An exploration of healthcare providers learning needs and strategies for engagement in Polygenic Risk education

Abstract

Polygenic risk scores (PRS) provide an estimate of the genetic contribution to health conditions. Despite increasing clinical translation, healthcare providers (HPs) report a lack of PRS knowledge, representing a major barrier to safe and effective use in practice. This study aimed to i) identify HPs learning and resource needs for PRS delivery, and ii) outline strategies to best engage clinicians in PRS education, with findings used to inform the co-design of an educational program. To ensure informed responses, genetic healthcare providers with prior experience using PRS, and/or who had completed PRS education were recruited to participate in focus groups (n=30). Recordings were transcribed and content analysis conducted with themes mapped to the Capability, Opportunity and Motivation model for Behavior change (COM-B) to identify strategies to engage providers in PRS education. Among this cohort of experienced providers, residual PRS-related knowledge, skills and implementation gaps were frequently noted. Two themes encompassed PRS learning and resource needs: i) PRS specific knowledge base including fundamental principles, understanding clinical guidelines and test limitations, and ii) communication skills needed to discuss results and facilitate risk management and health behavior changes. Themes mapped to capability included access to training and time-poorness as a primary barrier. Limited awareness of educational initiatives, including practice resources and position statements from professional bodies, was noted. Opportunities comprised of building on existing workplace training and activities such as multidisciplinary team meetings and journal clubs. All participants noted that motivation for completing PRS training was primarily driven by a desire to improve patient-centered care and clinical outcomes. Findings highlight the complexity of PRS education and priority learning areas and will be used to inform the development of tailored PRS education for HPs to support implementation of PRS into clinical research and practice.