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Casillan A, Florido ME, Galarza-Cornejo J, Bakken S, Lynch JA, Chung WK, Mittendorf KF, Berner ES, Connolly JJ, Weng C, Holm IA, Khan A, Kiryluk K, Limdi NA, Petukhova L, Sabatello M, Wynn J. Participant-guided development of bilingual genomic educational infographics for Electronic Medical Records and Genomics Phase IV study. J Am Med Inform Assoc 2024; 31:306-316. [PMID: 37860921 PMCID: PMC10797276 DOI: 10.1093/jamia/ocad207] [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] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Developing targeted, culturally competent educational materials is critical for participant understanding of engagement in a large genomic study that uses computational pipelines to produce genome-informed risk assessments. MATERIALS AND METHODS Guided by the Smerecnik framework that theorizes understanding of multifactorial genetic disease through 3 knowledge types, we developed English and Spanish infographics for individuals enrolled in the Electronic Medical Records and Genomics Network. Infographics were developed to explain concepts in lay language and visualizations. We conducted iterative sessions using a modified "think-aloud" process with 10 participants (6 English, 4 Spanish-speaking) to explore comprehension of and attitudes towards the infographics. RESULTS We found that all but one participant had "awareness knowledge" of genetic disease risk factors upon viewing the infographics. Many participants had difficulty with "how-to" knowledge of applying genetic risk factors to specific monogenic and polygenic risks. Participant attitudes towards the iteratively-refined infographics indicated that design saturation was reached. DISCUSSION There were several elements that contributed to the participants' comprehension (or misunderstanding) of the infographics. Visualization and iconography techniques best resonated with those who could draw on prior experiences or knowledge and were absent in those without. Limited graphicacy interfered with the understanding of absolute and relative risks when presented in graph format. Notably, narrative and storytelling theory that informed the creation of a vignette infographic was most accessible to all participants. CONCLUSION Engagement with the intended audience who can identify strengths and points for improvement of the intervention is necessary to the development of effective infographics.
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Affiliation(s)
- Aimiel Casillan
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
| | - Michelle E Florido
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
- Department of Genetics and Development, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, United States
| | - Jamie Galarza-Cornejo
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Suzanne Bakken
- Department of Nursing Scholarship and Research, School of Nursing, Columbia University Irving Medical Center, New York, NY 10032, United States
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - John A Lynch
- Department of Communication, School of Communication, Film, and Media Studies, University of Cincinnati, Cincinnati, OH 45221, United States
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Kathleen F Mittendorf
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Eta S Berner
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - John J Connolly
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, United States
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Ingrid A Holm
- Division of Genetics and Genomics and Manton Center for Orphan Diseases Research, Boston Children’s Hospital, Boston, MA 02115, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, United States
| | - Atlas Khan
- Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, United States
- Department of Medicine, Division of Nephrology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, United States
| | - Krzysztof Kiryluk
- Department of Medicine, Division of Nephrology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, United States
| | - Nita A Limdi
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Lynn Petukhova
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY 10032, United States
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Maya Sabatello
- Department of Medicine, Center for Precision Medicine and Genomics, Columbia University Irving Medical Center, New York, NY 10032, United States
- Department of Medical Humanities and Ethics, Division of Ethics, Columbia University Irving Medical Center, New York, NY 10032, United States
| | - Julia Wynn
- Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, United States
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Lemke AA, Esplin ED, Goldenberg AJ, Gonzaga-Jauregui C, Hanchard NA, Harris-Wai J, Ideozu JE, Isasi R, Landstrom AP, Prince AER, Turbitt E, Sabatello M, Schrier Vergano SA, Taylor MRG, Yu JH, Brothers KB, Garrison NA. Addressing underrepresentation in genomics research through community engagement. Am J Hum Genet 2022; 109:1563-1571. [PMID: 36055208 PMCID: PMC9502069 DOI: 10.1016/j.ajhg.2022.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The vision of the American Society of Human Genetics (ASHG) is that people everywhere will realize the benefits of human genetics and genomics. Implicit in that vision is the importance of ensuring that the benefits of human genetics and genomics research are realized in ways that minimize harms and maximize benefits, a goal that can only be achieved through focused efforts to address health inequities and increase the representation of underrepresented communities in genetics and genomics research. This guidance is intended to advance community engagement as an approach that can be used across the research lifecycle. Community engagement uniquely offers researchers in human genetics and genomics an opportunity to pursue that vision successfully, including by addressing underrepresentation in genomics research.
