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Jane Ling MY, Ahmad N, Noor Aizuddin A, Ja’afar MH. A systematic review on the level of risk perception of diabetes mellitus: The role of environmental factor. PLoS One 2024; 19:e0308152. [PMID: 39078862 PMCID: PMC11288419 DOI: 10.1371/journal.pone.0308152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Risk perception plays important role in motivating preventive health behaviours. The objective of this systematic review was to explore the level of diabetes risk perception among individuals with and without apparent risk for diabetes, and to consider the effect of environmental factors on the level of diabetes risk perception. METHODS This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The literature search was carried out through PubMed, Web of Science, and Scopus. Original articles written in English and published between 2013 and 2023 were considered. Study quality was appraised using the Mixed Methods Appraisal Tool. Narrative synthesis was undertaken due to methodological heterogeneity in the included studies. RESULTS A total of 13 cross-sectional studies, two randomized controlled trials, two cohort studies, two mixed methods studies and one quasi-experiment with a control group were included. An overall low level of diabetes risk perception was reported particularly in those without apparent risk for diabetes. The 20 included studies reported widely varied measures for calculating diabetes risk perception. The influence of environmental factors on the risk perception of diabetes was highlighted. LIMITATIONS The use of study-specific and non-validated measures in the included studies weakens the authors' ability to compare across studies. The role of language and publication bias within this systematic review should be acknowledged as we included only English-language studies published in peer-reviewed journals. Another limitation is the exclusion of dimensions of risk perception such as optimistic bias as search terms. CONCLUSION The overall low risk perception of diabetes calls for urgent need of public health interventions to increase the risk perception of diabetes. In the future, researchers should ensure the validity and reliability of the measures being used. The influence of environmental factors on the diabetes risk perception indicates that diabetes preventive interventions targeting environmental factors may be effective in increasing the risk perception of diabetes.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Hasni Ja’afar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Law JH, Sultan N, Finer S, Fudge N. Advancing the communication of genetic risk for cardiometabolic diseases: a critical interpretive synthesis. BMC Med 2023; 21:432. [PMID: 37953248 PMCID: PMC10641935 DOI: 10.1186/s12916-023-03150-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Genetics play an important role in risk for cardiometabolic diseases-including type 2 diabetes, cardiovascular disease and obesity. Existing research has explored the clinical utility of genetic risk tools such as polygenic risk scores-and whether interventions communicating genetic risk information using these tools can impact on individuals' cognitive appraisals of disease risk and/or preventative health behaviours. Previous systematic reviews suggest mixed results. To expand current understanding and address knowledge gaps, we undertook an interpretive, reflexive method of evidence synthesis-questioning the theoretical basis behind current interventions that communicate genetic risk information and exploring how the effects of genetic risk tools can be fully harnessed for cardiometabolic diseases. METHODS We obtained 189 records from a combination of database, website and grey literature searches-supplemented with reference chaining and expert subject knowledge within the review team. Using pre-defined critical interpretive synthesis methods, quantitative and qualitative evidence was synthesised and critiqued alongside theoretical understanding from surrounding fields of behavioural and social sciences. FINDINGS Existing interventions communicating genetic risk information focus predominantly on the "self", targeting individual-level cognitive appraisals, such as perceived risk and perceived behavioural control. This approach risks neglecting the role of contextual factors and upstream determinants that can reinforce individuals' interpretations of risk. It also assumes target populations to embody an "ascetic subject of compliance"-the idea of a patient who strives to comply diligently with professional medical advice, logically and rationally adopting any recommended lifestyle changes. We developed a synthesising argument-"beyond the ascetic subject of compliance"-grounded in three major limitations of this perspective: (1) difficulty applying existing theories/models to diverse populations, (2) the role of familial variables and (3) the need for a life course perspective. CONCLUSIONS Interventions communicating genetic risk information should account for wider influences that can affect individuals' responses to risk at different levels-including through interactions with their family systems, socio-cultural environments and wider health provision. PROTOCOL REGISTRATION PROSPERO CRD42021289269.
