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She B, Lu F, Zhao R, Lin S, Sun J, He S, Liu Y, Su S, Zhang L. Examining the Effects of PrEP Use on Sexual Behaviors and Sexually Transmitted Infections Among Chinese Men who have Sex with Men: A Cross-Sectional Study. AIDS Behav 2024:10.1007/s10461-024-04398-9. [PMID: 39066859 DOI: 10.1007/s10461-024-04398-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 07/30/2024]
Abstract
Men who have sex with men (MSM) is a high-risk population for HIV and sexually transmitted infections (STIs). Pre-exposure prophylaxis (PrEP) is effective in HIV prevention. This study aims to examine the differences in sexual behaviors, STI prevalence and HIV/STI testing across subgroups of MSM with various PrEP use. Data were collected via a cross-sectional survey in an MSM community in Xi'an, Shaanxi, from 2022.01 to 2022.09. Participants were categorized as 'PrEP-naïve and unwilling to use', 'PrEP-naïve but willing to use', and 'current or former PrEP users'. Shannon index was used to assess sexual act diversity and multivariate logistic regression analyzed factors associated with PrEP use. Of the 1,131 MSM participants, 23.52% were PrEP-naïve and unwilling, 64.98% were PrEP-naïve but willing, and 11.49% were current or former PrEP users. The PrEP-naïve but willing group had the highest recent STI testing rates at 73.06% and showed greater sexual act diversity (Shannon index 1.61). This group also had the highest syphilis rates (7.49% vs. 6.47% and2.54%, p < 0.01). Younger age (18-30: OR = 0.39 (0.18-0.85); 31-40: OR = 0.43 (0.20-0.96)) and lower education (high school/vocational: OR = 0.15 (0.04-0.58); associate degree: OR = 0.21 (0.06-0.71)) were factors that negatively influenced PrEP use. Current or former PrEP users had the highest oropharyngeal gonorrhea (14.39% vs. 9.68% and 5.80%, p < 0.01) and overall gonorrhea rates (20.86% vs. 17.17% and 8.37%, p < 0.001). 'PrEP-naïve but willing' participants consistently demonstrated high-risk sexual behavior, increased STI testing, and more diverse sexual acts, whereas PrEP users had the highest STI prevalence.
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Affiliation(s)
- Bingyang She
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China
| | - Fang Lu
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China
| | - Rui Zhao
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China
| | - Siqi Lin
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China
| | - Jiajun Sun
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Shiyi He
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China
| | - Yi Liu
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China
| | - Shu Su
- Department of Epidemiology and Biostatistics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, China.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
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Oliva A, Kaphle A, Reguant R, Sng LMF, Twine NA, Malakar Y, Wickramarachchi A, Keller M, Ranbaduge T, Chan EKF, Breen J, Buckberry S, Guennewig B, Haas M, Brown A, Cowley MJ, Thorne N, Jain Y, Bauer DC. Future-proofing genomic data and consent management: a comprehensive review of technology innovations. Gigascience 2024; 13:giae021. [PMID: 38837943 PMCID: PMC11152178 DOI: 10.1093/gigascience/giae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/15/2024] [Accepted: 04/09/2024] [Indexed: 06/07/2024] Open
Abstract
Genomic information is increasingly used to inform medical treatments and manage future disease risks. However, any personal and societal gains must be carefully balanced against the risk to individuals contributing their genomic data. Expanding our understanding of actionable genomic insights requires researchers to access large global datasets to capture the complexity of genomic contribution to diseases. Similarly, clinicians need efficient access to a patient's genome as well as population-representative historical records for evidence-based decisions. Both researchers and clinicians hence rely on participants to consent to the use of their genomic data, which in turn requires trust in the professional and ethical handling of this information. Here, we review existing and emerging solutions for secure and effective genomic information management, including storage, encryption, consent, and authorization that are needed to build participant trust. We discuss recent innovations in cloud computing, quantum-computing-proof encryption, and self-sovereign identity. These innovations can augment key developments from within the genomics community, notably GA4GH Passports and the Crypt4GH file container standard. We also explore how decentralized storage as well as the digital consenting process can offer culturally acceptable processes to encourage data contributions from ethnic minorities. We conclude that the individual and their right for self-determination needs to be put at the center of any genomics framework, because only on an individual level can the received benefits be accurately balanced against the risk of exposing private information.
