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Knowledge, attitudes, and perceived barriers towards genetic testing across three rural Illinois communities. J Community Genet 2019; 10:417-423. [PMID: 30673953 DOI: 10.1007/s12687-019-00407-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 01/06/2019] [Indexed: 12/24/2022] Open
Abstract
Genetic testing is becoming more prevalent in detecting risk and guiding cancer treatment in our increasingly personalized medicine model. However, few studies have examined underserved populations' perceptions of genetic testing, especially those of rural dwelling populations. We asked residents of three rural communities to complete a self-administered survey gauging their knowledge, attitudes, and perceived barriers for genetic testing. 64.8% of participants of the overall study completed the survey. Most participants were aware of genetic testing for cancer screening (69.0%) and would likely share results with their family (88.5% if it indicated low risk, 85.9% for high risk). Some barriers were noted, including genetic testing not offered in a clinic nearby (46.9%), insurance company knowing the results (54.0%), cost (49.1%), and no accessible genetic counselors with whom to discuss results (45.6%). Our rural participants were generally knowledgeable about genetic testing, but this may not be reflective of all rural populations. Opportunities exist to mitigate use barriers, expand the utilization of telehealth services and regulatory agency-approved assays, and increase knowledge regarding privacy and protections offered by statute, such as the Genetic Information Nondiscrimination Act (US) and General Data Protection Regulation (Europe).
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Dean C, Fogleman AJ, Zahnd WE, Lipka AE, Malhi RS, Delfino KR, Jenkins WD. Engaging rural communities in genetic research: challenges and opportunities. J Community Genet 2017; 8:209-219. [PMID: 28477297 DOI: 10.1007/s12687-017-0304-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 04/27/2017] [Indexed: 12/13/2022] Open
Abstract
Statistical analyses of health and disease in rural communities is frequently limited by low sample counts. Still, some studies indicate increased risk for some diseases even after adjustment for known risk factors. It has been hypothesized that the context of community formation in rural areas facilitates the propagation of genetic founder effects-potentially impacting disease susceptibility. However, outright examination of genetic diversity in such communities has not been performed. Our objective was to engage otherwise research-inexperienced rural communities of largely European descent in genomic research in the context of cancer susceptibility. From September 2015 to February 2016, we implemented a systematic process of progressive community engagement. This iterative method sought project buy-in from first the town mayor, then village council. If approved by both, a focus group of community members examined how residents might view the research, informed consent and specimen collection, and issues of privacy. We were successful in engaging three of the four communities approached for the research project. There was universal enthusiasm for the project by all mayors and village councils. The focus groups' main point of discussion involved wording in the informed consent, with little concern regarding the research question or privacy. Perhaps contrary to popular thought, we found each community we approached to be both welcoming and enthusiastic about collaborating in research on genomic diversity. The systematic method of engagement did much to preserve community respect and autonomy and facilitated buy-in.
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Affiliation(s)
- Caress Dean
- Center for Clinical Research, Southern Illinois University School of Medicine, 201 E. Madison St., Springfield, IL, 62794-9664, USA
| | - Amanda J Fogleman
- Center for Clinical Research, Southern Illinois University School of Medicine, 201 E. Madison St., Springfield, IL, 62794-9664, USA
| | - Whitney E Zahnd
- Center for Clinical Research, Southern Illinois University School of Medicine, 201 E. Madison St., Springfield, IL, 62794-9664, USA
| | - Alexander E Lipka
- Department of Crop Sciences, University of Illinois, W-201B Turner Hall, 1102 S Goodwin Ave, Urbana, IL, 61801, USA
| | - Ripan Singh Malhi
- Departments of Anthropology & Animal Biology, Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, 209F Davenport Hall, 607 Matthews Ave., Urbana, IL, 61801, USA
| | - Kristin R Delfino
- Center for Clinical Research, Southern Illinois University School of Medicine, 201 E. Madison St., Springfield, IL, 62794-9664, USA
| | - Wiley D Jenkins
- Population Health Science Program, Southern Illinois University School of Medicine, 201 E. Madison St, Springfield, IL, 62794-9664, USA.
