{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:46:05Z","timestamp":1791776765691,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016939","name":"Myriad Genetics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016939","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Advanced practice providers (APPs), including certified nurse\u2010midwives (CNMs)\/certified midwives and nurse practitioners,\u00a0are well positioned to meet the growing demand for women's health care services. In interprofessional obstetric and gynecologic settings,\u00a0APPs\u2019\u00a0scope of practice includes performing hereditary cancer risk assessments (HCRAs) and genetic evaluations, comparable with physicians. However, time constraints, limited confidence, and inadequate resources may\u00a0hinder APPs\u2019 ability to\u00a0routinely and effectively incorporate HCRA\u00a0and genetic testing into practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Process<\/jats:title>\n                    <jats:p>This prospective, single\u2010arm health care quality improvement initiative introduced workflow innovations and tools to improve HCRA workflow. This intervention included training on using online family history screening and virtual patient education tools within a standardized HCRA. Metrics related to genetic evaluation and testing completion and the experiences of women and APP respondents were recorded preintervention and postintervention. Data were analyzed using descriptive statistics and univariate conditional logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Following workflow standardization, APPs noted increases of 27.1 percentage points in the proportion of women offered genetic testing and 26.4 percentage points in the genetic testing completion rate (26.4%). APPs agreed or strongly agreed that the workflow modification improved their confidence in performing HCRA (91.7%) and meeting the standard of care (91.7%) and supported guideline adherence (83.3%) and ease of practice integration (66.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>APPs care for women with similar risk profiles as physicians and are equally capable of implementing novel tools and processes to provide evidence\u2010based, personalized HCRA consistent with their scope of practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jmwh.70134","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:26:01Z","timestamp":1777379161000},"page":"754-760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing Hereditary Cancer Risk Assessment and Genetic Testing Workflow in Interprofessional Women's Health Practice: A Multicenter Survey of Advanced Practice Providers"],"prefix":"10.1111","volume":"71","author":[{"given":"Elaine","family":"Mielcarski","sequence":"first","affiliation":[{"name":"Associates for Women's Medicine  North Syracuse New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Karanik","sequence":"additional","affiliation":[{"name":"Associates for Women's Medicine  North Syracuse New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Bagley","sequence":"additional","affiliation":[{"name":"Myriad Genetics  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Smith","sequence":"additional","affiliation":[{"name":"Myriad Genetics  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Steele","sequence":"additional","affiliation":[{"name":"Myriad Genetics  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Logan","family":"Schneider","sequence":"additional","affiliation":[{"name":"Myriad Genetics  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Lenz","sequence":"additional","affiliation":[{"name":"Myriad Genetics  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Royce T.","family":"Adkins","sequence":"additional","affiliation":[{"name":"Myriad Genetics  Salt Lake City Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Midwives: Information on Births, Workforce, and Midwifery Education (GAO\u201023\u2010105861)","author":"United States Government Accountability Office: Report to Congressional Requesters","year":"2023"},{"key":"e_1_2_8_3_1","unstructured":"AANP News.Nurse practitioner profession grows to 385 000 strong.American Association of Nurse Practitioners. November 13 2023. Accessed April 3 2025.https:\/\/www.aanp.org\/news\u2010feed\/nurse\u2010practitioner\u2010profession\u2010grows\u2010to\u2010385\u2010000\u2010strong"},{"key":"e_1_2_8_4_1","unstructured":"Bureau of Health Workforce National Center for Health Workforce Analysis.Projections of supply and demand for women's health service providers: 2018\u20102030.US Department of Health and Human Services Health Resources and Services Administration.2024. Accessed August 29 2024.https:\/\/bhw.hrsa.gov\/data\u2010research\/projecting\u2010health\u2010workforce\u2010supply\u2010demand"},{"key":"e_1_2_8_5_1","unstructured":"U.S. Bureau of Labor Statistics.Occupational Outlook Handbook.U.S. Bureau of Labor Statistics. August 29 2024. Accessed April 3 2025.https:\/\/www.bls.gov\/ooh\/healthcare\/nurse\u2010anesthetists\u2010nurse\u2010midwives\u2010and\u2010nurse\u2010practitioners"},{"key":"e_1_2_8_6_1","unstructured":"American College of Nurse\u2010Midwives.Midwives are stronger together.American College of Nurse\u2010Midwives.2025. Accessed January 30 2025.https:\/\/www.midwife.org\/"},{"key":"e_1_2_8_7_1","unstructured":"National Association of Nurse Practitioners in Women's Health.National Association of Nurse Practitioners in Women's Health website.2025. Accessed January 30 2025.https:\/\/npwh.org\/"},{"key":"e_1_2_8_8_1","unstructured":"Women's Preventive Services Initiative.Recommendations for women's preventive healthcare.Women's Preventive Services Initiative.2024. Accessed January 30 2025.https:\/\/www.womenspreventivehealth.org\/"},{"key":"e_1_2_8_9_1","unstructured":"National Association of Nurse Practitioners in Women's Health.Position statement: hereditary breast and ovarian cancer risk assessment.National Association of Nurse Practitioners in Women's Health. Updated May 2022. Accessed July 10 2025.https:\/\/npwh.org\/resource\/resmgr\/positionstatement\/2024_updates\/NPWH_PositionStatement_Hered.pdf"},{"key":"e_1_2_8_10_1","unstructured":"American College of Obstetricians and Gynecologists.ACOG committee opinion number 793: hereditary cancer syndromes and risk assessment.American College of Obstetricians and Gynecologists. Updated 2020. 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