Download Step-by-step worksheets & directions

Clinicians, Researchers, and Educators

Step-by-step worksheet

Step-by-step directions


Step-by-step worksheet Industry

Ste-by-step directions Industry


Download Printable Tables

FOCUS tables for Clinicians, Researchers, and Educators

Table 1a – Communication Strategies

Table 1b – Process Measures

Table 2 – Patient Care Experiences

Table 3 – Patient Changes

Table 4 – Patient Health

Table 5 – Family Changes


FOCUS tables for Industry

Industry Table 1 – Processes

Industry Table 2 – Client Experiences

Industry Table 3 – Client Changes

Industry Table 4-  Company Changes



Bernhardt, B. A., Biesecker, B. B., & Mastromarino, C. L. (2000). Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment. American Journal of Medical Genetics, 94(3), 189–97.

Chivers Seymour, K., Addington-Hall, J., Lucassen, A. M., & Foster, C. L. (2010). What facilitates or impedes family communication following genetic testing for cancer risk? A systematic review and meta-synthesis of primary qualitative research. Journal of Genetic Counseling, 19(4), 330–42.

Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press. Retrieved from

Cragun, D. & Zierhut, H. Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.  J. Genet Counsel (2017).

DiClemente, R. J., Crosby, R. A., & Kegler, M. (2009). Emerging theories in health promotion pracitce and research. (R. J. DiClemente, R. A. Crosby, & M. Kegler, Eds.) (2nd ed.). San Francisco, CA: Jossey-Bass.

Donabedian, A. (1988). The Quality of Care – How Can It Be Assessed? JAMA, 260(12), 1743–1748.

George, R., Kovak, K., & Cox, S. L. (2015). Aligning policy to promote cascade genetic screening for prevention and early diagnosis of heritable diseases. Journal of Genetic Counseling, 24(3), 388–99.

Glanz, K., & Bishop, D. B. (2010). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399–418.

Ha Dinh, T. T., Bonner, A., Clark, R., Ramsbotham, J., & Hines, S. (2016). The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review. JBI Database of Systematic Reviews and Implementation Reports, 14(1), 210–47.

Hallowell, N., Lawton, J., & Gregory, S. (2005). Reflections on Research: The Realitities of Doing Research in the Social Sciences. New York, NY: Open University Press.

Hartmann, J. E., Veach, P. M., MacFarlane, I. M., & LeRoy, B. S. (2015). Genetic counselor perceptions of genetic counseling session goals: a validation study of the reciprocal-engagement model. Journal of Genetic Counseling, 24(2), 225–37.

Hoerger, M., Epstein, R. M., Winters, P. C., Fiscella, K., Duberstein, P. R., Gramling, R., … Kravitz, R. L. (2013). Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers. BMC Cancer, 13, 188.

House, J. S. (1981). Work stress and social support. Addison-Wesley Pub Co.

Kenyon, C. C., Palakshappa, D., & Feudtner, C. (2015). Logic Models–Tools to Bridge the Theory-Research-Practice Divide. JAMA Pediatrics, 169(9), 801–2.

Kinney, A. Y., Boonyasiriwat, W., Walters, S. T., Pappas, L. M., Stroup, A. M., Schwartz, M. D., … Higginbotham, J. C. (2014). Telehealth personalized cancer risk communication to motivate colonoscopy in relatives of patients with colorectal cancer: the family CARE Randomized controlled trial. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 32(7), 654–62.

Légaré, F., O’Connor, A. C., Graham, I., Saucier, D., Côté, L., Cauchon, M., & Paré, L. (2006). Supporting patients facing difficult health care decisions: use of the Ottawa Decision Support Framework. Canadian Family Physician Medecin de Famille Canadien, 52, 476–7. Retrieved from

Lerner, J. S., Li, Y., Valdesolo, P., & Kassam, K. S. (2015). Emotion and Decision Making. Annu. Rev. Psychol, 6633.

Lundahl, B., Moleni, T., Burke, B. L., Butters, R., Tollefson, D., Butler, C., & Rollnick, S. (2013). Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Education and Counseling, 93(2), 157–68.

Makoul, G., & Clayman, M. L. (2006). An integrative model of shared decision making in medical encounters. Patient Education and Counseling, 60(3), 301–12.

McAllister, M., & Dearing, A. (2015). Patient reported outcomes and patient empowerment in clinical genetics services. Clinical Genetics, 88(2), 114–21.

McAllister, M., Moldovan, R., Paneque, M., & Skirton, H. (2016). The need to develop an evidence base for genetic counselling in Europe. European Journal of Human Genetics : EJHG, 24(4), 504–5.

McAllister, M., Payne, K., Macleod, R., Nicholls, S., Dian Donnai, & Davies, L. (2008). Patient empowerment in clinical genetics services. Journal of Health Psychology, 13(7), 895–905.

McAllister, M., Payne, K., Nicholls, S., MacLeod, R., Donnai, D., & Davies, L. M. (2007). Improving service evaluation in clinical genetics: identifying effects of genetic diseases on individuals and families. Journal of Genetic Counseling, 16(1), 71–83.

Mcallister, M., Wood, A., Dunn, G., Shiloh, S., & Todd, C. (2011). The Genetic Counseling Outcome Scale: A new patient-reported outcome measure for clinical genetics services. Clinical Genetics, 79, 413–424.

