"If It Helps, It's Worth a Try": an Investigation of Perceptions and Attitudes about Genetic Counseling among Southern Manitoba Hutterites

Putting the Patient First: A Scoping Review of Patient Desires in Canada

Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments.

Knowledge and attitudes about genetic counseling in patients at a major hospital in Addis Ababa, Ethiopia

Previous work at St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, demonstrated a need for genetic counseling (GC) services, with 4% of pediatric, neonatal intensive care, and prenatal patients identified as having indications for genetic evaluation (Quinonez et al, 2019). The aim of this study was to investigate SPHMMC patients' familiarity with, knowledge of, and attitudes toward GC services. Surveys were adapted from previous work in North America populations (Riesgraf et al, 2015 and Gemmell et al, 2017) and administered to 102 patients, and results were compared to North American populations using Student's t test. 30% of respondents reported at least some familiarity with GC, primarily via the media or healthcare providers. Patients had generally positive attitudes toward GC, reporting they would trust information provided by a genetic counselor and that GC is in line with their values. Knowledge of GC showed similar trends overall when compared to results from North American populations. Our work indicates limited exposure to GC in this population, but generally positive feelings toward GC. Patients' attitudes toward GC were comparable to rural North American populations surveyed using the same tool on most items; however, cultural differences including views on abortions and directiveness of healthcare providers could account for discrepancies and are important considerations when implementing genetic services globally.

"They're Not Going to Do Nothing for Me": Research Participants' Attitudes towards Elective Genetic Counseling

As applications of genomic sequencing have expanded, offering genetic counseling support to all patients is arguably no longer practical. Additionally, whether individuals desire and value genetic counseling services for genomic screening is unclear. We offered elective genetic counseling to 5110 individuals prior to undergoing sequencing and 2310 participants who received neutral results to assess demand. A total of 0.2% of the study participants accessed genetic counseling services prior to sequencing, and 0.3% reached out after receiving neutral results. We later conducted 50 interviews with participants to understand why they did not access these services. Many interviewees did not recall the availability of genetic counseling and were unfamiliar with the profession. Interviewees described not needing counseling before sequencing because they understood the study and felt that they could cope with any result. Counseling was considered equally unnecessary after learning neutral results. Although the participants had questions about their results, they did not feel that speaking with a genetic counselor would be helpful. Genomic screening efforts that employ opt-in models of genetic counseling may need to clarify the potential value of genetic counseling support from the outset and feature genetic counseling services more prominently in program materials.

A roadmap for precision medicine research recruitment: empirical assessment of the public's willingness to participate

Aim: Precision medicine research recruitment poses challenges. To better understand factors impacting recruitment, this study assessed hypothetical willingness, public opinions of and familiarity with precision medicine research. Materials & methods: Adult attendees (n = 942) at the 2017 Minnesota State Fair completed an electronic survey. Results: Few respondents had heard of 'precision medicine' (18%), and familiarity came mostly from media (43%). Fifty-six percent expressed hypothetical willingness to participate in precision medicine research. Significant predictors of willingness were: comfort with unconditional research; perceiving precision medicine research as beneficial, trustworthy and confidential; having a graduate degree; comfort with self- but not family-participation; and familiarity with precision/personalized medicine. Conclusion: This study identified predictors of hypothetical willingness to participate in precision medicine research. Alternative recruitment strategies are needed.

Limitations and opportunities in male fertility databases

Over the last several years, the male component of reproduction has begun to gain clinical momentum. The medical literature has traditionally focused on infertility from the female perspective, but recent publications have demonstrated that male infertility is an important marker of overall health for infertile men as well as their family members. In order to perform large-scale, quality research related to male infertility, comprehensive databases are necessary. Currently, research in male infertility is limited by the fact that there is not a centralized, comprehensive database specifically designed to collect patient information related to male fertility. A database of this nature exists for female infertility research in the form of the Society for Assisted Reproductive Technology (SART) clinical summary report and the National ART Surveillance System (NASS) published by the Centers for Disease Control (CDC). This review outlines the strengths and weaknesses of several male fertility data sources, including the National Survey of Family Growth, the Reproductive Medicine Network, the Andrology Research Consortium (ARC), the Truven Health MarketScan^® databases, the Utah Population Database, and data available from the Ober Lab related to the Hutterites. While each of these sources has been instrumental in the creation of meaningful research within the field of male fertility, a need remains for the creation of a centralized database for use in future male fertility research. The ideal database would consist of vast amounts of patient data which link individuals and couples to biologic specimens as well as data from family members, designed with parameters specifically purposed for male fertility research. The use of electronic medical records (EMR) systems such as Epic may play a role in the development of such a database going forward. At present, although some information is available through current databases, researchers must utilize suboptimal data sources to perform studies.