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Gooding DC, Mohrbacher DA, Umucu E, Van Hulle CA, Lewis JP, Carter FP, Gleason CE. Ethnoracialized group differences in attitudes and knowledge about schizophrenia and willingness to engage in biomarker research: The UBIGR Study. Psychiatry Res 2024; 334:115776. [PMID: 38377801 DOI: 10.1016/j.psychres.2024.115776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
Although there is renewed optimism in biomarker research in schizophrenia, there is also need for greater inclusion of historically underrepresented groups in the research. In the present study, we surveyed 599 African American, 352 American Indian/Alaska Native, and 725 NonHispanic White participants about their attitudes toward research, knowledge and attitudes about schizophrenia, and willingness to engage in biomarker testing. Attitudes toward research were examined using the standardized 7-item Research Attitudes Questionnaire (RAQ) measure. Using structural equation modeling (SEM), we tested our predictive model of the likelihood of willingness to engage in biomarker testing for schizophrenia risk. Members of historically underrepresented groups were less willing to engage in biomarker testing. Overall, attitudes toward research, particularly trust, influenced biomarker testing willingness. These findings suggest that factors influencing willingness to engage in schizophrenia biomarker testing may be modifiable by outreach engagement and education.
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Affiliation(s)
- Diane Carol Gooding
- Department of Psychology, UW-Madison, Madison, WI, USA; Department of Psychiatry, SMPH, UW-Madison, Madison, WI, USA; Geriatrics and Gerontology, Dept. of Medicine, SMPH, UW-Madison, Madison, WI, USA.
| | - Denise A Mohrbacher
- Department of Population Health Sciences, SMPH, UW-Madison, Madison, WI, USA
| | - Emre Umucu
- Department of Public Health Sciences, University of Texas - El Paso, TX, USA
| | - Carol A Van Hulle
- Geriatrics and Gerontology, Dept. of Medicine, SMPH, UW-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, UW-Madison, Madison, WI, USA
| | - Jordan P Lewis
- Memory Keepers Medical Discovery Team, Dept of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth campus, MN, USA
| | - Fabu P Carter
- Wisconsin Alzheimer's Disease Research Center, UW-Madison, Madison, WI, USA
| | - Carey E Gleason
- Geriatrics and Gerontology, Dept. of Medicine, SMPH, UW-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, UW-Madison, Madison, WI, USA; Geriatric Research, Education, and Clinical Center, William S. Middleton Memorial VA Hospital, UW-Madison, WI, USA
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2
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Atkins R, Kelly TA, Johnson S, Deatrick JA, Wunnenberg M, Joseph PV, Pudasainee-Kapri S, Gage G, Pontes NMH, Cresse N, Williams W. Beliefs and willingness towards participating in genetic testing for depression in low-income and racial/ethnic minority mothers at-risk. Arch Psychiatr Nurs 2022; 41:153-165. [PMID: 36428043 PMCID: PMC11036348 DOI: 10.1016/j.apnu.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 06/03/2022] [Accepted: 07/03/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To identify mothers' salient normative, behavioral and control beliefs and willingness towards participating in genetic salivary testing for depression. DESIGN A qualitative, descriptive design was employed. 41 multi-ethnic mothers completed surveys that underwent directed content analysis according to The Theory of Planned Behavior. Percentages and frequency counts were used to categorize responses and calculate willingness. FINDINGS Salient beliefs included: Behavioral: Finding a cure/treatment for depression (29.3 %), Normative: Family would approve (46.3 %), and Church associates would disapprove (19.5 %). CONTROL Lacking information/explanations (34.1 %) as barriers, convenient locations (24.4 %) as facilitators. Most mothers indicated a willingness to participate (90.2 %). CONCLUSIONS Interventions should target families, emphasize benefits, explain purposes and procedures, and use community based participatory methods.
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Affiliation(s)
- Rahshida Atkins
- The College of New Jersey, School of Nursing and Health Sciences, 2000 Pennington Road, Room 113, Ewing, NJ 08102, USA.
| | - Terri-Ann Kelly
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Shanda Johnson
- New Jersey City University, 2039 John F. Kennedy Blvd, Jersey City, NJ 07305, USA.
| | - Janet A Deatrick
- The University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA, USA.
| | - Mary Wunnenberg
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Paule V Joseph
- Section of Sensory Science and Metabolism (SenSMet), National Institute on Alcohol Abuse and Alcoholism & National Institute of Nursing Research, National Institutes of Health, Bethesda, MD.
| | - Sangita Pudasainee-Kapri
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Gale Gage
- Essex County College, Division of Nursing & Health Sciences, 303 University Avenue, Newark, NJ 07102, USA
| | - Nancy M H Pontes
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Nancy Cresse
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
| | - Wanda Williams
- Rutgers The State University of New Jersey School of Nursing-Camden, 530 Federal Street, Camden, NJ 08102, USA.
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Otufowora AA, Striley CW, Vaddiparti K, Scicchitano MJ, Cottler LB. Study Navigation and Enrollment in a Community Sample: Does Generational Cohort Matter? JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2022; 21:299-320. [PMID: 37724159 PMCID: PMC10506841 DOI: 10.1080/15350770.2022.2041526] [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] [Indexed: 10/19/2022]
Abstract
The socioecological model (SEM) was used as a conceptual framework to examine the effect of generational cohorts on study navigation and enrollment in health research. The study population was 7,370 community-dwelling Gen Xers and Baby Boomers in North Central Florida. Analyses found that Leading-edge Boomers (individuals born between 1946 and 1955) [vs Gen Xers (individuals born between 1965 and 1955)] and individuals with higher trust (vs lower trust) were 41% and 25% respectively more likely to be enrolled in health research compared to their counterparts, controlling for factors at the individual, relationship, and community levels of the SEM. We conclude the study with a summary of the findings and the recruitment implications for study enrollment.