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Affiliation(s)
- Amy A Lemke
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Norton Children's Research Institute, affiliated with the University of Louisville School of Medicine, Louisville, KY, USA.
| | - Edward D Esplin
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Invitae, San Francisco, CA, USA
| | - Aaron J Goldenberg
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland OH, USA
| | - Claudia Gonzaga-Jauregui
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; International Laboratory for Human Genome Research, Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Querétaro, México
| | - Neil A Hanchard
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Childhood Complex Disease Genomics Section, Center for Precision Health Research, National Human Genomics Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Julie Harris-Wai
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; University of California at San Francisco, Department of Social and Behavioral Sciences, Program on Bioethics, Institute for Health and Aging, San Francisco CA, USA
| | - Justin E Ideozu
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Genomic Medicine, Genetic Research Center, AbbVie, Chicago, IL, USA
| | - Rosario Isasi
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Dr. J. T. Macdonald Foundation Department of Human Genetics, University of Miami Leonard M. Miller School of Medicine, Miami FL, USA; John P. Hussman Institute for Human Genomics, University of Miami Leonard M. Miller School of Medicine, Miami FL, USA
| | - Andrew P Landstrom
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Department of Pediatrics, Division of Pediatric Cardiology, Duke University School of Medicine, Durham, NC, USA
| | - Anya E R Prince
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; University of Iowa College of Law, Iowa City IA, USA
| | - Erin Turbitt
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Discipline of Genetic Counselling, University of Technology Sydney, Ultimo NSW 2007, Australia
| | - Maya Sabatello
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Center for Precision Medicine and Genomics, Department of Medicine, Columbia University, New York, NY, USA; Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Samantha A Schrier Vergano
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, VA, USA
| | - Matthew R G Taylor
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Adult Medical Genetics Program, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joon-Ho Yu
- Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Division of Genetic Medicine, Department of Pediatrics , University of Washington School of Medicine, Seattle, WA, USA; Division of Bioethics and Palliative Care, Department of Pediatrics , University of Washington School of Medicine, Seattle, WA, USA; Institute for Public Health Genetics, School of Public Health, University of Washington, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, Seattle, WA, USA
| | - Kyle B Brothers
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Norton Children's Research Institute, affiliated with the University of Louisville School of Medicine, Louisville, KY, USA
| | - Nanibaa' A Garrison
- Professional Practice and Social Implications Committee, American Society of Human Genetics, Rockville MD, USA; Professional Practice and Social Implications Community Engagement Guidance Writing Group, American Society of Human Genetics, Rockville, MD, USA; Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA; Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Lindberg NM, Gutierrez AM, Mittendorf KF, Ramos MA, Anguiano B, Angelo F, Joseph G. Creating accessible Spanish language materials for Clinical Sequencing Evidence-Generating Research consortium genomic projects: challenges and lessons learned. Per Med 2021; 18:441-454. [PMID: 34448595 PMCID: PMC8438935 DOI: 10.2217/pme-2020-0075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/26/2021] [Indexed: 01/31/2023]
Abstract
Aim: To increase Spanish speakers' representation in genomics research, accessible study materials on genetic topics must be made available in Spanish. Materials & methods: The Clinical Sequencing Evidence-Generating Research consortium is evaluating genome sequencing for underserved populations. All sites needed Spanish translation of recruitment materials, surveys and return of results. Results: We describe our process for translating site-specific materials, as well as shared measures across sites, to inform future efforts to engage Spanish speakers in research. Conclusion: In translating and adapting study materials for roughly 1000 Spanish speakers across the USA, and harmonizing translated measures across diverse sites, we overcame numerous challenges. Translation should be performed by professionals. Studies must allocate sufficient time, effort and budget to translate and adapt participant materials.
