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Eliciting Willingness and Beliefs towards Participation in Genetic Psychiatric Testing in Black/African American Mothers at Risk for Depression. Behav Sci (Basel) 2020; 10:bs10120181. [PMID: 33256064 PMCID: PMC7760786 DOI: 10.3390/bs10120181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/13/2020] [Accepted: 11/19/2020] [Indexed: 11/22/2022] Open
Abstract
Black/African American women are at high risk for depression, yet are underrepresented in psychiatric genetic research for depression prevention and treatment. Little is known about the factors that influence participation in genetic testing for Black/African American women at risk. The purpose of this study was to elicit the beliefs that underlie participation in genetic testing for depression in Black/African American mothers, a subgroup at high risk. Willingness to participate in genetic testing procedures was also determined. A qualitative, descriptive design was employed. Exactly 19 mothers aged 21–42 completed open-ended questionnaires. Directed content and descriptive analyses of the text were conducted based on the Theory of Planned Behavior. Salient beliefs included: behavioral advantages—diagnosing/detecting depression (31.6%), finding cure/treatment (21.1%); disadvantages—not finding follow-up treatment/help (21.1%); salient referents, who approves—family members (47.4%), agencies/organizations (26.3%); who disapproves—church associates (21.1%). Control beliefs included: barriers—unpleasant/difficult testing procedures (42.1%), limited knowledge about the purpose of testing (26.3%); facilitator—a convenient location (21.1%). Most mothers (89.5%) indicated willingness to participate in testing. Interventions can target families, address barriers, emphasize future benefits, and use convenient locations and community-based participatory research methods. Policies can address social determinants of participation to increase inclusion of these mothers in psychiatric genetic research.
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Wright ML, Newhall K, Barcelona V, Taylor JY. African American mothers' attitudes towards genetic testing in the InterGEN study. J Community Genet 2020; 11:285-290. [PMID: 31811592 PMCID: PMC7295918 DOI: 10.1007/s12687-019-00440-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022] Open
Abstract
The paucity of representation of people of color, particularly those of African ancestry, is a major issue in contemporary omics research. Metadata summarizing genome-wide association studies from 2005 to 2015 suggest that nearly 80% of participants are of European ancestry and only 2.4% are of African ancestry. Negative attitude towards genetic testing is a commonly cited belief as to why there is low representation of Americans of African ancestry participating in genetic studies. Using the attitudes towards genetic testing survey, administered as part of our parent (epi)genome-wide association study, we characterized the perceptions of genetic research among our cohort of African ancestry women (n = 168). Our data show generally favorable perceptions of genetic testing among our cohort. Further, we demonstrate that more favorable attitudes towards genetic testing correlated with higher levels of income, even when accounting for commonly cited negative predictors such as maternal age, education, country of origin, and religion. Overall, our data characterize generally positive perceptions of genetic testing among women of African ancestry.
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Affiliation(s)
- Michelle L. Wright
- School of Nursing, University of Texas, Austin, TX USA
- Dell Medical School, Department of Women’s Health, Austin, TX USA
| | - Kevin Newhall
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY USA
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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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Hickey KT, Taylor JY, Barr TL, Hauser NR, Jia H, Riga TC, Katapodi M. Nursing genetics and genomics: The International Society of Nurses in Genetics (ISONG) survey. NURSE EDUCATION TODAY 2018; 63:12-17. [PMID: 29407254 PMCID: PMC6461386 DOI: 10.1016/j.nedt.2018.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/04/2018] [Indexed: 05/02/2023]
Abstract
BACKGROUND The International Society of Nursing in Genetics (ISONG) fosters scientific and professional development in the discovery, interpretation, and application of genomic information in nursing research, education, and clinical practice. OBJECTIVES Assess genomic-related activities of ISONG members in research, education and practice, and competencies to serve as global leaders in genomics. DESIGN Cross-sectional survey (21-items) assessing genomic-related training, knowledge, and practice. SETTINGS An email invitation included a link to the anonymous online survey. PARTICIPANTS All ISONG members (n = 350 globally) were invited to partake. METHODS Descriptive statistics and Wilcoxon Rank Sum Test for between-group comparisons. RESULTS Respondents (n = 231, 66%), were mostly Caucasian, female, with a master's degree or higher. Approximately 70% wanted to incorporate genomics in research, teaching, and practice. More than half reported high genomic competency, and over 95% reported that genomics is relevant the next 5 years. CONCLUSIONS Findings provide a foundation for developing additional educational programs for an international nursing workforce in genomics.