Meiser, B., Butow, P. N., Barratt, A. L., Schnieden, V., Gattas, M., Kirk, J., … Psychological Impact Collaborative Group. (2001). Long-term outcomes of genetic counseling in women at increased risk of developing hereditary breast cancer. Patient Education and Counseling, 44(3), 215–25.

Meiser, B., Irle, J., Lobb, E., & Barlow-Stewart, K. (2008). Assessment of the content and process of genetic counseling: a critical review of empirical studies. Journal of Genetic Counseling, 17(5), 434–51.

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: helping people change (3rd ed.). New York, NY: The Guilford Press.

National Quality Measures Clearninghouse. (2017). Retrieved February 6, 2017, from

Nci, DCCPS, & Arp. (2007). Patient-Centered Communication in Cancer Care: Promoting Healing & Reducing Suffering. Bethesda, MD: NIH publication.

Nilsen, P., Eccles, M., Grimshaw, J., Walker, A., Johnston, M., Pitts, N., … Baumgardner, M. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53.

Paul, J., Metcalfe, S., Stirling, L., Wilson, B., & Hodgson, J. (2015). Analyzing communication in genetic consultations–a systematic review. Patient Education and Counseling, 98(1), 15–33.

Payne, K., Nicholls, S. G., McAllister, M., MacLeod, R., Ellis, I., Donnai, D., & Davies, L. M. (2007). Outcome measures for clinical genetics services: a comparison of genetics healthcare professionals and patients’ views. Health Policy (Amsterdam, Netherlands), 84(1), 112–22.

Payne, K., Nicholls, S., McAllister, M., Macleod, R., Donnai, D., & Davies, L. M. (2007). Outcome measurement in clinical genetics services: a systematic review of validated measures. Value in Health : The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 11(3), 497–508.

Pengchit, W., Walters, S. T., Simmons, R. G., Kohlmann, W., Burt, R. W., Schwartz, M. D., & Kinney, A. Y. (2011). Motivation-based intervention to promote colonoscopy screening: an integration of a fear management model and motivational interviewing. Journal of Health Psychology, 16(8), 1187–97.

Peters, K. F., & Petrill, S. A. (2011). A comparison of the background, needs, and expectations of patients seeking genetic counseling services. American Journal of Medical Genetics. Part A, 155A(4), 697–705.

Pithara, C. (2014). Identifying outcomes of clinical genetic services: qualitative evidence and methodological considerations. Journal of Genetic Counseling, 23(2), 229–38.

Redlinger-Grosse, K., Veach, P. M., Cohen, S., LeRoy, B. S., MacFarlane, I. M., & Zierhut, H. (2015). Defining Our Clinical Practice: The Identification of Genetic Counseling Outcomes Utilizing the Reciprocal Engagement Model. Journal of Genetic Counseling.

Roter, D., Ellington, L., Erby, L. H., Larson, S., & Dudley, W. (2006). The Genetic Counseling Video Project (GCVP): models of practice. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 142C(4), 209–20.

Ruiter, R. A. C., Kessels, L. T. E., Peters, G.-J. Y., & Kok, G. (2014). Sixty years of fear appeal research: current state of the evidence. International Journal of Psychology : Journal International de Psychologie, 49(2), 63–70.

Silvey, K., Stock, J., Hasegawa, L. E., & Au, S. M. (2009). Outcomes of genetics services: creating an inclusive definition and outcomes menu for public health and clinical genetics services. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 151C(3), 207–13.

Street, R. L. (2013). How clinician-patient communication contributes to health improvement: modeling pathways from talk to outcome. Patient Education and Counseling, 92(3), 286–91.

Street, R. L., & Epstein, R. M. (2007). Patient-Centered Communication in Cancer Care: Promoting Healing & Reducing Suffering. Bethesda, MD: NIH publication.

Street, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling, 74(3), 295–301.

Uhlmann, W. R., Schuette, J. L., & Yashar, B. M. (2009). A guide to genetic counseling. (W. R. Uhlmann, J. L. Schuette, & B. M. Yashar, Eds.) (2nd ed.). Hoboken, NJ: Wiley-Blackwell.

Veach, P. M., Bartels, D. M., & LeRoy, B. S. (2007). Coming full circle: A reciprocal-engagement model of genetic counseling practice. Journal of Genetic Counseling, 16, 713–728.

Veach, P. M., LeRoy, B., & Bartels, D. M. (2010). Genetic counseling practice : advanced concepts and skills. Wiley-Blackwell.

Veach, P. M., LeRoy, B. S., & Bartels, D. M. (2003). Facilitating the genetic counseling process: a practice manual. New York: Springer-Verlag.

Wang, C., Gonzalez, R., & Merajver, S. D. S. D. (2004). Assessment of genetic testing and related counseling services: current research and future directions. Social Science & Medicine, 58, 1427–1442.

Wiseman, M., Dancyger, C., & Michie, S. (2010). Communicating genetic risk information within families: a review. Familial Cancer, 9(4), 691–703.

Witte, K. (1992). Putting the fear back into fear appeals: The extended parallel process model. Communication Monographs, 59(4), 329–349.

Zellerino, B. C., Milligan, S. A., Gray, J. R., Williams, M. S., & Brooks, R. (2009). Identification and prioritization of quality indicators in clinical genetics: an international survey. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 151C(3), 179–90.

Zierhut, H. A., Shannon, K. M., Cragun, D. L., & Cohen, S. A. (2016). Elucidating Genetic Counseling Outcomes from the Perspective of Genetic Counselors. Journal of Genetic Counseling, 25(5), 993–1001.