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Affiliation(s)
| | - Catherine W Striley
- College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Krishna Vaddiparti
- College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Linda B Cottler
- College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
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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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Theisen JG, Amarillo IE. Creating Affirmative and Inclusive Practices When Providing Genetic and Genomic Diagnostic and Research Services to Gender-Expansive and Transgender Patients. J Appl Lab Med 2020; 6:142-154. [PMID: 33236080 DOI: 10.1093/jalm/jfaa165] [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: 07/01/2020] [Accepted: 08/24/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Gender expansive and transgender (GET) healthcare extends beyond gender-affirming therapies, reaching every medical specialty and subspecialty. As the number of GET patients seeking health services has increased, so has the need for standards of care regarding GET-affirmative practices throughout the healthcare system. As such, the number of publications surrounding GET-affirmative practices has steadily risen. However, even as such research has gained ground in other areas, one realm in which there has been a relative lag is genetics and genomics (GG). CONTENT In this article, we track the GET patient and their laboratory sample from the clinic to the GG laboratory and back. Throughout the preanalytical, analytical, and postanalytical phases, we identify publications, recommendations, and guidelines relevant to the care of the GET community. We also identity knowledge gaps in each area and provide recommendations for affirmative and inclusive processes for addressing those gaps. SUMMARY We have identified the practices involved in GG services that would benefit from GET-affirmative process improvement, reviewing relevant affirmative guidelines. Where guidelines could not be found, we identified those knowledge gaps and suggested potential solutions and future directions for implementing GET-affirmative practices.
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Affiliation(s)
- J Graham Theisen
- Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology, Infertility, and Genetics, Medical College of Georgia, Augusta University, Augusta, GA
| | - Ina E Amarillo
- Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine in Saint Louis, MO
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Kumari S, Bhatia T, Mishra NN, Kumari N, Narayanan SS, Malik D, Deshpande SN. Why parents consent to their children's participation in genetic research: A study of parental decision making. Indian J Med Ethics 2020; 4 (NS). [PMID: 31791933 DOI: 10.20529/ijme.2019.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Parents need to be asked to provide informed consent on behalf of their child for participation in genetic research. Decision making for such parents is difficult because ethical challenges in paediatric genetic research studies are different from similar adult studies. This paper focuses on interviews conducted with parents who were asked to consent to their children's participation (or not) in a genetic research study of intellectual disability and/or autism.
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Affiliation(s)
- Sunita Kumari
- Social Worker, Dept. of Psychiatric Social Work, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital , New Delhi 110 001, INDIA
| | - Triptish Bhatia
- Senior Research Scientist, Indo-US Projects, Centre of Excellence in Mental Health, Dept. of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia .Hospital, New Delhi-110001, INDIA
| | - Nagendra N Mishra
- Assistant Professor and HOD, Dept. of Psychology, LS College, Muzaffarpur, Bihar, INDIA
| | - Nupur Kumari
- Junior Research Fellow, SATYAM project, Centre of Excellence in Mental Health, Dept. of Psychiatry, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia.Hospital, New Delhi 110 001, INDIA
| | - Sreelatha S Narayanan
- Senior Research Fellow, Institute of Home Economics, University of Delhi, Delhi, INDIA
| | - Deepak Malik
- Scientist 'B', Division of Sociobehavioural and Health Systems Research, Indian Council of Medical Research, New Delhi 110 001 INDIA
| | - Smita N Deshpande
- Senior Consultant and Professor, Dept. of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi 110001, INDIA
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Fisher ER, Pratt R, Esch R, Kocher M, Wilson K, Lee W, Zierhut HA. The role of race and ethnicity in views toward and participation in genetic studies and precision medicine research in the United States: A systematic review of qualitative and quantitative studies. Mol Genet Genomic Med 2019; 8:e1099. [PMID: 31867882 PMCID: PMC7005620 DOI: 10.1002/mgg3.1099] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/18/2019] [Accepted: 12/10/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Racial/ethnic minority populations in the United States are consistently underrepresented in genetic research. Large-scale public participation is required to ensure discoveries from precision medicine research are applicable to everyone. To evaluate views toward and facilitators of participation among minority populations in the United States, we conducted a systematic review of literature. METHODS Six databases were searched for articles published from 2005 to 2018 assessing minority populations' views and/or willingness to participate in genetic research. A thematic framework was applied to extracted data to synthesize findings, and the Socio-Ecological Model was used to evaluate papers. RESULTS Review of 2,229 titles and abstracts identified 27 papers (n = 8 qualitative, n = 19 quantitative). Themes included knowledge of genetics, engagement in research, facilitators and barriers to participation, and cultural considerations. Understanding of genetics was low, yet the majority of participants were willing to participate in genetic research among all populations included in the literature (range: 57%-97%). Recommendations for research included utilizing community-based participatory approaches, evaluating participants' informational needs, incentivizing participation, and providing direct benefits (e.g., genetic test results). CONCLUSION Results could influence future study designs that incorporate all levels of the Socio-Ecological Model and better meet the needs of underrepresented groups, thereby ensuring precision medicine research findings are applicable to all.