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Affiliation(s)
- Adrien Oliva
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
| | - Anubhav Kaphle
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
| | - Roc Reguant
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
| | - Letitia M F Sng
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
| | - Natalie A Twine
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
| | - Yuwan Malakar
- Responsible Innovation Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Brisbane, 41 Boggo Rd, Dutton Park QLD 4102, Australia
| | - Anuradha Wickramarachchi
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
| | - Marcel Keller
- Data61, Commonwealth Scientific and Industrial Research Organisation, Level 5/13 Garden St, Eveleigh NSW 2015, Australia
| | - Thilina Ranbaduge
- Data61, Commonwealth Scientific and Industrial Research Organisation, Building 101, Clunies Ross St, Black Mountain, Canberra, ACT 2601, Australia
| | - Eva K F Chan
- NSW Health Pathology, Sydney, 1 Reserve Road, St Leonards NSW 2065, Australia
| | - James Breen
- Telethon Kids Institute, Perth, WA 6009, Australia
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Sam Buckberry
- Telethon Kids Institute, Perth, WA 6009, Australia
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Boris Guennewig
- Sydney Medical School, Brain and Mind Centre, The University of Sydney, Sydney, 94 Mallett St, Camperdown NSW 2050, Australia
| | - Matilda Haas
- Australian Genomics, Parkville, VIC 3052, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria 3052, Australia
| | - Alex Brown
- Telethon Kids Institute, Perth, WA 6009, Australia
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Mark J Cowley
- Children’s Cancer Institute, Lowy Cancer Research Centre, Level 4, Lowy Cancer Research Centre Corner Botany & High Streets UNSW Kensington Campus UNSW Sydney, Kensington NSW 2052, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Wallace Wurth Building (C27), Cnr High St & Botany St, UNSW Sydney, Kensington NSW 2052, Australia
| | - Natalie Thorne
- University of Melbourne, Melbourne, Parkville VIC 3052, Australia
- Melbourne Genomics Health Alliance, Melbourne 1G, Walter and Eliza Hall Institute/1G Royal Parade, Parkville VIC 3052, Australia
- Walter and Eliza Hall Institute, Melbourne, 1G, Walter and Eliza Hall Institute/1G Royal Parade, Parkville VIC 3052, Australia
| | - Yatish Jain
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 3/160 Hawkesbury Rd, Westmead NSW 2145, Australia
- Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Applied BioSciences 205B Culloden Rd Macquarie University, NSW 2109, Australia
| | - Denis C Bauer
- Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Applied BioSciences 205B Culloden Rd Macquarie University, NSW 2109, Australia
- Department of Biomedical Sciences, MQ Health General Practice - Macquarie University, Suite 305, Level 3/2 Technology Pl, Macquarie Park NSW 2109, Australia
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Gate 13, Kintore Avenue University of Adelaide, Adelaide SA 5000, Australia
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Likhanov M, Zakharov I, Awofala A, Ogundele O, Selita F, Kovas Y, Chapman R. Attitudes towards genetic testing: The role of genetic literacy, motivated cognition, and socio-demographic characteristics. PLoS One 2023; 18:e0293187. [PMID: 37967060 PMCID: PMC10651000 DOI: 10.1371/journal.pone.0293187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/26/2023] [Indexed: 11/17/2023] Open
Abstract
Understanding reasons for why people choose to have or not to have a genetic test is essential given the ever-increasing use of genetic technologies in everyday life. The present study explored the multiple drivers of people's attitudes towards genetic testing. Using the International Genetic Literacy and Attitudes Survey (iGLAS), we collected data on: (1) willingness to undergo testing; (2) genetic literacy; (3) motivated cognition; and (4) demographic and cultural characteristics. The 37 variables were explored in the largest to-date sample of 4311 participants from diverse demographic and cultural backgrounds. The results showed that 82% of participants were willing to undergo genetic testing for improved treatment; and over 73%-for research. The 35 predictor variables together explained only a small proportion of variance: 7%-in the willingness to test for Treatment; and 6%-for Research. The strongest predictors of willingness to undergo genetic testing were genetic knowledge and deterministic beliefs. Concerns about data misuse and about finding out unwanted health-related information were weakly negatively associated with willingness to undergo genetic testing. We also found some differences in factors linked to attitudes towards genetic testing across the countries included in this study. Our study demonstrates that decision-making regarding genetic testing is influenced by a large number of potentially interacting factors. Further research into these factors may help consumers to make decisions regarding genetic testing that are right for their specific circumstances.
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Affiliation(s)
- Maxim Likhanov
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Ilya Zakharov
- Ural Federal University Named after the First President of Russia B. N. Yeltsin, Yekaterinburg, Russia
- Psychological Institute of Russian Academy of Education, Moscow, Russia
| | - Adeyemi Awofala
- Department of Biological Sciences, Tai Solarin University of Education, Ijebu-Ode, Nigeria
| | - Olusegun Ogundele
- Department of Biological Sciences, Tai Solarin University of Education, Ijebu-Ode, Nigeria
| | - Fatos Selita
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Yulia Kovas
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Robert Chapman
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
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Oluloro A, Temkin SM, Jackson J, Swisher EM, Sage L, Doll K. What's in it for me?: A value assessment of gynecologic cancer clinical trials for Black women. Gynecol Oncol 2023; 172:29-35. [PMID: 36931101 PMCID: PMC10192016 DOI: 10.1016/j.ygyno.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVE Underrepresented groups may be dissuaded from clinical trial participation without perceived value. We therefore comprehensively assessed gynecologic cancer clinical trial protocols for the inclusion of items of value most important to Black individuals. METHODS ClinicalTrials.gov was queried for NCI-sponsored gynecologic cancer clinical trials in the US between Jan.1994 and Nov.2021. Pre-specified return of value (ROV) items were abstracted from each protocol. Inclusion proportions were calculated for each ROV item and temporal changes assessed with chi-square tests. Temporality of proportional trends was further assessed by slope and departure from linearity calculations. RESULTS 279 gynecologic cancer clinical trials were included. Most commonly trials had first accrual in 2001-2007 (37%) and involved ovarian cancer (48%), phase II studies (53%), and chemotherapy (60%) or targeted therapy (34%). Trials often included ROV items in basic information (99%), medical record information (99%), and imaging (82%). 41% of trials included ROV items in biomarker testing, 20% genetic testing, and 20% in patient-reported outcome questionnaires. Over time, there were significant increases in the proportion of trials that included genetic (3% to 51%; p < 0.001) and biomarker testing (14 to 78%, p < 0.001). Information on lifestyle risk factors was rare (1%). No trials included ROV items in ancestry, how to connect with other participants, or remuneration. CONCLUSIONS Gynecologic cancer clinical trials include few design elements that provide high value to Black individuals like lifestyle risk factors, ancestry, and remuneration. In any multi-pronged effort to improve diversity in clinical trial enrollment, inclusion of items valued by Black individuals should be considered.