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Affiliation(s)
- Nangel M Lindberg
- Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Ave, Portland, OR 97227, USA
| | - Amanda M Gutierrez
- Baylor College of Medicine Center for Medical Ethics & Health Policy, One Baylor Plaza, Suite 310D, Houston, TX 77030, USA
| | - Kathleen F Mittendorf
- Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Ave, Portland, OR 97227, USA
| | - Michelle A Ramos
- Department of Population Health Science & Policy Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY 10029, USA
| | - Beatriz Anguiano
- University of California, San Francisco (UCSF) Program in Bioethics, 3333 California Ave (suite 340), San Francisco, CA 94606, USA
| | - Frank Angelo
- CSER Coordinating Center, University of Washington, Division of Medical Genetics, Health Sciences Building, K-253 Box 357720 Seattle, WA 98195, USA
| | - Galen Joseph
- University of California San Francisco Department of Humanities & Social Sciences, 1450 3rd Street, Rm. 551 San Francisco, CA 94143, USA
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Passmore SR, Jamison AM, Abdelwadoud M, Rogers TB, Wiggan M, Mullins DC, Thomas SB. Use of a Qualitative Story Deck to Create Scenarios and Uncover Factors Associated with African American Participation in Genomics Research. FIELD METHODS 2021; 33:159-174. [PMID: 34326707 PMCID: PMC8318208 DOI: 10.1177/1525822x20982089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
To gain a complex understanding of willingness to participate in genomics research among African Americans, we developed a technique specifically suited to studying decision making in a relaxed social setting. The "Qualitative Story Deck," (QSD) is a gamified, structured elicitation technique that allows for the spontaneous creation of scenarios with variable attributes. We used the QSD to create research scenarios that varied on four details (race/ethnicity of the researcher; research goal; biospecimen requested; and institutional affiliation). Participants created scenarios by randomly choosing cards from these categories and provided: (1) a judgement about their willingness to participate in the research project represented; and (2) their thought process in reaching a decision. The QSD has applicability to topics involving decision making or in cases where it would be beneficial to provide vignettes with alternate attributes. Additional benefits include: rapid establishment of rapport and engagement and the facilitation of discussion of little known or sensitive topics.
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Srinivasan T, Sutton EJ, Beck AT, Cuellar I, Hernandez V, Pacyna JE, Shaibi GQ, Kullo IJ, Lindor NM, Singh D, Sharp RR. Integrating Genomic Screening into Primary Care: Provider Experiences Caring for Latino Patients at a Community-Based Health Center. J Prim Care Community Health 2021; 12:21501327211000242. [PMID: 33729042 PMCID: PMC7975483 DOI: 10.1177/21501327211000242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introduction: Minority communities have had limited access to advances in genomic medicine.
Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health
Center in Phoenix, Arizona, partnered to assess the feasibility of offering
genomic screening to Latino patients receiving care at a community-based
health center. We examined primary care provider (PCP) experiences reporting
genomic screening results and integrating those results into patient
care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other
members of the health care team charged with supporting patients who
received positive genomic screening results. Interviews were recorded,
transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results
indicating a genetic variant that warranted clinical management. PCPs felt
genomic screening was valuable to patients and their families, and that
genomic research should strive to include underrepresented minorities.
Providers identified multiple challenges integrating genomic sequencing into
patient care, including difficulties maintaining patient contact over time;
arranging follow-up medical care; and managing results in an environment
with limited genetics expertise. Providers also reflected on the ethics of
offering genomic sequencing to patients who may not be able to pursue
diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing
advances in precision medicine to community-based health centers serving
under-resourced populations. By proactively considering patient support
needs, and identifying financial assistance programs and patient-referral
mechanisms to support patients who may need specialized medical care, PCPs
and other health care providers can help to ensure that precision medicine
lives up to its full potential as a tool for improving patient care.
