MODELING THE EFFECTS OF SURVEY TIMING ON SCORES FOR THE WORKING ALLIANCE INVENTORY IN A SECONDARY DATA ANALYSIS OF CARDIOVASCULAR GENETIC COUNSELING OUTCOMES

Abstract

Genetic counseling (GC) research has increasingly regarded the therapeutic alliance, often assessed with the Working Alliance Inventory – Short Revised (WAI-SR), as a variable through which GC outcomes may be mediated. In psychological research the WAI-SR is typically measured immediately following an encounter, but the increase in telemedicine has changed how and when patient surveys are administered. This exploratory analysis of GC outcomes aims to identify whether there may be a relationship between the time lag between the visit and administration of the WAI-SR measure.

The data for this analysis were drawn from two groups of research participants being seen for GC at the Johns Hopkins Center for Inherited Heart Disease (Group 1 N = 106, Group 2 N = 242). Multiple linear regression was used to assess possible relationships between WAI-SR scores and time to post-survey completion by quartile, controlling for demographic and session variables, and WAI-SR scores, participant empowerment, and cardiac anxiety. For Group 1, the second time quartile was found to have a statistically significant relationship to WAI-SR scores (p = .003) when controlling for demographic and session confounders. WAI-SR subscale scores were significantly different in the second time quartile, but there were no interaction effects between the subscale scores and time quartile. No significant relationships to time were uncovered for Group 2. The lack of replication in WAI-SR score differences in the second group with a larger sample size offers initial reassurance that therapeutic alliance scores are consistent regardless of whether the measure was administered immediately following a GC visit or at a later time.