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Affiliation(s)
- Ann Oluloro
- University of Washington, 1959 Pacific Street, Box 356460, Seattle, WA 98195, USA.
| | - Sarah M Temkin
- Office of Research on Women's Health, 6707 Democracy Boulevard, Suite 400, Bethesda, MD 20817, USA
| | - Jonathan Jackson
- The CARE Research Center, Massachusetts General Hospital, 50 Staniford Street, Suite 1082, Boston, MA 02114, USA
| | - Elizabeth M Swisher
- University of Washington, 1959 Pacific Street, Box 356460, Seattle, WA 98195, USA
| | - Liz Sage
- University of Washington, 1959 Pacific Street, Box 356460, Seattle, WA 98195, USA
| | - Kemi Doll
- University of Washington, 1959 Pacific Street, Box 356460, Seattle, WA 98195, USA
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Lewis MA, Uhrig JD, Adams ET, Brown JA, Sanders A. Engagement marketing for social good: Application to the All of Us Research Program. Front Genet 2022; 13:889195. [PMID: 36993788 PMCID: PMC10041337 DOI: 10.3389/fgene.2022.889195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/06/2022] [Indexed: 03/16/2023] Open
Abstract
Engagement marketing, when applied to increasing the social good, involves making a deliberate effort to engage communities with an organization’s brand that might not have otherwise happened organically. Organizations that typically focus on increasing the social good include non-profits, community organizations, public health departments, and federal, state, and local agencies. Engagement marketing builds relationships, gives a voice to, and fosters collaboration with community members to transform their insights into impactful experiences that motivate and empower them to act to increase the social good. These actions may include making an informed decision, changing a health or prosocial behavior, or joining an effort that promotes or increases social good. In this paper, we translate the commercial engagement marketing approach, typically used, and studied widely to increase profits, to one that uses engagement marketing to increase prosocial outcomes. We propose a new definition of engagement marketing applied to the social good, a multi-level conceptual framework that integrates individual, social, community and macro-level processes and outcomes, and illustrates an example applying this translated model to co-create digital engagement experiences using a human centered design approach for the All of Us Research Program. This model can also guide research and practice related to DNA-based population screening.
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Rubanovich CK, Zisook S, Bloss CS. Associations Between Privacy-Related Constructs and Depression and Suicide Risk in Health Care Professionals, Trainees, and Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:239-246. [PMID: 34789664 DOI: 10.1097/acm.0000000000004513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The University of California, San Diego screens health care professionals, trainees, and students for depression and suicide risk. Individuals complete a voluntary, anonymous online screening tool and choose whether to provide personal demographic information. This study assessed the relationship between privacy-related constructs and self-rated depression and suicide risk. METHOD The authors analyzed responses to the screening tool collected from January 2018 to December 2019. Measures of depression, suicidal ideation and behaviors, and worry about stigma for seeking mental health services (i.e., privacy-related concern) were gathered. The number of demographic item nonresponses (i.e., age, gender, ethnicity/race, professional position) was operationalized as privacy-related behavior. Linear and logistic regression models were used to determine associations between privacy-related constructs (concern and behavior) and depression and suicide measures. RESULTS A total of 1,224 respondents were included. On average, respondents reported mild depression (mean = 9.12, standard deviation = 5.94), but 43% (524/1,224) reported at least moderate depression. One in 5 respondents (248/1,224) reported worry about stigma for seeking mental health services, and more than 17% (212/1,224) skipped at least 1 demographic question. Privacy-related concern was statistically significantly and positively associated with recent depression and suicidal ideation and behaviors (odds ratios [ORs] = 3.13-7.02; 95% confidence interval [CI], 2.23-19.20; P's < .001) and with lifetime suicide attempts (OR = 1.76; 95% CI, 1.08-2.86; P = .02). Privacy-related behavior was statistically significantly and positively associated with suicide action (OR = 2.23; 95% CI, 1.24-4.02; P = .008). CONCLUSIONS Privacy-related constructs may be meaningful correlates of mental health as respondents who endorsed these constructs had increased odds of worse depression and suicidal ideation and behaviors. Considering privacy-related constructs may be useful for identifying health care professionals, trainees, and students experiencing distress and in need of imminent mental health resources.
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Affiliation(s)
- Caryn Kseniya Rubanovich
- C.K. Rubanovich is a doctoral student, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, California; ORCID: https://orcid.org/0000-0002-0975-6416
| | - Sidney Zisook
- S. Zisook is distinguished professor, Department of Psychiatry, and director, Healer Education Assessment and Referral (HEAR) program, University of California, San Diego, La Jolla, California; ORCID: https://orcid.org/0000-0003-3341-9185
| | - Cinnamon S Bloss
- C.S. Bloss is professor, Herbert Wertheim School of Public Health and Human Longevity Science, director, Center for Empathy and Technology, and associate director, T. Denny Sanford Institute for Empathy and Compassion, University of California, San Diego, La Jolla, California; ORCID: https://orcid.org/0000-0003-1315-8387
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Actkins KV, Srinivasan S, Spees LP, Turbitt E, Allen CG, Roberts MC. Uptake of Genetic Testing Among Patients with Cancer At Risk for Lynch Syndrome in the National Health Interview Survey. Cancer Prev Res (Phila) 2021; 14:927-932. [PMID: 34341014 DOI: 10.1158/1940-6207.capr-21-0073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/14/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022]
Abstract
Lynch syndrome is the most common inherited cancer syndrome that increases the risk of developing colorectal and endometrial cancer. Universal screening guidelines were first recommended by the Centers for Disease Control and Prevention (CDC) in 2009 and are updated annually by multiple societies. Therefore, one would expect genetic testing rates to increase over time. But testing remains underutilized among those with colorectal or endometrial cancer, even though early detection can improve prognosis and survival rates. In this study, we aimed to understand differences in genetic testing uptake among those with colorectal cancer or endometrial cancer from 2005, 2010, 2015, using data from the National Health Interview Survey (NHIS). We examined genetic testing uptake across cancer-type, age (≤50 or ≥51), sex, race, insurance, and education using a χ2 statistical analysis. Despite an upward genetic testing trend in 2010, we found no significant differences in genetic testing uptake over time. In 2010, non-White individuals experienced the highest increase from 2005 in comparison with White individuals. However, genetic testing rates declined for both groups by 2015. Our findings show that genetic testing for colorectal cancer and endometrial cancer did not increase over a 10-year period in spite of guidelines that recommend testing. PREVENTION RELEVANCE: Genetic testing uptake for colorectal cancer and endometrial cancer has not increased over a 10-year period in spite of universal screening guidelines. More genetic testing education is needed at the provider and patient level to improve screening strategies for cancer patients who are most at risk for Lynch syndrome.