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Jenkins W, Lipka A, Fogleman A, Delfino K, Malhi R, Hendricks B. Variance in disease risk: rural populations and genetic diversity. Genome 2016; 59:519-25. [DOI: 10.1139/gen-2016-0077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Over 19% of the US population resides in rural areas, where studies of disease risk and disease outcomes are difficult to assess due to smaller populations and lower incidence. While some studies suggest rural disparities for different chronic diseases, the data are inconsistent across geography and definitions of rurality. We reviewed the literature to examine if local variations in population genomic diversity may plausibly explain inconsistencies in estimating disease risk. Many rural communities were founded over 150 years ago by small groups of ethnically and ancestrally similar families. These have since endured relative geographical isolation, similar to groups in other industrialized nations, perhaps resulting in founder effects impacting local disease susceptibility. Studies in Europe and Asia have found that observably different phenotypes may appear in isolated communities within 100 years, and that genomic variation can significantly vary over small geographical scales. Epidemiological studies utilizing common “rural” definitions may miss significant disease differences due to assumptions of risk homogeneity and misinterpretation of administrative definitions of rurality. Local genomic heterogeneity should be an important aspect of chronic disease epidemiology in rural areas, and it is important to consider for designing studies and interpreting results, enabling a better understanding of the heritable components of complex diseases.
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Affiliation(s)
- W.D. Jenkins
- Population Health Science Program, Southern Illinois University School of Medicine, 801 N. Rutledge St., Springfield, IL 62794-9664, USA
| | - A.E. Lipka
- Department of Crop Sciences, University of Illinois, W-201B Turner Hall, 1102 S Goodwin Ave., Urbana IL 61801, USA
| | - A.J. Fogleman
- Center for Clinical Research, Southern Illinois University School of Medicine, 801 N. Rutledge St., Springfield, IL 62794-9664, USA
| | - K.R. Delfino
- Center for Clinical Research, Southern Illinois University School of Medicine, 801 N. Rutledge St., Springfield, IL 62794-9664, USA
| | - R.S. Malhi
- Depts. of Anthropology & Animal Biology, Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, 209F Davenport Hall, 607 Matthews Ave., Urbana, IL 61801, USA
| | - B. Hendricks
- Department of History, Southern Illinois University, 1000 Faner Drive, Rm 3374, Carbondale, IL 62901, USA
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Biino G, Portas L, Murgia F, Vaccargiu S, Parracciani D, Pirastu M, Balduini CL. A population-based study of an Italian genetic isolate reveals that mean platelet volume is not a risk factor for thrombosis. Thromb Res 2012; 129:e8-13. [DOI: 10.1016/j.thromres.2011.11.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 10/12/2011] [Accepted: 11/10/2011] [Indexed: 12/21/2022]
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Poveda A, Ibáñez ME, Rebato E. Heritability and genetic correlations of obesity-related phenotypes among Roma people. Ann Hum Biol 2012; 39:183-9. [DOI: 10.3109/03014460.2012.669794] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Alaitz Poveda
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU),
Bilbao 48080, Spain
| | - Ma Eugenia Ibáñez
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU),
Bilbao 48080, Spain
| | - Esther Rebato
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU),
Bilbao 48080, Spain
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Biino G, Balduini CL, Casula L, Cavallo P, Vaccargiu S, Parracciani D, Serra D, Portas L, Murgia F, Pirastu M. Analysis of 12,517 inhabitants of a Sardinian geographic isolate reveals that predispositions to thrombocytopenia and thrombocytosis are inherited traits. Haematologica 2010; 96:96-101. [PMID: 20823129 DOI: 10.3324/haematol.2010.029934] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Thrombocytopenia is a common finding in several diseases but almost nothing is known about the prevalence of thrombocytopenia in the general population. We examined the prevalence of thrombocytopenia and determinants of platelet count in a healthy population with a wide age range. DESIGN AND METHODS We performed a cross-sectional study on 12,517 inhabitants of ten villages (80% of residents) in a secluded area of Sardinia (Ogliastra). Participants underwent a complete blood count evaluation and a structured questionnaire, used to collect epidemiological data. RESULTS We observed a platelet count lower than 150 × 10⁹/L in 3.2% (2.8%-3.6%) of females and 4.8% (4.3%-5.4%) of males, with a value of 3.9% (3.6%-4.3%) in the entire population. Thrombocytopenia was mild (platelet count: 100 × 10⁹/L-150 × 10⁹/L), asymptomatic and not associated with other cytopenias or overt disorders in most cases. Its standardized prevalence was quite different in different villages, with values ranging from 1.5% to 6.8%, and was negatively correlated with the prevalence of a mild form of thrombocytosis, which ranged from 0.9% to 4.5%. Analysis of platelet counts across classes of age revealed that platelet number decreased progressively with aging. As a consequence, thrombocytopenia was nearly absent in young people and its prevalence increased regularly during lifetime. The opposite occurred for thrombocytosis. CONCLUSIONS Given the high genetic differentiation among Ogliastra villages with "high" and "low" platelet counts and the substantial heritability of this quantitative trait (54%), we concluded that the propensity to present mild and transient thrombocytosis in youth and to acquire mild thrombocytopenia during aging are new genetic traits.
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