地域医療と健康教育

抽象的な

Genetics in Primary Healthcare in Brazil: Potential Contribution of Mid-level Providers and Community Health Workers

Gramasco HHF, Baptista FH, Ribeiro MG, de Avó LRS, Germano CMR and Melo DG

Objective: This study aimed to investigate genetic care competencies of mid-level health providers and community health workers in Brazil.

Methods: It is a descriptive survey study, whereby mid-level health providers (nursing auxiliaries and technicians, and auxiliaries in oral health) and community health workers were invited to participate by answering a questionnaire including 10 structured genetics-oriented issues. Data were presented as percentages. Differences between groups were assessed by the Fisher exact test, with the level of significance set at p<0.05.

Results: Concerning knowledge, most of the participants valued important aspects of family history like the distribution of a disease over successive generations and presence of consanguinity, and 79% of them recognized that there are families at increased risk of developing cancers. They also had good knowledge about exposure to teratogens and neonatal screening. Regarding clinical skills, practitioners were able to recognize facial dysmorphias and 63% showed predisposition to gather information about genetic disease in the family history. Regarding attitudes, 65% believed that patients with rare diseases require interdisciplinary approach and 61% showed initiative to refer patients for specialist. In general, there was no significant difference between both professional groups on the investigated knowledge, skills and attitudes, except for the skill to distinguish the phenotype of Down and Crouzon syndromes, which was more present among the mid-level health providers (p 0.04).

Conclusion: These findings may contribute to developing an ongoing education program for mid-level health providers and community health workers, leading to a strategy to overcome the challenges of integrating genetics into primary healthcare in Brazil.