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Affiliation(s)
- Ky'Era V Actkins
- Department of Microbiology, Immunology, and Physiology, Meharry Medical College, Nashville, Tennessee
| | - Swetha Srinivasan
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lisa P Spees
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,UNC Lineberger Comprehensive Cancer Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Erin Turbitt
- Discipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caitlin G Allen
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Megan C Roberts
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. .,UNC Lineberger Comprehensive Cancer Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Szakály Z, Kovács B, Szakály M, T. Nagy-Pető D, Popovics P, Kiss M. Consumer acceptance of genetic-based personalized nutrition in Hungary. GENES & NUTRITION 2021; 16:3. [PMID: 33648454 PMCID: PMC7923598 DOI: 10.1186/s12263-021-00683-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/06/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Despite the increasing number of personalized nutrition services available on the market, nutrigenomics-based level of personalization is still the exception rather than a mainstream activity. This can be partly explained by various factors of consumer acceptance of the new technology. While consumer attitudes toward genetic tests aiming to reveal the risks of a predisposition to various illnesses have already been examined by several research studies worldwide; consumer acceptance of nutrigenomics-based personalized nutrition has only been examined by a significantly lower number of papers, especially in the Central and Eastern European region. OBJECTIVE The purpose of this paper is to examine consumer acceptance of genetic-based personalized nutrition in Hungary. Therefore a national representative survey was conducted involving 1000 individuals. The starting point of the model used is the assumption that the consumer acceptance of personalized nutrition is influenced by its consumer perceptions, which are affected by psychological processes that, in a more general sense, determine acceptance of food innovations. RESULTS The results show that 23.5% of respondents accept genetic test-based personalized nutrition. Women were found to reject the new technology in a significantly smaller proportion than men. The relationship between other demographic variables (i.e. age groups, education and subjective income level) and the perception of genetic-based personalized nutrition is also significant. Our results indicate that it is perceived cost/benefit that is most strongly related to genetically based personalized dietary preferences, followed by perceived risk and subjective norms. Perceived uncertainty and perceived behavioural control, however, have only a weak relationship with genetic-based personalized dietary preferences. CONCLUSIONS Compared with the magnitude of the effect of socio-demographic criteria, it can be concluded that, on the whole, psychological processes in the individual have a greater influence on the development of preferences for genetic-based personalized nutrition than any socio-demographic factor. This also confirms the trend that there are more and more value-added products or value propositions (where a significant part of the value added is to be found in product innovation), for which psychological characteristics are/should be given more emphasis among the segmentation criteria.
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Affiliation(s)
- Zoltán Szakály
- Institute of Marketing and Commerce, Faculty of Economics and Business, University of Debrecen, Debrecen, 4032 Hungary
| | - Bence Kovács
- Institute of Marketing and Commerce, Faculty of Economics and Business, University of Debrecen, Debrecen, 4032 Hungary
| | - Márk Szakály
- Institute of Marketing and Commerce, Faculty of Economics and Business, University of Debrecen, Debrecen, 4032 Hungary
| | - Dorka T. Nagy-Pető
- Institute of Marketing and Commerce, Faculty of Economics and Business, University of Debrecen, Debrecen, 4032 Hungary
| | - Péter Popovics
- Institute of Applied Economics Sciences, Faculty of Economics and Business, University of Debrecen, Debrecen, 4032 Hungary
| | - Marietta Kiss
- Institute of Marketing and Commerce, Faculty of Economics and Business, University of Debrecen, Debrecen, 4032 Hungary
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Teteh DK, Dawkins-Moultin L, Hooker S, Hernandez W, Bonilla C, Galloway D, LaGroon V, Santos ER, Shriver M, Royal CDM, Kittles RA. Genetic ancestry, skin color and social attainment: The four cities study. PLoS One 2020; 15:e0237041. [PMID: 32813691 PMCID: PMC7446776 DOI: 10.1371/journal.pone.0237041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction The Black population in the US is heterogeneous but is often treated as monolithic in research, with skin pigmentation being the primary indicator of racial classification. Objective: This paper examines the differences among Blacks by comparing genetic ancestry, skin color and social attainment of 259 residents across four US cities—Norman, Oklahoma; Cincinnati, Ohio; Harlem, New York; and Washington, District of Columbia. Methods Participants were recruited between 2004 and 2006 at community-based forums. Cross-sectional data were analyzed using chi-square tests, correlation analyses and logistic regression. Results There were variations in ancestry, melanin index and social attainment across some cities. Overall, men with darker skin color, and women with lighter skin color were significantly more likely to be married. Darker skin individuals with significantly more West African ancestry reported attainment of graduate degrees, and professional occupations than lighter skin individuals. Conclusions Our findings suggest differences in skin pigmentation by geography and support regional variations in ancestry of US Blacks. Biomedical research should consider genetic ancestry and local historical/social context rather than relying solely on skin pigmentation as a proxy for race.