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Affiliation(s)
- Elena R Fisher
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Riley Esch
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, USA
| | - Megan Kocher
- University of Minnesota Libraries, Minneapolis, MN, USA
| | - Katie Wilson
- University of Minnesota Libraries, Minneapolis, MN, USA
| | - Whiwon Lee
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Heather A Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
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8
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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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9
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Watson KS, Hulbert A, Henderson V, Chukwudozie IB, Aponte-Soto L, Lerner L, Martinez E, Kim S, Winn RA. Lung Cancer Screening and Epigenetics in African Americans: The Role of the Socioecological Framework. Front Oncol 2019; 9:87. [PMID: 30915271 PMCID: PMC6423082 DOI: 10.3389/fonc.2019.00087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 01/30/2019] [Indexed: 11/13/2022] Open
Abstract
Lung cancer is the leading cause of cancer morbidity and mortality in the U.S. and racial/ethnic minorities carry the greatest burden of lung cancer disparities with African Americans (AAs) impacted disproportionately. Inequities in lung cancer health disparities are often associated with multiple bio-behavioral and socio-cultural factors among racial/ethnic minorities. Epigenetic research has advanced the understanding of the intersectionality between biological and socio-cultural factors in lung cancer disparities among AAs. However, gaps exist in the engagement of diverse populations in epigenetic lung cancer research, which poses a challenge in ensuring the generalizability and implementation of epigenetic research in populations that carry an unequal cancer burden. Grounding epigenetic lung cancer research within a socio-ecological framework may prove promising in implementing a multi-level approach to community engagement, screening, navigation, and research participation among AAs. The University of Illinois Cancer Center (UI Cancer Center) is employing an evidence–based (EB) model of community/patient engagement utilizing the socio-ecological model (SEM) to develop a culturally sensitive epigenetic lung cancer research program that addresses multiple factors that impact lung cancer outcomes in AAs. By implementing epigenetic research within a group of Federally Qualified Health Centers (FQHCs) guided by the SEM, the UI Cancer Center is proposing a new pathway in mitigating lung cancer disparities in underserved communities. At the individual level, the framework examines tobacco use among patients at FQHCs (the organizational level) and also tailors epigenetic research to explore innovative biomarkers in high risk populations. Interpersonal interventions use Patient Navigators to support navigation to EB tobacco cessation resources and lung cancer screening. Community level support within the SEM is developed by ongoing partnerships with local and national partners such as the American Lung Association (ALA) and the American Cancer Society (ACS). Lastly, at the policy level, the UI Cancer Center acknowledges the role of policy implications in lung cancer screening and advocates for policies and screening recommendations that examine the current guidelines from the United States Preventive Services Task Force (USPTF).
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Affiliation(s)
| | - Alicia Hulbert
- Cancer Center, University of Illinois at Chicago, Chicago, IL, United States.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, United States
| | - Vida Henderson
- Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
| | | | - Lisa Aponte-Soto
- Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
| | - Lane Lerner
- Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
| | - Erica Martinez
- Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
| | - Sage Kim
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Robert A Winn
- Cancer Center, University of Illinois at Chicago, Chicago, IL, United States.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, United States.,Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL, United States
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Canedo JR, Miller ST, Myers HF, Sanderson M. Racial and ethnic differences in knowledge and attitudes about genetic testing in the US: Systematic review. J Genet Couns 2019; 28:587-601. [PMID: 30663831 DOI: 10.1002/jgc4.1078] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/25/2018] [Accepted: 12/03/2018] [Indexed: 12/26/2022]
Abstract
Precision medicine has grown over the past 20 years with the availability of genetic tests and has changed the one-size-fits-all paradigm in medicine. Precision medicine innovations, such as newly available genetic tests, could potentially widen racial and ethnic disparities if access to them is unequal and if interest to use them differs across groups. The objective of this systematic review was to synthesize existing evidence on racial and ethnic differences in knowledge of and attitudes toward genetic testing among adult patients and the general public in the US, focusing on research about the use of genetic testing in general, not disease-specific tests. Twelve articles published in 1997-2017 met inclusion and exclusion criteria, with 10 including knowledge variables and seven including attitude variables. Studies found consistent patterns of lower awareness of genetic testing in general among non-Whites compared to Whites, lower factual knowledge scores among Blacks and Hispanics/Latinos, and mixed findings of differences in awareness of direct-to-consumer (DTC) genetic testing or the term precision medicine. Blacks, Hispanics/Latinos, and non-Whites generally had more concerns about genetic testing than Whites. The findings suggest that patients and the general public need access to culturally appropriate educational material about the use of genetic testing in precision medicine.
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Affiliation(s)
- Juan R Canedo
- Department of Internal Medicine, Meharry Medical College, Nashville, Tennessee
| | | | - Hector F Myers
- Center for Medicine, Health and Society, Vanderbilt University, Nashville, Tennessee
| | - Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee
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Lewis KL, Facio FM, Berrios CD. Using the diffusion of innovations model to guide participant engagement in the genomics era. J Genet Couns 2019; 28:419-427. [PMID: 30653790 DOI: 10.1002/jgc4.1090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/06/2018] [Accepted: 12/09/2018] [Indexed: 12/12/2022]
Abstract
Exome and genome sequencing (EGS) are increasingly the genetic testing modalities of choice among researchers owing to their ready availability, low cost, and large data output. Recruitment of larger, more diverse cohorts into long-term studies with extensive data collection is fundamental to the success of EGS research and to the widespread benefit of genomic medicine to various populations. Effective engagement will be critical to meeting this demand. The Diffusion of Innovation (DOI) model provides a framework for how new technologies are adopted in communities, including antecedents of an individual's decision to adopt the technology, how the technology's attributes influence its acceptability, the predictors of sustained use of that technology, and its diffusion through society. We apply the DOI model to frame participant engagement in EGS research and to guide the proposal of potential strategies that aim to overcome forecasted challenges. Finally, we suggest a variety of ways genetic counselors can apply their skills and training to the development and implementation of these strategies.
