My research focuses on understanding the diverse and multiple decisions that individuals and families face when dealing with hereditary cancer risk (HCR). These experiences begin from the time people first become aware of the possibility of hereditary cancer risk, and span the cancer control spectrum from cancer risk assessment, prevention, surveillance, to cancer treatment. Awareness of hereditary cancer risk, manifested as elevated risk perception, may arise in response to different triggers, such as different cancer sites, the cancer situation (affected or at-risk), and within the context of different sites of health care delivery by either genetic specialist or non-specialist health care providers. The response of individuals and families to these HCR decisions involves multiple dimensions -- the cognitive dimension, which may require information; the behavioral dimension, which may call for emotional support; and the social dimension, involving friends and family as well as health professionals. Improved understanding of these HCR decisions and experiences is combined with evidence from the literature to guide the development of HCR decision support interventions for individuals and families. Building on cancer risk assessment, HCR decision support must go beyond merely assessing and providing information, but also be tailored to needs based on patient preferences, values, insufficient support, and inadequate decision making or communication skills. Delivery of HCR decision support to patients and families incorporates new modes of delivery beyond intensive one-on-one interactions and innovative systems of care delivery involving consumer health informatics and public channel delivery. This research is innovative because it reconceptualizes decision experiences related to hereditary cancer risk, redefines patient decision support more broadly, and moves genetic health care beyond specialty care. It is translational because it incorporates basic science in cancer risk perception, risk assessment, and risk communication to new areas.