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Affiliation(s)
- Dede K. Teteh
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | - Lenna Dawkins-Moultin
- Department of Health Disparities Research, M.D. Anderson Cancer Center, Houston, Texas, United States of America
| | - Stanley Hooker
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | - Wenndy Hernandez
- Department of Medicine, Section of Cardiology, University of Chicago, Chicago, Illinois, United States of America
| | - Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Butanta, Brazil
| | - Dorothy Galloway
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | - Victor LaGroon
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
| | | | - Mark Shriver
- Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Charmaine D. M. Royal
- Department of African & African American Studies, Duke University, Durham, North Carolina, United States of America
| | - Rick A. Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope Medical Center, Duarte, California, United States of America
- * E-mail:
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Impacts of personal DNA ancestry testing. J Community Genet 2020; 12:37-52. [PMID: 32789669 DOI: 10.1007/s12687-020-00481-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/29/2020] [Indexed: 11/27/2022] Open
Abstract
Consumer uptake of direct-to-consumer (DTC) DNA ancestry testing is accelerating, yet few empirical studies have examined test impacts on recipients despite the DTC ancestry industry being two decades old. Participants in a longitudinal cohort study of response to health-related DTC genomic testing also received personal DNA ancestry testing at no additional cost. Baseline survey data from the primary study were analyzed together with responses to an additional follow-up survey focused on the response to ancestry results. Ancestry results were generated for 3466 individuals. Of those, 1317 accessed their results, and 322 individuals completed an ancestry response survey, in other words, approximately one in ten who received ancestry testing responded to the survey. Self-reported race/ethnicity was predictive of those most likely to view their results. While 46% of survey responders (N = 147) reported their ancestry results as surprising or unexpected, less than 1% (N = 3) were distressed by them. Importantly, however, 21% (N = 67) reported that their results reshaped their personal identity. Most (81%; N = 260) planned to share results with family, and 12% (N = 39) intended to share results with a healthcare provider. Many (61%; N = 196) reported test benefits (e.g., health insights), while 12% (N = 38) reported negative aspects (e.g., lack of utility). Over half (N = 162) reported being more likely to have other genetic tests in the future. DNA ancestry testing affected individuals with respect to personal identity, intentions to share genetic information with family and healthcare providers, and the likelihood to engage with other genetic tests in the future. These findings have implications for medical care and research, specifically, provider readiness to engage with genetic ancestry information.
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Faust N, Muller C, Prenner J, Lee SM, Kupfer SS. Low Rates of Genetic Counseling and Testing in Individuals at Risk for Lynch Syndrome Reported in the National Health Interview Survey. Gastroenterology 2020; 158:1159-1161. [PMID: 31816299 PMCID: PMC7062561 DOI: 10.1053/j.gastro.2019.11.297] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 12/02/2022]
Affiliation(s)
- Nolan Faust
- Department of Medicine, The University of Chicago, Chicago, USA
| | - Charles Muller
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, The University of Chicago Medicine, Chicago, USA
| | - Joshua Prenner
- The University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Sang Mee Lee
- Department of Health Studies, The University of Chicago, Chicago, USA
| | - Sonia S. Kupfer
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, The University of Chicago Medicine, Chicago, USA
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Boland SE, Street RL, Persky S. Weight-related genomic information and provider communication approach: looking through the lens of patient race. Per Med 2019; 16:387-397. [PMID: 31552797 DOI: 10.2217/pme-2018-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This report explores the process of weight-related genomic information provision considering patient race as an important potential moderator of patient response. Methods: Health beliefs and perceived stigma were assessed following provision of genomic (versus behavioral) information by a virtual reality-based physician using either a supportive or directive communication style. Participants included 168 women with overweight. Results: Genomic explanations, combined with supportive communication, resulted in some improved health behavior-related and interpersonal outcomes for white patients, but not black participants. Black participants, on average, did not have diminished outcomes when provided with genomic information. Conclusion: Genomic communications may elicit more positive interpersonal responses than behavioral explanations among both majority and minority populations, but these effects may be moderated by patient race.
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Affiliation(s)
- Sarah E Boland
- Social and Behavioral Research Branch, National Human Genome Research Institute 31 Center Drive, B1B36, Bethesda, MD 20892, USA
| | - Richard L Street
- Department of Communication, Texas A&M University, 4234 TAMU, College Station, TX 77843-4234, USA.,Department of Houston Center for Quality Care & Utilization Studies Section for Health Services Research, Baylor College of Medicine, Houston, TX 77030, USA
| | - Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute 31 Center Drive, B1B36, Bethesda, MD 20892, USA
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Teteh DK, Dawkins-Moultin L, Robinson C, LaGroon V, Hooker S, Alexander K, Kittles RA. Use of community forums to increase knowledge of HPV and cervical cancer in African American communities. J Community Health 2019; 44:492-499. [DOI: 10.1007/s10900-019-00665-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Olwi D, Merdad L, Ramadan E. Knowledge of Genetics and Attitudes toward Genetic Testing among College Students in Saudi Arabia. Public Health Genomics 2016; 19:260-8. [PMID: 27544410 DOI: 10.1159/000446511] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 04/29/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Genetic testing has been gradually permeating the practice of medicine. Health-care providers may be confronted with new genetic approaches that require genetically informed decisions which will be influenced by patients' knowledge of genetics and their attitudes toward genetic testing. This study assesses the knowledge of genetics and attitudes toward genetic testing among college students. METHODS A cross-sectional study was conducted using a multistage stratified sample of 920 senior college students enrolled at King Abdulaziz University, Saudi Arabia. Information regarding knowledge of genetics, attitudes toward genetic testing, and sociodemographic data were collected using a self-administered questionnaire. RESULTS In general, students had a good knowledge of genetics but lacked some fundamentals of genetics. The majority of students showed positive attitudes toward genetic testing, but some students showed negative attitudes toward certain aspects of genetic testing such as resorting to abortion in the case of an untreatable major genetic defect in an unborn fetus. The main significant predictors of knowledge were faculty, gender, academic year, and some prior awareness of 'genetic testing'. The main significant predictors of attitudes were gender, academic year, grade point average, and some prior awareness of 'genetic testing'. CONCLUSION The knowledge of genetics among college students was higher than has been reported in other studies, and the attitudes toward genetic testing were fairly positive. Genetics educational programs that target youths may improve knowledge of genetics and create a public perception that further supports genetic testing.
