Women who learn through genetic testing that they are at high risk for developing hereditary breast and ovarian cancer may choose to undertake several risk-reducing strategies, including surgery, chemoprevention, and increased screening. An emerging body of research is beginning to describe high-risk women’s experiences and satisfaction upon adopting these risk-reducing strategies; however, little is known about how women come to make these decisions. Because of the highly personal nature of this decision, most health care providers attempt to support decision-making about risk-reducing strategies, rather than recommend particular courses of action. In order to support women and to develop and evaluate appropriate interventions, it is essential to understand how women arrive at these decisions. Fuchsia Howard is identifying the personal, psychological and social contextual factors that influence women’s decision-making about breast and ovarian cancer risk-reducing strategies. This research will contribute to an understanding of the impact of genetic testing for hereditary breast and ovarian cancer risk on the psychological health and quality of life of women found to be at high-risk. This understanding will inform future development of appropriate interventions within programs offering genetic services.