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Affiliation(s)
- Jing Hui Law
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Najia Sultan
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sarah Finer
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Barts Health NHS Trust, London, UK
| | - Nina Fudge
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Rodriguez SA, Tiro JA, Baldwin AS, Hamilton-Bevil H, Bowen M. Measurement of Perceived Risk of Developing Diabetes Mellitus: A Systematic Literature Review. J Gen Intern Med 2023; 38:1928-1954. [PMID: 37037984 PMCID: PMC10272015 DOI: 10.1007/s11606-023-08164-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/10/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND This systematic review describes approaches to measuring perceived risk of developing type 2 diabetes among individuals without diagnoses and describes the use of theories, models, and frameworks in studies assessing perceived risk. While a systematic review has synthesized perceived risk of complications among individuals with diabetes, no reviews have systematically assessed how perceived risk is measured among those without a diagnosis. METHODS Medline, PubMed, PsycINFO, and CINAHAL databases were searched for studies conducted through October 2022 with measures of perceived risk among adults ≥ 18 years without a diabetes diagnosis. Extracted data included study characteristics, measures, and health behavior theories, models, or frameworks used. RESULTS Eighty-six studies met inclusion criteria. Six examined perceived risk scales' psychometric properties. Eighty measured perceived risk using (1) a single item; (2) a composite score from multiple items or subconstructs; and (3) multiple subconstructs but no composite score. Studies used items measuring "comparative risk," "absolute or lifetime risk," and "perceived risk" without defining how each differed. Sixty-four studies used cross-sectional designs. Twenty-eight studies mentioned use of health behavior theories in study design or selection of measures. DISCUSSION There was heterogeneity in how studies operationalized perceived risk; only one third of studies referenced a theory, model, or framework as guiding design or scale and item selection. Use of perceived lifetime risk, absolute risk, or comparative risk limits comparisons across studies. Consideration of context, target population, and how data are utilized is important when selecting measures; we present a series of questions to ask when selecting measures for use in research and clinical settings. This review is the first to categorize how perceived risk is measured in the diabetes prevention domain; most literature focuses on perceived risk among those with diabetes diagnoses. Limitations include exclusion of non-English and gray literature and single reviewer screening and data extraction.
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Affiliation(s)
- Serena A. Rodriguez
- Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health, Trinity Towers, 2777 N Stemmons Fwy, Ste 8400, TX 75207 Dallas, USA
- UTHealth Houston School of Public Health, Center for Health Promotion & Prevention Research, 7000 Fannin Street, Houston, TX 77030 USA
| | - Jasmin A. Tiro
- Department of Public Health Sciences, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637 USA
- University of Chicago Medicine Comprehensive Cancer Center, 5841 S. Maryland Avenue, Chicago, IL 60637 USA
| | - Austin S. Baldwin
- Department of Psychology, Southern Methodist University, Expressway Tower, PO Box 750442, Dallas, TX 75275 USA
| | - Hayley Hamilton-Bevil
- University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 75229 USA
| | - Michael Bowen
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390 USA
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Drazba KT, Denton JJ, Hurst CB, McGwin G, MacLennan PA, Ovalle F. Incorporation of a genetics-based information module into standardized diabetes patient education. Prim Care Diabetes 2021; 15:706-712. [PMID: 33994279 DOI: 10.1016/j.pcd.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the effectiveness of a genetics educational module created to improve understanding about the genetics of diabetes, assess motivation to engage in healthy lifestyle behaviors, and gauge interest in genetic testing for diabetes. METHODS Participants were recruited from the Multidisciplinary Comprehensive Diabetes Clinic at the University of Alabama at Birmingham. Participants completed a pre-survey to assess three domains: (1) knowledge about diabetes etiology and testing, (2) healthy lifestyle behaviors, and (3) interest in genetic testing. Participants viewed a short, recorded educational module, then completed a post-survey to re-assess the domains. RESULTS Participants increased knowledge about genetics of diabetes (p < 0.0001) and genetic testing (p = 0.0184), demonstrated motivation to adopt healthy behaviors (p < 0.0001), and decreased interest in genetic testing (p = 0.0833) after viewing the module. CONCLUSIONS The educational module increased understanding of diabetes and increased motivation to adopt healthy behaviors. The need for patient-friendly educational modules explaining the genetics of diabetes will likely increase with continued discoveries of how genetics contributes to diabetes risk and outcomes. This short, educational module has the potential to provide genetic information in an effective way that is easily adapted in a routine clinic setting.