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Affiliation(s)
- Duaa Olwi
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Eismann S, Vetter L, Keller M, Bruckner T, Golatta M, Hennings A, Domschke C, Dikow N, Sohn C, Heil J, Schott S. Long-term experiences with genetic consultation in people with hereditary breast and ovarian cancer. Arch Gynecol Obstet 2016; 294:1011-1018. [DOI: 10.1007/s00404-016-4133-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/02/2016] [Indexed: 12/30/2022]
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Critchley C, Nicol D, Otlowski M, Chalmers D. Public reaction to direct-to-consumer online genetic tests: Comparing attitudes, trust and intentions across commercial and conventional providers. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2015; 24:731-750. [PMID: 24553439 DOI: 10.1177/0963662513519937] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The success of personalised medicine depends upon the public's embracing genetic tests. Tests that claim to predict an individual's future health can now be accessed via online companies outside of conventional health regulations. This research assessed the extent to which the public embrace direct-to-consumer (DTC) genetic tests relative to those obtained by a conventional medical practitioner (MP). It also examined the reasons for differences across providers using a randomised experimental telephone survey of 1000 Australians. Results suggest that people were significantly less likely to approve of, and order a DTC genetic test administered by a company compared to a MP because they were less trusting of companies' being able to protect their privacy and provide them with access to genetic expertise and counselling. Markets for DTC genetic tests provided by companies would therefore significantly increase if trust in privacy protection and access to expertise are enhanced through regulation.
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Promoting healthy dietary behaviour through personalised nutrition: technology push or technology pull? Proc Nutr Soc 2014; 74:171-6. [PMID: 25342299 DOI: 10.1017/s0029665114001529] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The notion of educating the public through generic healthy eating messages has pervaded dietary health promotion efforts over the years and continues to do so through various media, despite little evidence for any enduring impact upon eating behaviour. There is growing evidence, however, that tailored interventions such as those that could be delivered online can be effective in bringing about healthy dietary behaviour change. The present paper brings together evidence from qualitative and quantitative studies that have considered the public perspective of genomics, nutrigenomics and personalised nutrition, including those conducted as part of the EU-funded Food4Me project. Such studies have consistently indicated that although the public hold positive views about nutrigenomics and personalised nutrition, they have reservations about the service providers' ability to ensure the secure handling of health data. Technological innovation has driven the concept of personalised nutrition forward and now a further technological leap is required to ensure the privacy of online service delivery systems and to protect data gathered in the process of designing personalised nutrition therapies.
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Perceptions of genetic testing and genomic medicine among drug users. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 26:100-6. [PMID: 25037119 DOI: 10.1016/j.drugpo.2014.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 06/13/2014] [Accepted: 06/17/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Genetic testing will soon enter care for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), and for addiction. There is a paucity of data on how to disseminate genetic testing into healthcare for marginalized populations. We explored drug users' perceptions of genetic testing. METHODS Six focus groups were conducted with 34 drug users recruited from syringe exchange programmes and an HIV clinic between May and June 2012. Individual interviews were conducted with participants reporting previous genetic testing. RESULTS All participants expressed acceptance of genetic testing to improve care, but most had concerns regarding confidentiality and implications for law enforcement. Most expressed more comfort with genetic testing based on individual considerations rather than testing based on race/ethnicity. Participants expressed comfort with genetic testing in medical care rather than drug treatment settings and when specifically asked permission, with peer support, and given a clear rationale. CONCLUSION Although participants understood the potential value of genetic testing, concerns regarding breaches in confidentiality and discrimination may reduce testing willingness. Safeguards against these risks, peer support, and testing in medical settings based on individual factors and with clear rationales provided may be critical in efforts to promote acceptance of genetic testing among drug users.
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Yu JH, Crouch J, Jamal SM, Bamshad MJ, Tabor HK. Attitudes of non-African American focus group participants toward return of results from exome and whole genome sequencing. Am J Med Genet A 2014; 164A:2153-60. [PMID: 24845082 DOI: 10.1002/ajmg.a.36610] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/11/2014] [Indexed: 12/23/2022]
Abstract
Exome sequencing and whole genome sequencing (ES/WGS) present individuals with the opportunity to benefit from a broad scope of genetic results of clinical and personal utility. Yet, it is unclear which genetic results people want to receive (i.e., what type of genetic information they want to learn about themselves) or conversely not receive, and how they want to receive or manage results over time. Very little is known about whether and how attitudes toward receiving individual results from ES/WGS vary among racial/ethnic populations. We conducted 13 focus groups with a racially and ethnically diverse parent population (n = 76) to investigate attitudes toward return of individual results from WGS. We report on our findings for non-African American (non-AA) participants. Non-AA participants were primarily interested in genetic results on which they could act or "do something about." They defined "actionability" broadly to include individual medical treatment and disease prevention. The ability to plan for the future was both a motivation for and an expected benefit of receiving results. Their concerns focused on the meaning of results, specifically the potential inaccuracy and uncertainty of results. Non-AA participants expected healthcare providers to be involved in results management by helping them interpret results in the context of their own health and by providing counseling support. We compare and contrast these themes with those we previously reported from our analysis of African American (AA) perspectives to highlight the importance of varying preferences for results, characterize the central role of temporal orientation in framing expectations about the possibility of receiving ES/WGS results, and identify potential avenues by which genomic healthcare disparities may be inadvertently perpetuated.