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Chartier KG, Martinez P, Cummings C, Riley BP, Karriker-Jaffe KJ. Recruiting for diversity: a pilot test of recruitment strategies for a national alcohol survey with mail-in genetic data collection. J Community Genet 2021; 12:459-468. [PMID: 33398649 DOI: 10.1007/s12687-020-00502-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022] Open
Abstract
We assessed the feasibility and acceptability of collecting a saliva sample for DNA through the mail from a national sample of drinkers and examined whether targeted messaging would increase the response rates of Black/African American and Hispanic/Latino participants. We invited respondents from two prior national population surveys to participate in a brief telephone survey regarding recent alcohol use and to mail in a self-administered saliva sample. Blacks/African Americans, Hispanics/Latinos, and Whites had similar rates of consenting to participate. A higher proportion of respondents with a college education and a family history of alcohol problems consented. The differences in participation between respondents receiving targeted and general messaging were not statistically significant. This study provides preliminary evidence for the feasibility of recruiting diverse participants into a genetic study of alcohol use disorder.
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Affiliation(s)
- Karen G Chartier
- School of Social Work and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
| | | | - Cory Cummings
- School of Social Work, Monmouth University, West Long Branch, NJ, USA
| | - Brien P Riley
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Owen-Smith AA, Sesay MM, Lynch FL, Massolo M, Cerros H, Croen LA. Factors Influencing Participation in Biospecimen Research among Parents of Youth with Mental Health Conditions. Public Health Genomics 2020; 23:122-132. [PMID: 32698180 DOI: 10.1159/000509120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 06/02/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Biospecimens are tools that have the potential to improve early identification and treatment for autism spectrum disorders (ASD) and bipolar disorders (BPD). Unfortunately, most biobanks lack racial/ethnic diversity. One challenge to including a diverse sample of youth is recruiting and engaging families. OBJECTIVE We sought to better understand facilitators and barriers to participation in biospecimen research among a diverse group of parents of youth with ASD and BPD. METHODS The current study involved 3 Mental Health Research Network sites. At each site, parents participated in an interview that explored attitudes and beliefs about genetic research. Interviews were audio-recorded, and audio files were transcribed and coded using content analysis. RESULTS A total of 58 interviews were conducted. Four challenges emerged: (1) contacting and engaging potential research participants, (2) motivating potential participants to read recruitment and consent materials, (3) motivating participation in research, in general, and (4) motivating participation in research involving biospecimen donation, specifically. CONCLUSIONS Participants were eager to participate as long as the research process involved trust, clarity, and flexibility. Future research involving youth with mental health conditions would benefit from implementing multimodal strategies for recruitment and data collection and sharing knowledge gained by the research with study participants.
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Affiliation(s)
- Ashli A Owen-Smith
- Georgia State University, School of Public Health, Atlanta, Georgia, USA, .,Kaiser Permanente Georgia, Center for Research and Evaluation, Atlanta, Georgia, USA,
| | - Musu M Sesay
- Kaiser Permanente Georgia, Center for Research and Evaluation, Atlanta, Georgia, USA
| | - Frances L Lynch
- Kaiser Permanente Northwest, Center for Health Research, Portland, Oregon, USA
| | - Maria Massolo
- Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
| | - Hilda Cerros
- Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
| | - Lisa A Croen
- Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
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Implementation of a Stress Intervention with Latino Immigrants in a Non-traditional Migration City. J Immigr Minor Health 2019; 21:372-382. [PMID: 29623527 DOI: 10.1007/s10903-018-0732-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Stress negatively impacts health outcomes across all racial and ethnic groups, but the health disparities experienced by Latino immigrants in nontraditional migration cities are exacerbated by undeveloped infrastructure and weak social support networks. Immigrants in new migration cities can be difficult to engage in health interventions and are therefore underrepresented in the very research where their inclusion is most crucial. To effectively engage Latino immigrants, a team of academic and community researchers collaborated on a community-based participatory research project to design and implement a stress and coping intervention. Top stressors reported were family, children, and work, but health was most commonly identified as the primary stressor. Participants overwhelmingly chose physical activity goals for stress reduction. Pre- to post- intervention results revealed significant improvements in social support and stress management. Results demonstrate the effectiveness of a peer-led, community-partnered approach to implementing a stress intervention with Latino immigrants in a nontraditional migration city.