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Affiliation(s)
- Kathryn T Drazba
- Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jessica Johnson Denton
- Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Christina Barger Hurst
- Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gerald McGwin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Paul A MacLennan
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Fernando Ovalle
- Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham, Birmingham, AL, United States
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Allen CG, Peterson S, Khoury MJ, Brody LC, McBride CM. A scoping review of social and behavioral science research to translate genomic discoveries into population health impact. Transl Behav Med 2021; 11:901-911. [PMID: 32902617 PMCID: PMC8240657 DOI: 10.1093/tbm/ibaa076] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Since the completion of the Human Genome Project, progress toward translating genomic research discoveries to address population health issues has been limited. Several meetings of social and behavioral scientists have outlined priority research areas where advancement of translational research could increase population health benefits of genomic discoveries. In this review, we track the pace of progress, study size and design, and focus of genomics translational research from 2012 to 2018 and its concordance with five social and behavioral science recommended priorities. We conducted a review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines for Scoping Reviews. Steps involved completing a search in five databases and a hand search of bibliographies of relevant literature. Our search (from 2012 to 2018) yielded 4,538 unique studies; 117 were included in the final analyses. Two coders extracted data including items from the PICOTS framework. Analysis included descriptive statistics to help identify trends in pace, study size and design, and translational priority area. Among the 117 studies included in our final sample, nearly half focused on genomics applications that have evidence to support translation or implementation into practice (Centers for Disease Control and Prevention Tier 1 applications). Common study designs were cross-sectional (40.2%) and qualitative (24.8%), with average sample sizes of 716 across all studies. Most often, studies addressed public understanding of genetics and genomics (33.3%), risk communication (29.1%), and intervention development and testing of interventions to promote behavior change (19.7%). The number of studies that address social and behavioral science priority areas is extremely limited and the pace of this research continues to lag behind basic science advances. Much of the research identified in this review is descriptive and related to public understanding, risk communication, and intervention development and testing of interventions to promote behavior change. The field has been slow to develop and evaluate public health-friendly interventions and test implementation approaches that could enable health benefits and equitable access to genomic discoveries. As the completion of the human genome approaches its 20th anniversary, full engagement of transdisciplinary efforts to address translation challenges will be required to close this gap.
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Affiliation(s)
- Caitlin G Allen
- Behavioral, Social and Health Education Sciences Department, Emory University, Atlanta, GA, USA
| | - Shenita Peterson
- Woodruff Health Science Center Library, Emory University, Atlanta, GA, USA
| | - Muin J Khoury
- Office of Genomics and Precision Public Health, Office of Science, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lawrence C Brody
- Gene and Environment Interaction Section, National Human Genome Research Institute, Bethesda, MD, USA
| | - Colleen M McBride
- Behavioral, Social and Health Education Sciences Department, Emory University, Atlanta, GA, USA
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Xie F, Chan JCN, Ma RCW. Precision medicine in diabetes prevention, classification and management. J Diabetes Investig 2018; 9:998-1015. [PMID: 29499103 PMCID: PMC6123056 DOI: 10.1111/jdi.12830] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 02/12/2018] [Indexed: 12/18/2022] Open
Abstract
Diabetes has become a major burden of healthcare expenditure. Diabetes management following a uniform treatment algorithm is often associated with progressive treatment failure and development of diabetic complications. Recent advances in our understanding of the genomic architecture of diabetes and its complications have provided the framework for development of precision medicine to personalize diabetes prevention and management. In the present review, we summarized recent advances in the understanding of the genetic basis of diabetes and its complications. From a clinician's perspective, we attempted to provide a balanced perspective on the utility of genomic medicine in the field of diabetes. Using genetic information to guide management of monogenic forms of diabetes represents the best-known examples of genomic medicine for diabetes. Although major strides have been made in genetic research for diabetes, its complications and pharmacogenetics, ongoing efforts are required to translate these findings into practice by incorporating genetic information into a risk prediction model for prioritization of treatment strategies, as well as using multi-omic analyses to discover novel drug targets with companion diagnostics. Further research is also required to ensure the appropriate use of this information to empower individuals and healthcare professionals to make personalized decisions for achieving the optimal outcome.