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Affiliation(s)
- Joon-Ho Yu
- Department of Pediatrics, University of Washington, Seattle, Washington
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20
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Freedman BI, Fletcher AJ, Sanghani VR, Spainhour M, Graham AW, Russell GB, Cooke Bailey JN, Iltis AS, King NMP. Perceptions regarding genetic testing in populations at risk for nephropathy. Am J Nephrol 2013; 38:453-7. [PMID: 24280773 DOI: 10.1159/000356244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 10/10/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Population ancestry-based differences exist in genetic risk for many kidney diseases. Substantial debate remains regarding returning genetic test results to participants. African-Americans (AAs) and European-Americans (EAs) at risk for end-stage kidney disease were queried for views on the value and use of genetic testing in research. METHODS A standardized survey regarding attitudes toward genetic testing was administered to 130 individuals (64 AA, 66 EA) with first-degree relatives on dialysis. Fisher's exact test was used to assess differences in participant attitudes between population groups. RESULTS Mean (SD) age of surveyed AAs and EAs was 45.5 (12.8) and 50.5 (14.4) years, respectively (p = 0.04), with similar familial relationships (p = 0.22). AAs and EAs wished to know their test results if risk could be: (1) reduced by diet or exercise (100 and 98%, p = 0.99); (2) reduced by medical treatment (100 and 98%, p = 0.99), or (3) if no treatments were available (90 and 82%, p = 0.21). If informed they lacked a disease susceptibility variant, 87% of AAs and 88% of EAs would be extremely or pretty likely to inform family members (p = 0.84). If informed they had a disease susceptibility variant, 92% of AAs and 89% of EAs would be extremely or pretty likely to inform their family (p = 0.43). CONCLUSIONS Attitudes toward obtaining and using genetic test results for disease in research contexts were similar in AAs and EAs at risk for end-stage kidney disease. A substantial majority would want information regardless of available treatments and would share the information with the family. These results have important implications for patient care, study design and the informed consent process.
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Affiliation(s)
- Barry I Freedman
- Department of Internal Medicine - Section on Nephrology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, N.C., USA
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21
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Public opinion on policy issues in genetics and genomics. Genet Med 2013; 16:491-4. [DOI: 10.1038/gim.2013.175] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 10/04/2013] [Indexed: 12/23/2022] Open
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Wikler EM, Blendon RJ, Benson JM. Would you want to know? Public attitudes on early diagnostic testing for Alzheimer's disease. Alzheimers Res Ther 2013; 5:43. [PMID: 24010759 PMCID: PMC3978817 DOI: 10.1186/alzrt206] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/17/2013] [Accepted: 09/06/2013] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Research is underway to develop an early medical test for Alzheimer's disease (AD). METHODS To evaluate potential demand for such a test, we conducted a cross-sectional telephone survey of 2,678 randomly selected adults across the United States and four European countries. RESULTS Most surveyed adults (67%) reported that they are "somewhat" or "very likely" to get an early medical test if one becomes available in the future. Interest was higher among those worried about developing AD, those with an immediate blood relative with AD, and those who have served as caregivers for AD patients. Older respondents and those living in Spain and Poland also exhibited greater interest in testing. Knowing AD is a fatal condition did not influence demand for testing, except among those with an immediate blood relative with the disease. CONCLUSIONS Potential demand for early medical testing for AD could be high. A predictive test could not only advance medical research, it could transform political and legal landscapes by creating a large constituency of asymptomatic, diagnosed adults.
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Affiliation(s)
- Elizabeth M Wikler
- Harvard Graduate School of Arts and Sciences, 14 Story Street, 4th Floor, Cambridge, MA 02138 USA
| | - Robert J Blendon
- Department of Health Policy and Management, 677 Huntington Avenue, Kresge Building, Room 402, Boston, MA 02115 USA
| | - John M Benson
- Department of Health Policy and Management, 677 Huntington Avenue, Kresge Building, Room 402, Boston, MA 02115 USA
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Maio M, Carrion P, Yaremco E, Austin JC. Awareness of genetic counseling and perceptions of its purpose: a survey of the Canadian public. J Genet Couns 2013; 22:762-70. [PMID: 23963834 DOI: 10.1007/s10897-013-9633-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
Abstract
Genetic counseling can result in better outcomes when clients understand what to expect, and at least theoretically, at some point in their lifespan, anyone could be referred for or benefit from genetic counseling. Thus, in order to identify (and ultimately address) issues around awareness of genetic counseling and perceptions of its purpose, we surveyed the Canadian general population. We acquired 1,000 telephone numbers corresponding to a demographically representative sample of Canada from Survey Sampling International, and invited individuals to participate in a telephone-based survey. We administered a purpose-designed survey (in either French or English) comprising questions regarding: demographics, whether or not the individual had heard of genetic counseling, and 15 Likert scale-rated (strongly disagree-strongly agree) items about the possible purposes of genetic counseling. Responses to these 15 items were used to generate a total "knowledge score". Of the 1,000 numbers, n = 372 could not be reached, and the survey was successfully administered to n = 188 individuals (response rate 30 %). Most respondents (n = 129, 69 %) had not heard of genetic counseling, and substantial proportions thought that genetic counseling aims to prevent genetic diseases and abnormalities, help couples have children with desirable characteristics, and help people to understand their ancestry. These data could be used to inform the strategy for development of future awareness efforts, and as a baseline from which to measure their effects.
