This study used structurating activity theory to analyze 21 conversations between genetic counselors and individuals at increased risk for familial colorectal cancer. The qualitative analysis revealed ways elements of family, primary health care, cancer prevention and treatment, and other systems emerged in intervention conversations as shaping colorectal cancer screening attitudes and behaviors. Results indicate that family stories, norms, and roles are resources for enacting health practices in families and that the authority of health care providers is a resource for making screening decisions. Conclusions include practical implications for using findings in clinical applications as well as future research directions to build on this exploratory study.
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