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9
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Priscilla M, Zemore SE. Feasibility of a mail-in, self-administered dried blood spot collection method in national, population-based alcohol surveys in the United States. Addiction 2019; 114:1303-1308. [PMID: 30889308 PMCID: PMC6548634 DOI: 10.1111/add.14603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/21/2018] [Accepted: 03/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Including a low-intensity blood collection method in population-based alcohol studies would advance our ability to study biological mechanisms related to alcohol. However, the likelihood of participation in such a blood collection method remains understudied. This study's primary aims were to (1) estimate the return rate of mail-in, self-administered dried blood spot (saDBS) samples in national surveys and (2) test correlates of returning a sample. DESIGN Re-contact of all eligible participants from two telephone, population-based alcohol surveys followed by χ2 tests and multivariate logistic regression analysis. SETTING Non-institutionalized US population in all 50 states and Washington, DC. PARTICIPANTS Adults aged 18+ who reported drinking at least one alcoholic beverage in the past 12 months (assessed 2017-18). Contact was made with 680 eligible participants, and 257 consented. MEASUREMENTS The return rate of saDBS samples was defined as the proportion of returned samples among those who were eligible and contacted. Key correlates examined were gender, age, race/ethnicity and education. FINDINGS Among the 680 eligible people contacted, 179 (26.3%) returned a saDBS sample. Blacks [odds ratio (OR) = 0.58, 95% confidence interval (CI) = 0.35-0.95], Latinos (OR = 0.40, 95% CI = 0.23-0.69) and those with a high school education or less (OR = 0.50, 95% CI = 0.31-0.81). CONCLUSIONS The likelihood of participating in mail-in, self-administered dried blood spot (saDBS) sampling among drinkers in the US general population appears low, and blacks, Latinos and people with lower levels of education appear less likely to provide a saDBS sample compared with whites and people with higher levels of education.
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Affiliation(s)
| | - Sarah E. Zemore
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
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10
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Littman AJ, True G, Ashmore E, Wellens T, Smith NL. How can we get Iraq- and Afghanistan-deployed US Veterans to participate in health-related research? Findings from a national focus group study. BMC Med Res Methodol 2018; 18:88. [PMID: 30157766 PMCID: PMC6114046 DOI: 10.1186/s12874-018-0546-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 08/13/2018] [Indexed: 11/18/2022] Open
Abstract
Background Research participant recruitment is often fraught with obstacles. Poor response rates can reduce statistical power, threaten both internal and external validity, and increase study costs and duration. Military personnel are socialized to a specific set of laws, norms, traditions, and values; their willingness to participate in research may differ from civilians. The aims of this study were to better understand the views of United States (US) Veterans who served in Operation Enduring Freedom (OEF)/ Operation Iraqi Freedom (OIF) on research and motivators for participating in research to inform recruitment for a planned observational study of respiratory health in OEF/OIF Veterans. Methods We conducted 10 focus groups in a purposive sample of OEF/OIF Veterans (n = 89) in five US cities in 2015. Key topics included: reasons for participating or declining to participate in health-related research, logistics around study recruitment and conduct, compensation, written materials, and information sharing preferences for study results. Two authors independently coded the data using template analysis. Results Participants identified three criteria that motivated a decision to participate in health-related research: 1) adequate compensation, 2) desire to help other Veterans, and 3) significance and relevance of the research topic. For many, both sufficient compensation and a sense that the study would help other Veterans were critical. The importance of transparency arose as a key theme; Veterans communicated that vague language about study aims or procedures engendered distrust. Lastly, participants expressed a desire for studies to communicate results of their specific health tests, as well as overall study findings, back to research participants. Conclusions OEF/OIF Veterans described trust, transparent communication, and respect as essential characteristics of research in which they would be willing to participate. Additional studies are needed to determine whether our results generalize to other US Veterans; nevertheless, our results highlight precepts that have been reported as important for recruitment in other populations. Researchers may benefit from using community-engaged research methods to seek feedback on recruitment materials and strategies prior to initiating research. For costly studies targeting a large sample (i.e. in the thousands), it may be important to test a variety of recruitment strategies. Electronic supplementary material The online version of this article (10.1186/s12874-018-0546-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alyson J Littman
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. .,Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA. .,Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
| | - Gala True
- South Central Mental Illness Research Education and Clinical Center, Southeast Louisiana Veterans Healthcare System, New Orleans, Louisiana, USA.,Section of Population and Community Medicine, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