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Affiliation(s)
- Katie L Lewis
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland
| | - Flavia M Facio
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland
| | - Courtney D Berrios
- Center for Pediatric Genomic Medicine, Children's Mercy Kansas City, Kansas City, Missouri
- School of Medicine, University of Missouri Kansas City, Kansas City, Missouri
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12
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Roberts LW, Tsungmey T, Kim JP, Hantke M. Views of the importance of psychiatric genetic research by potential volunteers from stakeholder groups. J Psychiatr Res 2018; 106:69-73. [PMID: 30292779 PMCID: PMC6333463 DOI: 10.1016/j.jpsychires.2018.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/12/2018] [Accepted: 09/18/2018] [Indexed: 01/18/2023]
Abstract
Few studies have explored potential volunteers' attitudes toward genetic research. To address this gap in the literature, we developed an empirical project to document views held by individuals who may wish to enroll in genetic studies involving mental disorders. People living with mental illness, family members of people with mental illness, and community comparison volunteers were queried regarding their views on the importance of genetic research generally, in comparison with medical research, and in relation to 12 health conditions categorized in four types. T-tests and univariate and multivariate analysis of variance were used as appropriate. Participants expressed support for the importance of genetic research (mean = 9.43, scale = 1-10) and endorsed genetic research more highly compared with non-genetic medical research (mean = 9.43 vs. 8.69, P value = <0.001). The most highly endorsed genetic research was for cognitive disorders, followed by mental illness disorders, physical illness disorders, and addiction disorders (means = 8.88, 8.26, 8.16 and 7.55, respectively, P value = <0.001). Overall, this study provides evidence of strong endorsement of genetic research over non-genetic research by potential volunteers.
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Affiliation(s)
- Laura Weiss Roberts
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5717, USA.
| | - Tenzin Tsungmey
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA, 94305-5717
| | - Jane Paik Kim
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA, 94305-5717
| | - Melinda Hantke
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, USA, 94305-5717
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13
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Rogers CR, Rovito MJ, Hussein M, Obidike OJ, Pratt R, Alexander M, Berge JM, Dall'Era M, Nix JW, Warlick C. Attitudes Toward Genomic Testing and Prostate Cancer Research Among Black Men. Am J Prev Med 2018; 55:S103-S111. [PMID: 30670195 PMCID: PMC6352989 DOI: 10.1016/j.amepre.2018.05.028] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/18/2018] [Accepted: 05/24/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Black men are diagnosed with prostate cancer at nearly twice the rate of white men and are underrepresented in prostate cancer research, including validation studies of new clinical tools (e.g., genomic testing). Because healthcare system mistrust has contributed to these disparities for centuries, black men may be less inclined to pursue novel testing, and identification of facilitators to their participation in prostate cancer research studies remains warranted. METHODS A community-engaged approach involving a partnership with a community organization was used to conduct seven focus groups in Minnesota, Alabama, and California to explore black men's attitudes toward prostate cancer research participation and genomic testing for prostate cancer. Data were collected and analyzed from April 2015 to April 2017. RESULTS Identified genomic testing barriers included a lack of terminology understanding, healthcare system mistrust, reluctance to seek medical care, and unfavorable attitudes toward research. Facilitators included family history, value of prevention, and the desire for health education. Lack of prostate cancer knowledge, prostate-specific antigen testing confusion, healthcare system distrust, and misuse of personal health information were barriers to research study participation. Some black men were motivated to participate in research if it was seen as constructive and transparent. CONCLUSIONS Disparities for black men can both motivate and disincentivize participation depending upon a positive or negative view of research. Confusion over prostate cancer clinical care has fueled some mistrust among black men affecting both clinical care and research participation. With increased education, health literacy, and assurances of research integrity and transparency, black men may be more willing to participate in prostate cancer testing and research. SUPPLEMENT INFORMATION This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
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Affiliation(s)
- Charles R Rogers
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Michael J Rovito
- Department of Health Professions, University of Central Florida, Orlando, Florida
| | - Musse Hussein
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mark Alexander
- Health and Wellness Committee, 100 Black Men of America, Inc., Oakland, California
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Marc Dall'Era
- Department of Urology, University of California, Davis, Sacramento, California
| | - Jeffrey W Nix
- Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christopher Warlick
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota
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Murphy E, Hankerson S. Beliefs about causes of major depression: Clinical and treatment correlates among African Americans in an urban community. J Clin Psychol 2017; 74:594-607. [PMID: 29077209 DOI: 10.1002/jclp.22523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/28/2017] [Accepted: 07/17/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Major depression is increasingly viewed in the United States public as a medical disorder with biological and psychosocial causes. Yet little is known about how causal attributions about depression vary among low-income racial minorities. This study examined beliefs about causes of depression and their demographic, clinical and treatment correlates in a lower income African American sample. METHOD Volunteers (N = 110) aged 24-79 years, who participated in a family study of depression, completed a 45-item questionnaire on their beliefs about the causes of depression. We used multidimensional scaling (MDS) to cluster items into causal domains and multivariate regression analyses to test associations of causal domains with demographic and clinical characteristics and treatments received. RESULTS Three causal domains, conceptualized as Eastern culture/supernatural (ECS), Western culture/natural/psychosocial (WCN-P), and /neurobiological (WCN-N) attributions, were derived from MDS clusters. WCN-P was most commonly endorsed (50%-91%) and ECS least endorsed as causes of depression (10-44%). This pattern held across gender, age, educational levels, and diagnostic category. WCN-N items were moderately endorsed, with some distinction between genetic causes and other biological causes. WCN-N was positively associated with medication as opposed to other forms of treatment (B = 1.17; p = .049). CONCLUSION Among low-income African Americans, beliefs about causes of depression are varied but broadly consistent explanatory models that include a combination of psychosocial causes with genetic/biological contributions. For certain individuals, supernatural and natural causal attributions may coexist without dissonance. Causal attributions may be associated with types of treatment accepted and have implications for treatment compliance and adherence.
