Supplementary Material for: Medical Genetic Counseling for Breast Cancer in Primary Care: A Synthesis of Major Determinants of Physicians' Practices in Primary Care Settings

<b><i>Objectives:</i></b> This paper aims to identify relevant potential predictors of medical genetic counseling for breast cancer (MGC-BC) in primary care and to develop a comprehensive questionnaire to study MGC-BC. <b><i>Methods:</i></b> A scoping review was conducted to identify the predictors of MGC-BC among primary care physicians. Relevant articles were identified in selected databases (PubMed, Embase, CINAHL, ISI Web of Science, PsycINFO, and Cochrane CENTRAL) and 4 selected relevant electronic journals. <b><i>Results:</i></b> An inductive analysis of the 193 quantitatively tested variables, conducted by 3 researchers, showed that 6 conceptual categories of determinants, namely (1) demographic, (2) organizational, (3) experiential, (4) professional, (5) psychological, and (6) cognitive, influence MGC-BC practices. <b><i>Conclusion:</i></b> There is a scarcity of literature addressing the medical behavior determinants of MGC-BC. Future research is needed to identify effective strategies put into action to support the integration of MGC-BC in primary care medical practices and routines. However, our results shed light on 2 levels of actions that could improve genetic counseling services in primary care: (1) medical training and educational efforts emphasizing family history collection (individual level), and (2) clarification of roles and responsibilities in ordering and referral practices in genetic counseling and genetic testing for better healthcare management (organizational level).

**<i>研究目标：</i>** 本研究旨在识别基层医疗中乳腺癌医学遗传咨询（medical genetic counseling for breast cancer, MGC-BC）的相关潜在预测因素，并开发用于研究MGC-BC的综合调查问卷。
**<i>研究方法：</i>** 本研究采用范围综述法，针对基层医疗医师开展乳腺癌医学遗传咨询预测因素的识别工作。研究人员在选定的数据库（PubMed、Embase、CINAHL、ISI Web of Science、PsycINFO及Cochrane CENTRAL）以及4种相关电子期刊中检索到符合要求的文献。
**<i>研究结果：</i>** 由3名研究人员对193个经量化检验的变量进行归纳分析后发现，共有6大类决定因素影响乳腺癌医学遗传咨询的临床实践，分别为：(1) 人口统计学因素；(2) 组织管理因素；(3) 实践经验因素；(4) 专业素养因素；(5) 心理因素；(6) 认知因素。
**<i>研究结论：</i>** 目前针对乳腺癌医学遗传咨询医疗行为决定因素的相关文献较为匮乏。未来亟需开展相关研究，以确定可有效支持基层医疗实践与日常工作中融入该服务的实施策略。不过本研究结果明确了两类可改善基层医疗遗传咨询服务的干预方向：(1) 强化以家族史采集为重点的医学培训与教育工作（个体层面）；(2) 明确遗传咨询与基因检测环节的开单及转诊流程中的角色与职责，以优化医疗管理流程（组织层面）。