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Affiliation(s)
- Fangying Xie
- Department of Medicine and TherapeuticsPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
| | - Juliana CN Chan
- Department of Medicine and TherapeuticsPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
- Hong Kong Institute of Diabetes and ObesityPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
- Li Ka Shing Institute of Health SciencesPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
- CUHK‐SJTU Joint Research Centre in Diabetes Genomics and Precision MedicinePrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
| | - Ronald CW Ma
- Department of Medicine and TherapeuticsPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
- Hong Kong Institute of Diabetes and ObesityPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
- Li Ka Shing Institute of Health SciencesPrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
- CUHK‐SJTU Joint Research Centre in Diabetes Genomics and Precision MedicinePrince of Wales HospitalThe Chinese University of Hong KongShatinHong Kong
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Maloney KA, Alaeddin DS, von Coelln R, Dixon S, Shulman LM, Schrader K, Guan Y. Parkinson’s Disease: Patients’ Knowledge, Attitudes, and Interest in Genetic Counseling. J Genet Couns 2018; 27:1200-1209. [DOI: 10.1007/s10897-018-0239-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/08/2018] [Indexed: 01/08/2023]
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Dimova ED, Mohan ARM, Swanson V, Evans JMM. Interventions for prevention of type 2 diabetes in relatives: A systematic review. Prim Care Diabetes 2017; 11:313-326. [PMID: 28511962 DOI: 10.1016/j.pcd.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/07/2017] [Accepted: 04/10/2017] [Indexed: 01/13/2023]
Abstract
The relatives and partners of people with type 2 diabetes are at increased risk of developing type 2 diabetes. This systematic review examines randomized controlled trials, written in English that tested an intervention, which aimed to modify behaviors known to delay or prevent type 2 diabetes, among the relatives or partners of people with type 2 diabetes. Study quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias. Seven studies met the inclusion criteria. The majority of studies were at low risk of bias. Six studies tested an intervention in first-degree relatives of people with type 2 diabetes and one in partners. Intervention components and intervention intensity across studies varied, with those targeting diet and physical activity reporting the most significant changes in primary outcomes. Only one study did not observe significant changes in primary outcomes. There were three main recruitment approaches: advertising in the community, recruiting people through their relatives with diabetes, or identifying people as high risk by screening of their own health care contacts. Some evidence was found for potentially successful interventions to prevent type 2 diabetes among the relatives and partners of people with type 2 diabetes, although finding simple and effective methods to identify and recruit them remains a challenge. Future studies should explore the effect of patients' perceptions on their family members' behavior and capitalize on family relationships in order to increase intervention effectiveness.
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Affiliation(s)
- Elena Dimcheva Dimova
- Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA, Scotland, UK.
| | | | - Vivien Swanson
- Faculty of Natural Sciences, University of Stirling, FK9 4LA, Scotland, UK
| | - Josie M M Evans
- Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA, Scotland, UK
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A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling. J Genet Couns 2017; 26:902-933. [PMID: 28255928 DOI: 10.1007/s10897-017-0082-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
Abstract
With the advancements in precision medicine and health care reform, it is critical that genetic counseling practice respond to emerging evidence to maximize client benefit. The objective of this review was to synthesize evidence on outcomes from randomized controlled trials (RCTs) of genetic counseling to inform clinical practice. Seven databases were searched in conducting this review. Studies were selected for inclusion if they were: (a) RCTs published from 1990 to 2015, and (b) assessed a direct outcome of genetic counseling. Extracted data included study population, aims, and outcomes. Risk of bias was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions guidelines. A review of 1654 abstracts identified 58 publications of 54 unique RCTs that met inclusion criteria, the vast majority of which were conducted in cancer genetic counseling setting. Twenty-seven publications assessed 'enhancements' to genetic counseling, and 31 publications compared delivery modes. The methodological rigor varied considerably, highlighting the need for attention to quality criteria in RCT design. While most studies assessed several client outcomes hypothesized to be affected by genetic counseling (e.g., psychological wellbeing, knowledge, perceived risk, patient satisfaction), disparate validated and reliable scales and other assessments were often used to evaluate the same outcome(s). This limits opportunity to compare findings across studies. While RCTs of genetic counseling demonstrate enhanced client outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.