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Dick DM, Barr P, Guy M, Nasim A, Scott D. Review: Genetic research on alcohol use outcomes in African American populations: A review of the literature, associated challenges, and implications. Am J Addict 2017; 26:486-493. [PMID: 28240821 PMCID: PMC5884102 DOI: 10.1111/ajad.12495] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/18/2016] [Accepted: 12/18/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There have been remarkable advances in understanding genetic influences on complex traits; however, individuals of African descent have been underrepresented in genetic research. METHODS We review the limitations of existing genetic research on alcohol phenotypes in African Americans (AA) including both twin and gene identification studies, possible reasons for underrepresentation of AAs in genetic research, the implications of the lack of racially diverse samples, and special considerations regarding conducting genetic research in AA populations. RESULTS There is a marked absence of large-scale AA twin studies so little is known about the genetic epidemiology of alcohol use and problems among AAs. Individuals of African descent have also been underrepresented in gene identification efforts; however, there have been recent efforts to enhance representation. It remains unknown the extent to which genetic variants associated with alcohol use outcomes in individuals of European and African descent will be shared. Efforts to increase representation must be accompanied by careful attention to the ethical, legal, and social implications of genetic research. This is particularly true for AAs due to the history of abuse by the biomedical community and the persistent racial discrimination targeting this population. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Lack of representation in genetic studies limits our understanding of the etiological factors that contribute to substance use and psychiatric outcomes in populations of African descent and has the potential to further perpetuate health disparities. Involving individuals of diverse ancestry in discussions about genetic research will be critical to ensure that all populations benefit equally from genetic advances. (Am J Addict 2017;26:486-493).
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Affiliation(s)
- Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Peter Barr
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Mignonne Guy
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Aashir Nasim
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Denise Scott
- Department of Pediatrics and Human Genetics and Alcohol Research Center, Howard University College of Medicine, Washington, District of Columbia
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Martinez P, Cummings C, Karriker-Jaffe KJ, Chartier KG. Learning from Latino voices: Focus Groups' Insights on Participation in Genetic Research. Am J Addict 2017; 26:477-485. [PMID: 28376266 DOI: 10.1111/ajad.12531] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 02/01/2017] [Accepted: 02/19/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is a paucity of genetics research examining alcohol use among Latinos. The purpose of this study is to examine Latino perceptions of participation in alcohol studies that collect biological samples, an important precursor to increasing their participation in genetics research. METHODS A synthesis of the literature addressing participation of racial/ethnic minorities in alcohol genetics research was undertaken. We developed a framework of themes related to barriers and facilitators for participation, which we then used to analyze two focus groups held with 18 Latino participants. RESULTS From the literature review, we identified nine themes related to facilitators of and barriers to participation. They are, on continua: curiosity to disinterest; trust to mistrust; understanding to confusion; safety to danger; inclusion to exclusion; sense of connection to disconnection; hope to despair; ease to hassle; and benefit to cost. Another theme emerged from the focus groups: previous experience to no previous experience with health research. CONCLUSIONS Applying the themes from the literature review to Latino perspectives on providing biological samples for alcohol research helps expand their definition and applicability. Consideration of these themes when designing recruitment/retention materials and strategies may encourage Latino participation in alcohol genetics research. SCIENTIFIC SIGNIFICANCE An understanding of these themes and their significance for Latinos is offered in the form of "guiding questions" for researchers to consider as we strive for more inclusive research. Focus group participants were Mexican American; future research should further explore perspectives of this heterogeneous demographic group by studying other Latino subgroups. (Am J Addict 2017;26:477-485).
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Affiliation(s)
| | - Cory Cummings
- School of Social Work, Virginia Commonwealth University, Richmond, Virginia
| | | | - Karen G Chartier
- School of Social Work, Virginia Commonwealth University, Richmond, Virginia
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Hopes and Expectations Regarding Genetic Testing for Schizophrenia Among Young Adults at Clinical High-Risk for Psychosis. J Psychiatr Pract 2016; 22:442-449. [PMID: 27824776 PMCID: PMC5111622 DOI: 10.1097/pra.0000000000000188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Genetic tests for schizophrenia could introduce both risks and benefits. Little is known about the hopes and expectations of young adults at clinical high-risk for psychosis concerning genetic testing for schizophrenia, despite the fact that these youth could be among those highly affected by such tests. We conducted semistructured interviews with 15 young adults at clinical high-risk for psychosis to ask about their interest, expectations, and hopes regarding genetic testing for schizophrenia. Most participants reported a high level of interest in genetic testing for schizophrenia, and the majority said they would take such a test immediately if it were available. Some expressed far-reaching expectations for a genetic test, such as predicting symptom severity and the timing of symptom onset. Several assumed that genetic testing would be accompanied by interventions to prevent schizophrenia. Participants anticipated mixed reactions on finding out they had a genetic risk for schizophrenia, suggesting that they might feel both a sense of relief and a sense of hopelessness. We suggest that genetic counseling could play an important role in counteracting a culture of genetic over-optimism and helping young adults at clinical high-risk for psychosis understand the limitations of genetic testing. Counseling sessions could also invite individuals to explore how receiving genetic risk information might impact their well-being, as early evidence suggests that some psychological factors help individuals cope, whereas others heighten distress related to genetic test results.
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If We Would Only Ask: How Henrietta Lacks Continues to Teach Us About Perceptions of Research and Genetic Research Among African Americans Today. J Racial Ethn Health Disparities 2016; 4:735-745. [PMID: 27664025 DOI: 10.1007/s40615-016-0277-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/21/2016] [Accepted: 08/11/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND African Americans are under-represented in research, and there are perceptions of unwillingness among African Americans to participate in research. We explored barriers to African American research participation. METHODS We conducted a cross-sectional survey to explore knowledge and beliefs regarding medical and genetic research among adults (n = 169) at urban community events. Descriptive data were summarized by frequencies for survey responses. RESULTS Only 13 % of respondents had ever been approached for research; 93 % of those who had been approached for research had participated. Eighty-six percent of those who had previous research experience indicated willingness to participate again vs. only 30 % among those with no research experience. Seventy-four percent had altruistic views of research; 28 % were concerned about truthfulness of researchers; 52 % feared incidental discoveries. CONCLUSION African Americans have favorable views of research; however, few are being engaged in studies. Effective interventions to address identified barriers may improve participation and lead to better health outcomes among African Americans.
