Implementing a genetic testing station in a safety net setting for equitable genetic testing and counseling.

167 Background: Genetic testing (GT) in patients with hereditary cancers has significant implications for treatment options and risk reduction among family members. Recent GT guidelines have expanded the eligibility criteria with limited genetic counseling staff. Patients who are from marginalized groups, are under or uninsured, or have limited English proficiency continue to experience disparities in GT, underscoring the need for innovations in care delivery. Methods: From March 2021 to June 2023, we conducted a single-arm intervention study of a point-of-care genetic testing station (GTS) in a safety net hospital. Patients who met NCCN criteria for GT were eligible. We compared this group to a historical cohort who received GT either in person or via telehealth in the preceding two years and non- GTS cohort. The GTS intervention consisted of (1) screening of clinic schedules for eligible patients, (2) GT video-based education in English, Spanish, and Cantonese, (3) consent and collection of blood or saliva samples by a genetic counseling assistant, and (4) telehealth-based post-test counseling with a genetic counselor (GC). The historical cohort underwent GT in a traditional model: (1) oncologist-initiated electronic referral, (2) pretest counseling with a GC, (3) GT if appropriate, and (4) post-test counseling to review and discuss results. Our primary outcomes were completion of GT and time to result delivery. We evaluated all associations with the Chi-square test for categorical variables. Results: We enrolled a total of 256 participants, 26% were Asian, 18% were Black, 30% were Hispanic/Latinx, 13% were Non-Hispanic White, and 2% were Native Hawaiian/Pacific Islander. The most common languages were English 48%, Spanish 28%, Cantonese 20%, and Other 4%. 251 (98%) of GTS participants completed GT, and 241 (95%) completed the post-test GC visit, compared to the Non-GTS cohort (79%, p<0.001), pre-GTS cohort (85%, p<0.001) with traditional GT model with in-person at 122 (95%) and telehealth (72%). The median time to result delivery was 35 days (IQR 27 - 52) for the GTS cohort, 56 days for non-GTS cohort, 97 days for pre-GTS telehealth (IQR 24.7 - 111), and 21 days ( IQR 14-31) days for in-person. Conclusions: GTS resulted in more patients completing GT and promptly receiving their results with telehealth genetic counseling. As GT eligibility criteria broaden, innovative interventions, workflows, and tailored educational resources for diverse populations are needed to ensure equitable access to GT.