The objectives of the protocol are to: (1) evaluate the uptake of cascade screening and preventative therapies before and after the implementation of a simplified screening process and (2) assess proband and family member perspectives about the return of research results and cascade screening for the KCNQ1 Thr224Met variant. The investigators will conduct a mixed methods study in the Old Order Amish community where the KCNQ1 variant is enriched over 100,000-fold compared to other populations. The intervention will offer free, mail-in, saliva-based genetic testing for family members of probands. The rate of uptake of testing and preventative therapy will be compared before (i.e. when 'traditional' $50 blood-based testing was available to family members) and after the intervention is implemented (i.e. when 'simplified' free, mail-in, saliva-based testing was available). The primary outcome is the rate of uptake of cascade screening before ('traditional') versus after ('simplified') the intervention. The secondary outcomes include: extent of disclosure of genotype results before and after the intervention, proportion of informed relatives who get screened before and after the intervention, and the uptake of appropriate preventative care (e.g. seeing a cardiologist and/or taking beta-blocker). The tertiary outcomes are demographic characteristics associated with uptake of cascade screening or uptake of preventative therapy. The investigators will also assess qualitative themes surrounding the return of results process and cascade screening using interviews.
Name: Simplified Cascade Screening
Description: Screening of the KCNQ1 Thr224Met variant for family members of probandsType: GeneticSimplified Cascade Screening
Description: rate of uptake of cascade screening before ('traditional') versus after ('simplified') the intervention
Measure: Uptake of cascade screening determined by counting tests performed Time: 18 monthsDescription: proportion of family members told before ('traditional') versus after ('simplified') the intervention
Measure: Extent of disclosure determined by questionnaire Time: 18 monthsDescription: Proportion of informed family members tested before ('traditional') versus after ('simplified')
Measure: Proportion of informed relatives screened determined by questionnaire Time: 18 monthsDescription: Overall uptake of preventative therapy among carriers across probands and screened family members
Measure: Uptake of preventative therapy by questionnaire Time: 18 monthsSingle Group Assignment
There is one SNP
KCNQ1 Cascade Screening The objectives of the protocol are to: (1) evaluate the uptake of cascade screening and preventative therapies before and after the implementation of a simplified screening process and (2) assess proband and family member perspectives about the return of research results and cascade screening for the KCNQ1 Thr224Met variant. --- Thr224Met ---