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Lawrence RE, Friesen P, Brucato G, Girgis RR, Dixon L. Concerns about Genetic Testing for Schizophrenia among Young Adults at Clinical High Risk for Psychosis. AJOB Empir Bioeth 2015; 7:193-198. [PMID: 27529075 DOI: 10.1080/23294515.2015.1084553] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Genetic tests for schizophrenia may introduce risks and benefits. Among young adults at clinical high-risk for psychosis, little is known about their concerns and how they assess potential risks. METHODS We conducted semi-structured interviews with 15 young adults at clinical high-risk for psychosis to ask about their concerns. RESULTS Participants expressed concerns about test reliability, data interpretation, stigma, psychological harm, family planning, and privacy. Participants' responses showed some departure from the ethics literature insofar as participants were primarily interested in reporting their results to people to whom they felt emotionally close, and expressed little consideration of biological closeness. Additionally, if tests showed an increased genetic risk for schizophrenia, four clinical high-risk persons felt obligated to tell an employer and another three would "maybe" tell an employer, even in the absence of clinical symptoms. CONCLUSIONS These findings suggest opportunities for clinicians and genetic counselors to intervene with education and support.
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Affiliation(s)
- Ryan E Lawrence
- Department of Psychiatry, Columbia University Medical Center; New York - Presbyterian Hospital
| | | | - Gary Brucato
- Department of Psychiatry, Columbia University Medical Center; New York State Psychiatric Institute
| | - Ragy R Girgis
- Department of Psychiatry, Columbia University Medical Center; New York State Psychiatric Institute
| | - Lisa Dixon
- Department of Psychiatry, Columbia University Medical Center; New York State Psychiatric Institute
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"It takes a village": multilevel approaches to recruit African Americans and their families for genetic research. J Community Genet 2014; 6:39-45. [PMID: 25112899 DOI: 10.1007/s12687-014-0199-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022] Open
Abstract
One barrier to searching for novel mutations in African American families with breast cancer is the challenge of effectively recruiting families-affected and non-affected relatives-into genetic research studies. Using a community-based participatory research (CBPR) orientation, we incorporated several evidence-based approaches through an iterative fashion to recruit for a breast cancer genetic epidemiology study in African Americans. Our combined methods allowed us to successfully recruit 341 African American women (247 with breast cancer and 94 relatives without breast cancer) from 127 families. Twenty-nine percent of participants were recruited through National Witness Project (NWP) sites, 11 % came from in-person encounters by NWP members, 34 % from the Love Army of Women, 24 % from previous epidemiologic studies, and 2 % from a support group. In terms of demographics, our varied recruitment methods/sources yielded samples of African American women that differ in terms of several sociodemographic factors such as education, smoking, and BMI, as well as family size. To successfully recruit African American families into epidemiological research, investigators should include community members in the recruitment processes, be flexible in the adoption of multipronged, iterative methods, and provide clear communication strategies about the underlying benefit to potential participants. Our results enhance our understanding of potential benefits and challenges associated with various recruitment methods. We offer a template for the design of future studies and suggest that generalizability may be better achieved by using multipronged approaches.
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Perceptions of genetic testing and genomic medicine among drug users. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 26:100-6. [PMID: 25037119 DOI: 10.1016/j.drugpo.2014.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 06/13/2014] [Accepted: 06/17/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Genetic testing will soon enter care for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), and for addiction. There is a paucity of data on how to disseminate genetic testing into healthcare for marginalized populations. We explored drug users' perceptions of genetic testing. METHODS Six focus groups were conducted with 34 drug users recruited from syringe exchange programmes and an HIV clinic between May and June 2012. Individual interviews were conducted with participants reporting previous genetic testing. RESULTS All participants expressed acceptance of genetic testing to improve care, but most had concerns regarding confidentiality and implications for law enforcement. Most expressed more comfort with genetic testing based on individual considerations rather than testing based on race/ethnicity. Participants expressed comfort with genetic testing in medical care rather than drug treatment settings and when specifically asked permission, with peer support, and given a clear rationale. CONCLUSION Although participants understood the potential value of genetic testing, concerns regarding breaches in confidentiality and discrimination may reduce testing willingness. Safeguards against these risks, peer support, and testing in medical settings based on individual factors and with clear rationales provided may be critical in efforts to promote acceptance of genetic testing among drug users.
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Finding people who will tell you their thoughts on genomics-recruitment strategies for social sciences research. J Community Genet 2014; 5:291-302. [PMID: 24535681 PMCID: PMC4159472 DOI: 10.1007/s12687-014-0184-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/22/2014] [Indexed: 11/27/2022] Open
Abstract
This paper offers a description of how social media, traditional media and direct invitation were used as tools for the recruitment of 6,944 research participants for a social sciences study on genomics. The remit was to gather the views of various stakeholders towards sharing incidental findings from whole genome studies. This involved recruiting members of the public, genetic health professionals, genomic researchers and non-genetic health professionals. A novel survey was designed that contained ten integrated films; this was made available online and open for completion by anyone worldwide. The recruitment methods are described together with the convenience and snowballing sampling framework. The most successful strategy involved the utilisation of social media; Facebook, Blogging, Twitter, LinkedIn and Google Ads led to the ascertainment of over 75 % of the final sample. We conclude that the strategies used were successful in recruiting in eclectic mix of appropriate participants. Design of the survey and results from the study are presented separately.
