2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6fb,Cascade genetic testing in families with hereditary cancer syndromes is an important strategy to reduce the burden of cancer, but testing of relatives is low. Direct engagement of relatives through cancer survivors is a promising approach to bridge this gap. We conducted a population-based cluster-randomized clinical trial (Genetic Information and Family Testing [GIFT]) of an online, direct-to-family, cancer genetic education and communication tool including the offer of home testing to adult relatives of cancer survivors diagnosed in 2018-2019 who carried a pathogenic variant. We selected patients through SEER and surveyed them for eligibility followed by a trial invitation. Two features were randomized: assistance from a human navigator (yes, no) and testing cost (free Four thousand three hundred patients were surveyed and 2,285 responded (53.1%); 2,006 eligible respondents were invited (87.8%) and 414 enrolled (20.6%). Enrolled patients reported a total of 4,946 first- and second-degree relatives (mean, 12.3; standard deviation [SD], 8.6); they invited 948 relatives (19.2%) and 303 enrolled (32.0%). Most enrolled relatives ordered testing (267, 91.3%); more than double were tested in the free versus $50 arm (odds ratio [OR], 2.5 [1.6-3.9]), but the baseline fraction tested was low at 0.03 and thus the absolute increase was modest (0.04 [95% CI, 0.02 to 0.05]). We did not find evidence for increased testing in the navigation arm (OR, 1.3 [0.8-2.1]). GIFT is a promising blueprint for online cascade genetic education and testing. Results suggest that a low-cost, population-level intervention could be deployed without a human navigator. Additional intervention strategies are needed to increase the modest invitation and testing uptake observed in this study.31:Ta4e, PURPOSE Cascade genetic testing in families with hereditary cancer syndromes is an important strategy to reduce the burden of cancer, but testing of relatives is low. Direct engagement of relatives through cancer survivors is a promising approach to bridge this gap. METHODS We conducted a population-based cluster-randomized clinical trial (Genetic Information and Family Testing [GIFT]) of an online, direct-to-family, cancer genetic education and communication tool including the offer of home testing to adult relatives of cancer survivors diagnosed in 2018-2019 who carried a pathogenic variant. We selected patients through SEER and surveyed them for eligibility followed by a trial invitation. Two features were randomized: assistance from a human navigator (yes, no) and testing cost (free v $50). We hypothesized that the fraction of relatives tested in a family (primary outcome) would be higher with a navigator and free testing. RESULTS Four thousand three hundred patients were surveyed and 2,285 responded (53.1%); 2,006 eligible respondents were invited (87.8%) and 414 enrolled (20.6%). Enrolled patients reported a total of 4,946 first- and second-degree relatives (mean, 12.3; standard deviation [SD], 8.6); they invited 948 relatives (19.2%) and 303 enrolled (32.0%). Most enrolled relatives ordered testing (267, 91.3%); more than double were tested in the free versus $50 arm (odds ratio [OR], 2.5 [1.6-3.9]), but the baseline fraction tested was low at 0.03 and thus the absolute increase was modest (0.04 [95% CI, 0.02 to 0.05]). We did not find evidence for increased testing in the navigation arm (OR, 1.3 [0.8-2.1]). CONCLUSION GIFT is a promising blueprint for online cascade genetic education and testing. Results suggest that a low-cost, population-level intervention could be deployed without a human navigator. Additional intervention strategies are needed to increase the modest invitation and testing uptake observed in this study. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Cluster-Randomized Trial: study design Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Cluster-Randomized Trial (study design). Clinician-written summaries and actionable practice insights. 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In 2020–2021 (low influenza circulation), confirmed outbreaks were rare (16 vs. 15) and no significant difference was found.","limitations":"- The 2020–2021 season had very low influenza circulation (likely due to COVID-19 mitigation measures), limiting the ability to detect a vaccine effect in that year.\n- Outbreaks were facility-reported via monthly logs, introducing potential for underreporting or misclassification.