| | - Emily Ashmore
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | | | - Nicholas L Smith
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.,Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
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11
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Williams JR, Yeh VM, Bruce MA, Szetela C, Ukoli F, Wilkins CH, Kripalani S. Precision Medicine: Familiarity, Perceived Health Drivers, and Genetic Testing Considerations Across Health Literacy Levels in a Diverse Sample. J Genet Couns 2018; 28:10.1007/s10897-018-0291-z. [PMID: 30105426 PMCID: PMC6374217 DOI: 10.1007/s10897-018-0291-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 08/06/2018] [Indexed: 01/25/2023]
Abstract
A clear awareness of a patient's knowledge, values, and perspectives is an important component of effective genetic counseling. Advances in precision medicine, however, have outpaced our understanding of patient perceptions of this new approach. Patient views may differ across the three domains of precision medicine (genetics, behavioral, and environmental determinants of health), ethnic/racial groups, and health literacy levels. This study describes and compares group differences in familiarity, perceptions, and preferences for precision medicine in a diverse sample. Between 2016 and 2017, 252 participants completed a 10-15-min survey in three primary care clinics in Florida and Tennessee. The final sample was 42.5% African American/Black, 25.8% Hispanic/Latino, 25.0% White, and 6.7% other ethnicity/race. Less than a quarter of participants reported being familiar with the term "precision medicine," but were more familiar with basic genetic terms. Participants with higher health literacy reported greater familiarity with terms (p ≤ .003). African Americans/Black participants were more likely to identify ethnicity/race and discrimination as influencing their health (p ≤ .004). When deciding to get a genetic test, individuals across ethnic/racial groups shared similar considerations. Those with higher health literacy, however, gave significantly greater importance to provider trust (p ≤ .008). Given the recent emergence of precision medicine, at present there may be limited differences in patient perceptions across ethnic/racial groups. Culturally sensitive efforts, tailored to health literacy level, may aid equitable precision medicine uptake.
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Affiliation(s)
- Jessica R Williams
- School of Nursing, University of North Carolina at Chapel Hill, 5004 Carrington Hall, Campus Box 7460, Chapel Hill, NC, 27599-7460, USA.
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
| | - Vivian M Yeh
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marino A Bruce
- Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Carolyn Szetela
- Department of Professional and Medical Education, Meharry Medical College, Nashville, TN, USA
| | - Flora Ukoli
- Department of Surgery, Meharry Medical College, Nashville, TN, USA
| | - Consuelo H Wilkins
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Meharry-Vanderbilt Alliance, Nashville, TN, USA
| | - Sunil Kripalani
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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12
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Scott MS. Commentary: Perspectives on alcohol-related gene and environment interplay in diverse populations. Am J Addict 2018; 26:526-531. [PMID: 28745447 DOI: 10.1111/ajad.12584] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/26/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Racial/ethnic groups comprise more than 20% of the U.S. population, but many experience disproportionately high risk for alcohol misuse, often resulting in higher rates of alcohol-associated consequences. Completion of mapping the human genome has launched rapidly evolving research methods aimed at improved understanding of genetic contribution to disease. Despite decades of research on the influence of genetic and environmental risks on alcohol use disorders and outcomes, few studies have included racial/ethnic subpopulations in sufficient numbers to allow for proper statistical analysis. METHODS The papers in this special issue help to elucidate current knowledge on the etiology of genetic and environmental contributors and potential moderators of alcohol use and associated problems among racial/ethnic populations. The lack of racial/ethnic diversity across many genetic studies contributes to challenges in interpretation of findings and eventually applications to precision medicine. RESULTS Proposed approaches to overcome disparities in racial/ethnic participant recruitment in genetic studies include methods to address population stratification in allele frequency, improve transparency in subjects' consenting to participate, and engaging interdisciplinary research teams and community involvement to improve recruitment of racial/ethnic minorities. DISCUSSION AND CONCLUSIONS The reviews presented underscore various gaps in our knowledge of the genetic influences on alcohol use disorders due to the failure to include racially and ethnically diverse populations in genetic and epigenetic study samples. New directions are suggested to overcome the resulting research challenges and ultimately to inform future personalized intervention approaches for racial/ethnic populations. SCIENTIFIC SIGNIFICANCE Inclusion of heterogeneous populations in genomic research will provide a better comprehension of possible unique genetic factors in the broader general population that may be missed due to exclusion of unique and common variants that may be present in racial/ethnic populations. (Am J Addict 2017;26:526-531).
