes. These findings highlight the importance of tailored communication strategies in genetic counseling, emphasizing the need for a balanced approach that considers the strengths and limitations of both direct and HCP-mediated communication methods.