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Affiliation(s)
- Kathleen T Hickey
- Columbia University School of Nursing, 622 W. 168th St., New York, NY 10032, United States.
| | - Jacquelyn Y Taylor
- Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477, United States.
| | - Taura L Barr
- Valtari Bio Inc., United States; Case Western Reserve University, 8 Medical Center Drive, Morgantown, WV 26506, United States.
| | - Nicole R Hauser
- Columbia University Medical Center, 622 W. 168th St., New York, NY 10032, United States.
| | - Haomiao Jia
- Columbia University School of Nursing, 617 W. 168th St., New York, NY 10032, United States.
| | - Teresa C Riga
- Columbia University Medical Center, 622 W. 168th St., New York, NY 10032, United States.
| | - Maria Katapodi
- Faculty of Medicine, University of Basel, Switzerland; University of Michigan School of Nursing, 4056 Basel, Switzerland.
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Horowitz CR, Ferryman K, Negron R, Sabin T, Rodriguez M, Zinberg RF, Böttinger E, Robinson M. Race, Genomics and Chronic Disease: What Patients with African Ancestry Have to Say. J Health Care Poor Underserved 2018; 28:248-260. [PMID: 28238999 DOI: 10.1353/hpu.2017.0020] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Variants of the APOL1 gene increase risk for kidney failure 10-fold, and are nearly exclusively found in people with African ancestry. To translate genomic discoveries into practice, we gathered information about effects and challenges incorporating genetic risk in clinical care. METHODS An academic-community-clinical team tested 26 adults with self-reported African ancestry for APOL1 variants, conducting in-depth interviews about patients' beliefs and attitudes toward genetic testing- before, immediately, and 30 days after receiving test results. We used constant comparative analysis of interview transcripts to identify themes. RESULTS Themes included: Knowledge of genetic risk for kidney failure may motivate providers and patients to take hypertension more seriously, rather than inspiring fatalism or anxiety. Having genetic risk for a disease may counter stereotypes of Blacks as non-adherent or low-literate, rather than exacerbate stereotypes. CONCLUSION Populations most likely to benefit from genomic research can inform strategies for genetic testing and future research.
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Taylor JY, Barcelona de Mendoza V. Improving -Omics-Based Research and Precision Health in Minority Populations: Recommendations for Nurse Scientists. J Nurs Scholarsh 2017; 50:11-19. [PMID: 29140597 DOI: 10.1111/jnu.12358] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this article is to provide an overview of the role of nurse scientists in -omics-based research and to promote discussion around the conduct of -omics-based nursing research in minority communities. Nurses are advocates, educators, practitioners, scientists, and researchers, and are crucial to the design and successful implementation of -omics studies, particularly including minority communities. The contribution of nursing in this area of research is crucial to reducing health disparities. METHODS In this article, challenges in the conduct of -omics-based research in minority communities are discussed, and recommendations for improving diversity among nurse scientists, study participants, and utilization of training and continuing education programs in -omics are provided. FINDINGS AND CONCLUSIONS Many opportunities exist for nurses to increase their knowledge in -omics and to continue to build the ranks of nurse scientists as leaders in -omics-based research. In order to work successfully with communities of color, nurse scientists must advocate for participation in the Precision Medicine Initiative, improve representation of nurse faculty of color, and increase utilization of training programs in -omics and lead such initiatives. CLINICAL RELEVANCE All nursing care has the potential to be affected by the era of -omics and precision health. By taking an inclusive approach to diversity in nursing and -omics research, nurses will be well placed to be leaders in reducing health disparities through research, practice, and education.
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Affiliation(s)
- Jacquelyn Y Taylor
- Delta Mu, Associate Professor and Associate Dean of Diversity and Inclusion, Yale School of Nursing, Orange, CT, USA
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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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