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Calluori S, Heimke KK, Caga-Anan C, Kaufman D, Mechanic LE, McAllister KA. Ethical, Legal, and Social Implications of Gene-Environment Interaction Research. Genet Epidemiol 2024. [PMID: 39315585 DOI: 10.1002/gepi.22591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/08/2024] [Accepted: 09/03/2024] [Indexed: 09/25/2024]
Abstract
Many complex disorders are impacted by the interplay of genetic and environmental factors. In gene-environment interactions (GxE), an individual's genetic and epigenetic makeup impacts the response to environmental exposures. Understanding GxE can impact health at the individual, community, and population levels. The rapid expansion of GxE research in biomedical studies for complex diseases raises many unique ethical, legal, and social implications (ELSIs) that have not been extensively explored and addressed. This review article builds on discussions originating from a workshop held by the National Institute of Environmental Health Sciences (NIEHS) and the National Human Genome Research Institute (NHGRI) in January 2022, entitled: "Ethical, Legal, and Social Implications of Gene-Environment Interaction Research." We expand upon multiple key themes to inform broad recommendations and general guidance for addressing some of the most unique and challenging ELSI in GxE research. Key takeaways include strategies and approaches for establishing sustainable community partnerships, incorporating social determinants of health and environmental justice considerations into GxE research, effectively communicating and translating GxE findings, and addressing privacy and discrimination concerns in all GxE research going forward. Additional guidelines, resources, approaches, training, and capacity building are required to further support innovative GxE research and multidisciplinary GxE research teams.
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Affiliation(s)
- Stephanie Calluori
- Columbia Mailman School of Public Health, New York, New York, USA
- Division of Genome Sciences, NHGRI, Bethesda, Maryland, USA
| | - Kaitlin Kirkpatrick Heimke
- Genomic Epidemiology Branch, Epidemiology and Genomics Research Program, DCCPS, NCI, Bethesda, Maryland, USA
| | - Charlisse Caga-Anan
- Genomic Epidemiology Branch, Epidemiology and Genomics Research Program, DCCPS, NCI, Bethesda, Maryland, USA
| | - David Kaufman
- Division of Genomics and Society, NHGRI, Bethesda, Maryland, USA
| | - Leah E Mechanic
- Genomic Epidemiology Branch, Epidemiology and Genomics Research Program, DCCPS, NCI, Bethesda, Maryland, USA
| | - Kimberly A McAllister
- Genes, Environment, and Health Branch, Division of Extramural Research and Training, NIEHS, Durham, North Carolina, USA
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Pfleger E, Lutz R, Drexler H. [Environmental risks and health literacy: a systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:85-98. [PMID: 37823907 PMCID: PMC10776732 DOI: 10.1007/s00103-023-03782-5] [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: 03/13/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Environmental factors can play an important role in pathogenesis. However, the understanding of the relationship between environmental risks and health in the general population appears to be poor. The aim of this systematic review is to describe the state of research on the relationship between health literacy (HL) or environmental health literacy (EHL) and environmental risks differentiated by the researched environmental risks, the affected population, the measurement and level of HL or EHL, and their interaction with other variables. METHODS A systematic literature search was conducted using the Pubmed, Scopus, and LIVIVO databases. Original studies in German or English that investigated HL or EHL in the context of an environmental risk or pollutant in a population were included. The Navigation Guide was used to assess the methodological quality of the studies. RESULTS Twenty-four studies were included in the qualitative analysis. The operationalization of HL or EHL was heterogeneous in 22 studies. Nine studies referred to environmental issues in general, and 15 studies analyzed individual environmental risks. Eleven studies referred to the general population, 12 to specified target groups, and 1 study examined both. The level of HL or EHL proved to be in need of improvement in all populations. Interventions such as trainings were able to increase HL or EHL. DISCUSSION The heterogeneous operationalizations impede the comparability of the studies. Future work should target the standardization of methodological aspects. Overall, it appears that interventions such as trainings were conducive to improving HL or EHL. In practice, this should therefore be given greater focus in order to increase HL or EHL.