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Carmichael AG, Hulswit BB, Moe EJ, Jayaratne TE, Yashar BM. A Qualitative Study of Anticipated Decision Making around Type 2 Diabetes Genetic Testing: the Role of Scientifically Concordant and Discordant Expectations. J Genet Couns 2016; 26:469-479. [PMID: 27465809 DOI: 10.1007/s10897-016-9999-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
Type 2 diabetes mellitus (T2DM) genetic testing is undergoing clinical trials to measure the efficacy of genetic counseling for behavior-based risk reduction. The expectations patients bring to the testing process may play an important role in individual outcomes. We conducted a qualitative exploration of anticipated decision-making and expectations around T2DM genetic testing. Semi-structured interviews were completed with Mexican Americans (n = 34), non-Hispanic Black Americans (n = 39), and non-Hispanic White Americans (n = 39) at risk for T2DM. Transcripts were analyzed for themes. Most participants would accept T2DM genetic testing in order to motivate risk-reducing behaviors or apprise family members of their risk. Participants who would decline testing wished to avoid emotional distress or believed the test would not reveal new risk information. Non-Hispanic Whites and those with college education declined genetic testing more often than other groups. Those without college education were more likely to have testing expectations that were discordant with current science, such as conflating genetic testing with common 'blood tests.' Understanding expectations and decision-making factors around T2DM genetic testing will better prepare healthcare professionals to counsel their patients. This may lead to a higher efficacy of T2DM genetic testing and counseling.
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Affiliation(s)
- Alicia G Carmichael
- BioSocial Methods Collaborative, Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48109-1248, USA.
| | - Bailey B Hulswit
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Emily J Moe
- Genetics and Genomics Program, Children's Hospital of Wisconsin, Milwaukee, WI, USA
| | - Toby Epstein Jayaratne
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Beverly M Yashar
- Department of Human Genetics, University of Michigan, Ann Arbor, USA
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David D, Gherman A, Podina I, Mogoaşe C, Sucală M, Voinescu B. The Added Value of CBT in the Genetic Counseling Process: Concept Development, State of the Art and New Directions. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2016. [DOI: 10.1007/s10942-016-0245-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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McVay MA, Beadles C, Wu R, Grubber J, Coffman CJ, Yancy WS, Reiner IL, Voils CI. Effects of provision of type 2 diabetes genetic risk feedback on patient perceptions of diabetes control and diet and physical activity self-efficacy. PATIENT EDUCATION AND COUNSELING 2015; 98:S0738-3991(15)30002-1. [PMID: 26189166 DOI: 10.1016/j.pec.2015.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/19/2015] [Accepted: 06/20/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE We examined effects of providing type 2 diabetes genetic risk feedback on controllability perceptions. METHODS This is a secondary analysis of a randomized controlled trial in which overweight/obese Veterans Affairs patients without diabetes received conventional type 2 diabetes risk counseling that included either (1) personalized diabetes genetic risk feedback (genetic risk arm) or (2) eye disease counseling (comparison arm). Perceived diabetes control, and dietary and physical activity self-efficacy were compared between study arms, and between the comparison arm and each of 3 DNA-based genetic risk levels. RESULTS Participants (N=531) were predominately male, middle-age, and African American. Immediately post-counseling, perceived diabetes control was higher for the genetic risk arm (risk levels combined) than the comparison arm (p=0.005). In analyses by genetic risk levels, low genetic risk participants reported higher perceived diabetes control than comparison participants (p=0.007). Immediately post-counseling, low genetic risk participants reported higher dietary self-efficacy in situations when mood is negative compared with controls(p=0.01). At 3 months, no differences in constructs were observed. CONCLUSION Genetic risk feedback for diabetes has temporary effects on perceived controllability among patients with low genetic risk. PRACTICE IMPLICATIONS Clinicians and other stakeholders should consider the limited effects on behavior change of diabetes genetic risk feedback.
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Affiliation(s)
- Megan A McVay
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| | - Christopher Beadles
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Ryanne Wu
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Janet Grubber
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Cynthia J Coffman
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - William S Yancy
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | | | - Corrine I Voils
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA
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Johansen Taber KA, Dickinson BD. Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes. APPLICATION OF CLINICAL GENETICS 2015; 8:1-8. [PMID: 25609992 PMCID: PMC4293919 DOI: 10.2147/tacg.s75583] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Type 2 diabetes (T2D) is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D.
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Affiliation(s)
| | - Barry D Dickinson
- Department of Science and Biotechnology, American Medical Association, Chicago, IL, USA
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