Program Outcomes

Applicants should develop a logic model that is consistent with the outcomes below to guide their program planning and development efforts, using CDC’s logic model as a starting point. The bolded outcomes are required for all applicants; however, applicants are encouraged to identify additional outcomes to assess their programmatic activities, including proximal outcomes. Applicants may identify other outcomes from the CDC logic model, or with justification, identify additional outcomes that are specific to their proposed activities. Strategies and activities that programs choose to implement should link to short-term and/or intermediate outcomes, and the link should be evident in the work plan.

Long-Term Outcomes
Outcome Description
Increased appropriate utilization of genetic counseling and genetic testing This outcome relates to the use of genetic counseling and testing by individuals who meet criteria presented in recommendations based on their personal and family history.
Increased proportion of individuals at high risk for a hereditary cancer who are counseled on and utilize risk management strategies. This outcome relates to shared decision-making conversations and use of risk management services for individuals who have been shown to have a pathogenic variant in a highly penetrant gene or a family history that puts them at an increased risk of cancer relative to population risk.
Intermediate Outcomes
Outcome Description
Increased proportion of individuals report that they are aware of their family history of cancer and report having discussed their associated cancer risk with a provider This outcome relates to whether individuals have collected family history information and discussed it with a provider.
Increased number of providers using family history screening and tumor testing to identify individuals at high risk for hereditary cancer This outcome relates to the clinical use of family history by all types of providers. Family history is most relevant in primary care and oncology settings. Tumor testing is most relevant among newly diagnosed cancer patients with Lynch-associated cancers.
Improved referral patterns for cancer genetic services This outcome relates to health systems and payers having policies and practices that are concordant with recommendations for family history screening, tumor testing, referral of patients with increased risk to genetic counseling and testing, and cascade screening of relatives. It may include promoting, developing resources for, or helping establish referral networks within health systems and clinics for genetic counseling and alternative options, like telegenetics and telephone genetic counseling.
Increased health systems with universal tumor screening protocols for LS among newly diagnosed cancer patients This outcome relates to clinical and health system policies for routine tumor testing for Lynch syndrome, such as microsatellite instability or immunohistochemistry, for colorectal and endometrial cancer patients.
Short-Term Outcomes
Outcome Description
Improved data on hereditary cancer burden and utilization of cancer genetic services This outcome may include identifying data sources, modifying existing data sources, or developing new data sources to assess hereditary cancer burden and use of cancer genetic services, the dissemination of data, and use of data to inform program-planning efforts.
Increased public awareness and knowledge about family history of cancer and benefits of genetic counseling and testing This outcome relates to increased public awareness of family history as a tool for cancer prevention and control, and knowledge about the benefits and risks of undergoing genetic counseling and testing for those who are at increased risk for cancer.
Increased knowledge and self-efficacy among providers to apply professional recommendations, clinical communication, record family health history, use referral tools as recommended by USPSTF and to refer to genetic counseling and testing This outcome relates to provider knowledge of recommendations, and their ability to use criteria and tools to identify patients as having an increased risk of cancer and refer them to genetic counseling and testing.
Policy and systems change to improve access to and utilization of genetic counseling, testing and risk management for HBOC and LS This outcome may include assessment of policy, systems, and environmental factors that may improve access to and use of genetic counseling, testing, and risk management services; the development of partnerships that may be effective in making policy and systems changes; and dissemination of findings with relevant partners.
Reduced systems barriers for access of screening and genetic services This outcome may include assessment of barriers and dissemination of findings, and working with partners to make changes that may address barriers.