Grant: Operating Grant: Knowledge Synthesis Grants: Allied Health and Genetics

Background: Genetic testing is being used more widely across healthcare, creating long waitlists and overwhelming the traditional way these services are delivered. To keep up with demand, new approaches are being explored. These include using digital tools, having non-genetic specialists manage testing, and adding genetic counsellors or other trained professionals into medical teams. While early studies show promise in areas like rare diseases, heart disease, and cancer, we still don't have a clear picture of which of these new models work best, are cost-effective, and make care more fair and accessible. What we're doing: We will review international research to better understand how genetic services can be delivered effectively by AHPs-from the first steps like taking family history and providing education, to helping people make testing decisions, giving results, and planning follow-up care. Our framework: We will evaluate how these models impact patient experience, health outcomes, cost, access to care, and provider well-being-the "quintuple aim" in healthcare. Our method: We will systematically review and analyze the evidence, quality of studies, and use a realist review. These services may involve: 1.Allied health professionals (like nurses, genetic counsellors or physician assistants) 2.Digital or virtual tools Outcomes: 1.For patients: knowledge, emotional impact, decisions, behavior, family communication 2.For providers: experience, willingness to use new models 3.For health systems: time, costs, ease of implementation 4. For populations: diagnoses, screening rates 4.For equity: access across geography, literacy levels, income, and other barriers Sharing: We will create patient and clinician summaries as well as a flow chart showing which models work best in which settings, like cancer or rare diseases. We will share findings through a national workshop to reach consensus on best practices and capacity development to support AHPs in genetics.