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Affiliation(s)
- Melissa Maio
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
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Micheletto MRD, Valerio NI, Fett-Conte AC. Effects of a genetic counseling model on mothers of children with down syndrome: a Brazilian pilot study. J Genet Couns 2013; 22:784-94. [PMID: 23794002 DOI: 10.1007/s10897-013-9619-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 06/04/2013] [Indexed: 11/30/2022]
Abstract
Down syndrome occurs in approximately 1:600 live births. Genetic counseling is indicated for these families and may be beneficial for adaptation to the challenges that accompany by this diagnosis. Although the basic counseling goals are similar, there are many models of genetic counseling practiced around the world. The aim of this article is to report the results of a pilot study that evaluated the level of satisfaction with a model of service delivery of genetic counseling practiced in Brazil, the knowledge assimilated about Down syndrome and whether this process resulted in a feeling of well-being and psychological support. Thirty mothers of under 6-month-old children with Down syndrome were interviewed after having two sessions of genetic counseling in a public healthcare service within a period of 30 days. A semi-structured questionnaire was developed by the researchers to collect identification, socioeconomic and demographic data and to assess the client's satisfaction with the model of genetic counseling. Data were collected using both open and closed questions. The reported level of satisfaction was high. The knowledge assimilated about Down syndrome after only two sessions was considered technically vague by raters in 44 % of cases. Most mothers (96.7 %) reported that genetic counseling was beneficial and provided psychological support. The model was considered satisfactory, but further research is needed to identify ways to improve knowledge retention by this population. These results highlight the utility of referring families for genetic counseling when there is a suspicion of a diagnosis of Down syndrome.
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Wagner JK, Cooper JD, Sterling R, Royal CD. Tilting at windmills no longer: a data-driven discussion of DTC DNA ancestry tests. Genet Med 2012; 14:586-93. [PMID: 22382803 PMCID: PMC8339991 DOI: 10.1038/gim.2011.77] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Discussions about direct-to-consumer (DTC) DNA ancestry tests have to date been based primarily on conjectures, speculation, and anecdotes, despite the industry being more than a decade old. Representative, empirical data on consumer characteristics; motivations and expectations for testing; intended uses for the information; understanding of results; and behavioral and psychological reactions to the tests are absent. Although the 2010 American Society of Human Genetics white paper clarifies the number and some general characteristics of companies marketing and selling DNA ancestry tests, additional data about the industry's practices have been unavailable. METHODS To promote a data-driven discussion of the DNA ancestry testing industry, we conducted a systematic investigation to identify companies selling DNA ancestry tests and conducted an empirical study of the industry's practices using data collected from each company's website. RESULTS Here, we present a wealth of data, including an updated directory of companies, marketing slogans, product types and names, range of prices, diversity of reporting and representing results, noted benefits and limitations of testing, and a host of website practices. CONCLUSION The tremendous diversity of tests, information, and practices of companies in the DNA ancestry sector should be considered when policies for best practice guidelines or regulatory oversight are being developed.
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Affiliation(s)
- Jennifer K Wagner
- Center for the Integration of Genetic Healthcare Technologies, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Lemke AA, Halverson C, Ross LF. Biobank participation and returning research results: perspectives from a deliberative engagement in South Side Chicago. Am J Med Genet A 2012; 158A:1029-37. [PMID: 22438108 DOI: 10.1002/ajmg.a.34414] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 10/30/2011] [Indexed: 01/17/2023]
Abstract
To be respectful of the public, biobank guiding principles and operations should be responsive to and inclusive of the values and beliefs of their participants. In an effort to increase knowledge and inform institutional policies, we conducted a deliberative engagement of individuals from two healthcare facilities in South Side Chicago that serve different socioeconomic communities to consider biobank policies regarding return of research results. We recruited primary caregivers of children receiving care at either a Federally Qualified Health Center or a university-based practice to attend two full-day deliberative engagement sessions, which included four educational presentations followed by focus group discussions. Surveys were administered to assess attitudes before and after the engagement, and an evaluation was conducted to assess the deliberative engagement process. All 45 participants self-identified as African-American. Focus group themes included: (1) overall interest in biobank participation, broad consent, and recontact; (2) root causes of distrust and potential biobank strategies to facilitate trust; (3) perceived positive and negative aspects of receiving research results; and (4) strong interest in receiving and managing their children's research results. Survey data indicated the same degree of interest in receiving results about themselves as about their children. Pre- and post-session findings showed mainly non-significant attitudinal changes in level of interest in biobank participation and return of research results, although there was a decrease in level of concern regarding identification from research data. Our findings reveal shared community insights important in facilitating relationships and policy discussions between biobank researchers and research participants.
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Affiliation(s)
- Amy A Lemke
- Institute for Health and Society, Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
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Weitzel JN, Blazer KR, MacDonald DJ, Culver JO, Offit K. Genetics, genomics, and cancer risk assessment: State of the Art and Future Directions in the Era of Personalized Medicine. CA Cancer J Clin 2011; 61:327-59. [PMID: 21858794 PMCID: PMC3346864 DOI: 10.3322/caac.20128] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Scientific and technologic advances are revolutionizing our approach to genetic cancer risk assessment, cancer screening and prevention, and targeted therapy, fulfilling the promise of personalized medicine. In this monograph, we review the evolution of scientific discovery in cancer genetics and genomics, and describe current approaches, benefits, and barriers to the translation of this information to the practice of preventive medicine. Summaries of known hereditary cancer syndromes and highly penetrant genes are provided and contrasted with recently discovered genomic variants associated with modest increases in cancer risk. We describe the scope of knowledge, tools, and expertise required for the translation of complex genetic and genomic test information into clinical practice. The challenges of genomic counseling include the need for genetics and genomics professional education and multidisciplinary team training, the need for evidence-based information regarding the clinical utility of testing for genomic variants, the potential dangers posed by premature marketing of first-generation genomic profiles, and the need for new clinical models to improve access to and responsible communication of complex disease risk information. We conclude that given the experiences and lessons learned in the genetics era, the multidisciplinary model of genetic cancer risk assessment and management will serve as a solid foundation to support the integration of personalized genomic information into the practice of cancer medicine.
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Affiliation(s)
- Jeffrey N Weitzel
- Division of Clinical Cancer Genetics, Department of Population Sciences, City of Hope, Duarte, CA.
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