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Affiliation(s)
- Marcia S Scott
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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13
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Chartier KG, Hesselbrock MN, Hesselbrock VM. Conclusion: Special issue on genetic and alcohol use disorder research with diverse racial/ethnic groups: Key findings and potential next steps. Am J Addict 2018; 26:532-537. [PMID: 28745446 DOI: 10.1111/ajad.12585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/09/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This special issue brings together papers focusing on a wide range of topics relevant to the research and understanding of the role of race/ethnicity and genetic variation for the susceptibility of developing an alcohol use disorder (AUD). METHODS The key findings from the issue's 10 articles are reviewed and organized here around three topics: I: addictive behaviors and potential environmental influences; II: a focus on four racial/ethnic groups; and III: special methodologies. RESULTS Several potential next steps in improving effective research strategies are highlighted: (1) implementing best practices for outreach and community engagement may reduce reluctance to participate; (2) recruiting adequately sized and racially/ethnically diverse samples will require new collaborations with investigators who successfully work in diverse communities; (3) identifying and assessing environmental influences that are both unique to, and common among, racial/ethnic groups may inform preventions for AUD; (4) use of standardized measures will facilitate the generation of larger samples and meta-analysis of research findings; and (5) use of better analytic approaches and experimental methods will improve replication in gene finding research and help advance new areas of research. CONCLUSIONS Genetic research of AUD in diverse racial/ethnic populations is advancing. The articles in this issue examined the general theme of including diverse population groups in genetic studies and offered potential strategies for addressing some common problems. SCIENTIFIC SIGNIFICANCE Greater inclusion of diverse racial/ethnic populations in this research is important to ensure that the benefits of new knowledge and technology are equally shared. (Am J Addict 2017;26:532-537).
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Affiliation(s)
- Karen G Chartier
- School of Social Work, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Michie N Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Victor M Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut
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Chartier KG, Hesselbrock MN, Hesselbrock VM. Introduction: Special issue on genetic research of alcohol use disorder in diverse racial/ethnic populations. Am J Addict 2017; 26:422-423. [PMID: 28672076 DOI: 10.1111/ajad.12576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/20/2017] [Indexed: 11/29/2022] Open
Abstract
This special issue of The American Journal on Addictions is an extension of a workshop held at the Research Society on Alcoholism (2015) highlighting several important issues related to studies of the genetic bases of alcohol use disorder among racially/ethnically diverse populations. While not exhaustive in their coverage, the papers in this special issue focus on three important topics: (1) the importance of considering the social and environmental context in genetic analyses; (2) social and cultural considerations for engaging diverse communities in genetic research; and (3) methodologies related to phenotype development for use with racially/ethnically diverse populations. A brief overview of each paper included in these three sections is presented. The issue concludes with additional considerations for genetic research with racially/ethnically diverse population groups along with a commentary. (Am J Addict 2017;26:422-423).
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Affiliation(s)
- Karen G Chartier
- School of Social Work, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Michie N Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Victor M Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut
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