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Affiliation(s)
- Elisabeth Pfleger
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Deutschland.
| | - Regina Lutz
- FOM Hochschule für Oekonomie & Management, Essen, Deutschland
| | - Hans Drexler
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9-11, 91054, Erlangen, Deutschland
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Ayode D, Engdawork K, Moore R, Tadele G, Davey G, McBride CM. Evaluating Rural Ethiopian Youths' Willingness and Competency to Promote Literacy Regarding G × E Influences on Podoconiosis. Public Health Genomics 2023; 26:68-76. [PMID: 37231974 DOI: 10.1159/000530889] [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: 11/18/2022] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Engaging youth as peer educators has yet to be considered to promote literacy concerning conjoint genetic and environmental (G × E) influences on health conditions. Whether youth living in low- and middle-income countries (LMICs) could and would be willing to serve as lay educators of G × E education is unclear. METHODS A cross-sectional survey of youth living in Southern Ethiopia was conducted from August to September 2017. Trained data collectors administered the survey on 377 randomly selected youth who ranged in age from 15 to 24; 52% were female and 95% reported having some formal education. Self-reported willingness and a constructed competency score were assessed. Bivariate analyses tested for factors associated with willingness and competency to serve as lay G × E literacy builders. RESULTS Competency and willingness were significantly greater (p < 0.05) for youth who were male, had some formal education, and had civic or leadership experience. Differences in median willingness were significant for youth who scored as more competent versus those who scored as less competent (p < 0.001). There were no characteristics that moderated the association of competency with willingness. CONCLUSION Youth peer educator programs hold promise for disseminating improved G Χ E literacy and reducing stigma associated with deterministic misunderstandings. Thoughtful recruitment and training strategies will be needed to ensure that the broadest representation of youth in LMIC contexts has the opportunity to serve in this role, particularly girls and those without formal education.
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Affiliation(s)
- Desta Ayode
- Department of Sociology, College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia,
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA,
| | - Kibur Engdawork
- Department of Sociology, College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Renee Moore
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
| | - Getnet Tadele
- Department of Sociology, College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gail Davey
- Brighton and Sussex Medical School, University of Sussex, Brighton, Falmer, UK
| | - Colleen M McBride
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Sandberg JC, Trejo G, Howard TD, Moore D, Arcury TA, Quandt SA, Kortenaar P, Ip EH. Mental models about heredity among immigrant Latinx adults with limited education from Mexico and Central America. J Genet Couns 2022; 31:1090-1101. [PMID: 35468233 PMCID: PMC9790731 DOI: 10.1002/jgc4.1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 12/30/2022]
Abstract
An understanding of genetics is becoming increasingly relevant to receiving medical care. It is important for health care providers and educators, including genetic counselors, to understand patients' perceptions about trait transmission and their interpretation of terms used in biomedicine. Knowledge about the patient perspective about trait transmission is important when health care providers are not fluent in the patient's language. Sixty Latinx immigrant adults (30 men and 30 women) who were born in Mexico or Central America (MCA) and living in North Carolina were interviewed about their heredity beliefs. By design, most participants had limited education. Eight percent had a least a high school education; 45% had less than a seventh grade education. Semi-structured, in-depth interviews were conducted to examine how participants think and discuss trait transmission. The translated transcripts were systematically analyzed using a case-based approach, supplemented by theme-based coding. Five lay mental models of heredity were identified that varied in terms of involvement of genes. Four of the five heredity mental models encompass genes; four out of five mental models do not link DNA to heredity. The centrality of blood, whether used metaphorically or literally, varies widely across the models. One model references God and depicts that heredity involves blood and/or genes, but not DNA. The mental models of heredity for most adult immigrants with limited education do not include DNA. Trait transmission by blood appears to have a more prominent role in lay mental models held by Mexicans than Central Americans. Increased patient knowledge about genetics can facilitate shared decision-making as genetics becomes increasingly relevant to medical care. Efforts to educate people can be most effective when we first understand the layperson's conceptions or mental models. Health care providers and educators should be aware that MCA adults with limited formal education hold diverse mental models about heredity.
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Affiliation(s)
- Joanne C. Sandberg
- Department of Family & Community MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Grisel Trejo
- Department of Family & Community MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Timothy D. Howard
- Department of BiochemistryWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - DaKysha Moore
- Department of Visual, Performing & Communication ArtsJohnson C. Smith UniversityCharlotteNorth CarolinaUSA
- Present address:
John R. and Kathy R. Hairston College of Health and Human SciencesCollege of Health and Human SciencesSpeech ProgramNorth Carolina Agricultural & Technical State UniversityGreensboroNorth CarolinaUSA
| | - Thomas A. Arcury
- Department of Family & Community MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Sara A. Quandt
- Division of Public Health SciencesDepartment of Epidemiology and PreventionWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Paul Kortenaar
- KaleideumWinston‐SalemNorth CarolinaUSA
- Present address:
Ontario Science CentreTorontoOntarioCanada
| | - Edward H. Ip
- Division of Public Health SciencesDepartment Biostatistics and Data ScienceWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
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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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