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George S, Duran N, Norris K. A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders. Am J Public Health 2014; 104:e16-31. [PMID: 24328648 PMCID: PMC3935672 DOI: 10.2105/ajph.2013.301706] [Citation(s) in RCA: 934] [Impact Index Per Article: 93.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2013] [Indexed: 11/04/2022]
Abstract
To assess the experienced or perceived barriers and facilitators to health research participation for major US racial/ethnic minority populations, we conducted a systematic review of qualitative and quantitative studies from a search on PubMed and Web of Science from January 2000 to December 2011. With 44 articles included in the review, we found distinct and shared barriers and facilitators. Despite different expressions of mistrust, all groups represented in these studies were willing to participate for altruistic reasons embedded in cultural and community priorities. Greater comparative understanding of barriers and facilitators to racial/ethnic minorities' research participation can improve population-specific recruitment and retention strategies and could better inform future large-scale prospective quantitative and in-depth ethnographic studies.
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Affiliation(s)
- Sheba George
- Sheba George is with the Center for Biomedical Informatics, Charles R. Drew University of Medicine and Science, and the Department of Community Health Sciences, University of California Los Angeles (UCLA) Fielding School of Public Health, Los Angeles. Nelida Duran is with the Department of Community Health Sciences, UCLA Fielding School of Public Health. Keith Norris is with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles
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Enhancing the participation of african americans in health-related genetic research: findings of a collaborative academic and community-based research study. Nurs Res Pract 2013; 2013:749563. [PMID: 24369499 PMCID: PMC3867877 DOI: 10.1155/2013/749563] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 08/28/2013] [Accepted: 10/03/2013] [Indexed: 01/08/2023] Open
Abstract
The involvement of African Americans in research has long been expressed as a concern by the scientific community. While efforts have been undertaken to identify factors inhibiting the participation of African Americans in health-related research, few efforts have been undertaken to have highlight factors associated with their engagement of health-related research. An exploratory study of factors presumed to be associated with participation in health-related research was conducted among a nonprobability sample of African Americans (n = 212) from a large urban community in the Midwest. The study was guided by a framework that hypothesized the influence of knowledge, beliefs, and perceptions about genetics and the involvement of providers in decision-making on willingness to participate in health-related genetic research. The results revealed that knowledge, beliefs, and perceptions about genetics and the involvement of providers were associated with willingness to engage in health-related genetic research (P < .05). The most interesting, however, was that 88.7% of the participants who had not previously been involved in a health-related study who expressed a willingness to participate reported that they "had never been asked." Study findings suggest the need for research that further examines factors associated with the involvement of African Americans in health-related genetic research.
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Attitudes toward Genetic Testing for Hypertension among African American Women and Girls. Nurs Res Pract 2013; 2013:341374. [PMID: 24303212 PMCID: PMC3835880 DOI: 10.1155/2013/341374] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/29/2013] [Accepted: 09/17/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction. Although African American (AA) women have the highest prevalence of hypertension and many genetic studies have been conducted to examine this disparity, no published studies have investigated their attitudes toward genetic testing for hypertension. The purpose of the present study was to use the health belief model as a guide to examine attitudes toward perceived barriers and benefits of genetic testing held by AA multigenerational triads and to determine whether they differed by generation, age, education, or income level. Methods. A descriptive correlational research design were used with 183 African American women and girls from Detroit. Correlations between triad membership, age, income, and education level were examined for association with attitudes toward genetic testing. Results. Increasing age and education were associated with significant differences in attitudes regarding benefits (F[2, 160] = 5.19, P = 0.007, d = 0.06) and awareness (F[2, 160] = 6.49, P = 0.002, d = 0.08). No statistically significant differences existed on the three subscales when compared by income levels or triad membership. Conclusions. This highlights the need for increased outreach to younger generations regarding benefits of genetic services. Further research is necessary to determine whether rural and male populations have similar beliefs.
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Perspectives of surrogate decision makers for critically ill patients regarding gene variation research. Genet Med 2012; 15:368-73. [PMID: 23154525 DOI: 10.1038/gim.2012.142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We undertook this investigation to explore the manner in which surrogate decision makers for critically ill patients perceived genetic data collected in the context of clinical investigation. METHODS Surrogate decision makers for critically ill patients cared for in intensive care units of two urban hospitals participated in focus groups designed to explore perceptions regarding gene variation research. RESULTS Surrogate decision makers were generally familiar with genetic concepts and reported that they could provide an informed opinion regarding permitting (or declining) the participation of their loved ones in gene variation research. Respondents perceived the risk associated with this type of research largely as the risk associated with acquiring the sample (i.e., whether it involved an invasive procedure or not) but appreciated that genetic samples could provide information not readily obtained from nongenetic sources. Concerns about potential misuse of genetic data largely centered on misconduct, paternity, forensic applications, and insurance and employment discrimination. Although surrogate decision makers expressed that their loved ones would have interest in return of results and being recontacted for future use, these interests were secondary to confidentiality concerns. CONCLUSION Respondents perceived genetic and nongenetic data as comparable. Informed consent processes that provide clear information regarding confidentiality protections, specimen handling, and parameters for future use may enhance enrollment.Genet Med 2013:15(5):368-373.
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Freeman BD, Kennedy CR, Bolcic-Jankovic D, Eastman A, Iverson E, Shehane E, Celious A, Barillas J, Clarridge B. Considerations in the construction of an instrument to assess attitudes regarding critical illness gene variation research. J Empir Res Hum Res Ethics 2012; 7:58-70. [PMID: 22378135 DOI: 10.1525/jer.2012.7.1.58] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Clinical studies conducted in intensive care units are associated with logistical and ethical challenges. Diseases investigated are precipitous and life-threatening, care is highly technological, and patients are often incapacitated and decision-making is provided by surrogates. These investigations increasingly involve collection of genetic data. The manner in which the exigencies of critical illness impact attitudes regarding genetic data collection is unstudied. Given interest in understanding stakeholder preferences as a foundation for the ethical conduct of research, filling this knowledge gap is timely. The conduct of opinion research in the critical care arena is novel. This brief report describes the development of parallel patient/surrogate decision-maker quantitative survey instruments for use in this environment. Future research employing this instrument or a variant of it with diverse populations promises to inform research practices in critical illness gene variation research.