\n- Vaccination coverage rates among staff and residents were not detailed in the abstract, which may affect generalizability.","practice_takeaway":"During seasons with substantial influenza activity, RIV4 may meaningfully reduce facility-level influenza outbreak risk in nursing homes compared to standard-dose IIV4 — an 18% relative risk reduction in confirmed outbreaks. Long-term care facilities should consider prioritizing recombinant influenza vaccine for both residents and staff when it is available."}},{"doi":"10.1200/jco-25-02196","pmid":"41875376","title":"Results From the Genetic Information and Family Testing Study: A Cluster-Randomized Trial","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-03-24T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-02196","source_score":62,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-02","doi":"10.1200/jco-25-02196","days":"14","issn":"0732-183X","rank":"8","field":"Clinical Medicine","score":"62","category":"Oncology","categories":["Oncology"],"_categories":["Oncology"]},"pubmed":{"doi":"10.1200/JCO-25-02196","title":"Results From the Genetic Information and Family Testing Study: A Cluster-Randomized Trial.","journal":"Journal of clinical oncology : official journal of the American Society of Clinical Oncology","methods":"","results":"Four thousand three hundred patients were surveyed and 2,285 responded (53.1%); 2,006 eligible respondents were invited (87.8%) and 414 enrolled (20.6%). Enrolled patients reported a total of 4,946 first- and second-degree relatives (mean, 12.3; standard deviation [SD], 8.6); they invited 948 relatives (19.2%) and 303 enrolled (32.0%). Most enrolled relatives ordered testing (267, 91.3%); more than double were tested in the free versus $50 arm (odds ratio [OR], 2.5 [1.6-3.9]), but the baseline fraction tested was low at 0.03 and thus the absolute increase was modest (0.04 [95% CI, 0.02 to 0.05]). We did not find evidence for increased testing in the navigation arm (OR, 1.3 [0.8-2.1]).","abstract":"$30","keywords":[],"pubmed_id":"41875376","conclusions":"GIFT is a promising blueprint for online cascade genetic education and testing. Results suggest that a low-cost, population-level intervention could be deployed without a human navigator. Additional intervention strategies are needed to increase the modest invitation and testing uptake observed in this study.","publication_date":"2026-03-24T00:00:00"},"crossref":{"DOI":"10.1200/jco-25-02196","URL":"https://doi.org/10.1200/jco-25-02196","ISSN":["0732-183X","1527-7755"],"link":[{"URL":"https://ascopubs.org/doi/pdfdirect/10.1200/JCO-25-02196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1216-1224","type":"journal-article","issue":"13","score":1,"title":["Results From the Genetic Information and Family Testing Study: A Cluster-Randomized Trial"],"author":[{"given":"Steven J.","family":"Katz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, MI"},{"name":"Department of Health Management and Policy, School of Public Health and Department of Internal Medicine, University of Michigan, Ann Arbor, MI"}]},{"given":"Timothy 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Two features were randomized: human navigator assistance (yes vs. no) and testing cost (free vs. $50).","key_result":"Of 4,946 reported relatives, only 19.2% were invited and 32% of those enrolled; 91.3% of enrolled relatives ordered testing. Free testing more than doubled the odds of testing vs. $50 (OR 2.5, 95% CI 1.6–3.9), but the absolute increase in the fraction tested was modest (0.04, 95% CI 0.02–0.05). Human navigation did not significantly improve testing uptake (OR 1.3, 95% CI 0.8–2.1).","limitations":"Only 20.6% of eligible patients enrolled, limiting generalizability. Patients invited just 19.2% of their relatives, creating a major upstream bottleneck the intervention could not overcome. The absolute baseline testing fraction was very low (0.03), so even a significant relative improvement produced a small absolute gain.","practice_takeaway":"Removing cost barriers (offering free testing) meaningfully increases cascade genetic testing uptake and can be deployed without a human navigator, reducing program complexity and cost. However, clinicians should recognize that most relatives are never invited — strategies to boost patient-to-relative outreach remain the critical gap."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"study_design","value":"Cluster-Randomized Trial"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Study Designs","href":"/hub/tag/study_design"},{"name":"Cluster-Randomized Trial"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"study_design","hub_tag_value":"Cluster-Randomized Trial"}}}]]

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