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Affiliation(s)
- Bradley D Freeman
- Washington University School of Medicine, Department of Surgery, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
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Misiewicz S, Winawer MR. Recruitment for genetic studies of epilepsy. Epilepsy Res 2012; 101:122-8. [PMID: 22476038 DOI: 10.1016/j.eplepsyres.2012.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/05/2012] [Accepted: 03/09/2012] [Indexed: 10/28/2022]
Abstract
Virtually nothing has been published about recruitment of adults with sporadic temporal lobe epilepsy (TLE) for genetic studies. We examined eligibility, recruitment, participation rates, and reasons for exclusion in a genetic study of TLE. Participants with non-acquired TLE with onset ≤35 were recruited through review of records and screening of incoming patients at Columbia University Medical Center (CUMC). Eligible patients were asked to participate in an interview about seizures and give a blood sample for DNA extraction. Medical records were sought for each participant. Of 2974 patients screened 252 (8.5%) were eligible, and 40 (15.9% of eligible) participated. Leading reasons for ineligibility included an antecedent cause of epilepsy, syndrome other than TLE, and seizure onset after age 35. Those declining participation cited concerns about confidentiality, lack of compensation, and fear of phlebotomy. Although TLE is common and patients were recruited from a major surgical epilepsy center, a small proportion of potential participants participated. Large numbers need to be screened to reach the target sample size. Obtaining permission from treating physicians to contact their patients directly can improve recruitment. Saliva DNA collection, monetary incentives and patient education can improve participation. This information can facilitate study design in epilepsy genetics.
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Affiliation(s)
- Sylwia Misiewicz
- GH Sergievsky Center, Columbia University, New York, NY, United States.
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Nwulia EA, Hipolito MM, Aamir S, Lawson WB, Nurnberger JI. Ethnic disparities in the perception of ethical risks from psychiatric genetic studies. Am J Med Genet B Neuropsychiatr Genet 2011; 156B:569-80. [PMID: 21595007 DOI: 10.1002/ajmg.b.31198] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 04/25/2011] [Indexed: 11/12/2022]
Abstract
To examine if ethnic differences in concerns about unfavorable consequences from psychiatric genetic studies, existing between non-Hispanic Black and White populations, persist among participants in an actual genetic study of bipolar disorder. Historically, minority subjects have been less willing to participate in such studies. Participants in the US Bipolar Genome Study (BIGS) were assessed on six items of concerns in the Questionnaire on Genetic Risk (QGR). Each item had five response categories, ranging from "not at all" concerned to "very concerned." Responses from Black (N = 188) and White participants (N = 1,065) formed the base for this analysis. Concerns about unfavorable consequences of conducting psychiatric genetic studies were prevalent in the whole sample. Concern for medical insurance was most prevalent (63.4%), followed by job concern (58.8%) and stigma (57.4%). Racial discrimination was less prevalent (28.1%). Blacks endorsed significantly stronger concerns for all consequences except the medical insurance item (P < 0.008). The most significant ethnic disparity in concerns was for racial discrimination (P < 0.0001). Associations between levels of concern and ethnicity remained significant after adjustments for other factors in multivariate models. Ethnic differences (Blacks vs. Whites) in perceived concerns about unfavorable consequences from participation persist among participants in an actual psychiatric genetic study. This suggests that other factors may play a more critical role in the decision not to participate. Future studies should investigate more comprehensive sources of barriers to consenting for ongoing psychiatric genetic studies in representative samples, incorporating assessments from non-participants as well as participants.
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Affiliation(s)
- E A Nwulia
- Howard University College of Medicine, Washington, District of Columbia, USA.
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Abstract
The advent of genetic testing for psychiatric conditions raises difficult questions about when and how the tests should be used. Development of policies regarding these issues may be informed in a variety of ways by the views of key stakeholders: patients, family members, healthcare professionals, and the general public. Here, we review empirical studies of attitudes towards genetic testing among these groups. Patients and family members show strong interest in diagnostic and predictive genetic testing, and to a considerable extent psychiatrists share their enthusiasm. Prenatal test utilization seems likely to depend both on parental views on abortion and the seriousness of the disorder. Parents show a surprising degree of interest in predictive testing of children, even when there are no preventive interventions available. Many persons report themselves ready to alter their lifestyles and plans for marriage and family in response to test results. Respondents also fear negative consequences, from discrimination to being unable to cope with knowledge of their "genetic fate." Empirical studies of beliefs about genetic testing suggest tests are likely to be embraced widely, but the studies have methodologic limitations, reducing the certainty of their conclusions, and indicating a need for further research with more representative samples.
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Affiliation(s)
- Ryan E Lawrence
- Resident in the Department of Psychiatry, Columbia University Medical Center, New York, NY 10032
| | - Paul S. Appelbaum
- Elizabeth K Dollard Professor of Psychiatry, Medicine, and Law, and director of the Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics, Columbia University Medical Center, New York, NY 10032
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Johnson VA, Powell-Young YM, Torres ER, Spruill IJ. A systematic review of strategies that increase the recruitment and retention of African American adults in genetic and genomic studies. THE ABNF JOURNAL : OFFICIAL JOURNAL OF THE ASSOCIATION OF BLACK NURSING FACULTY IN HIGHER EDUCATION, INC 2011; 22:84-88. [PMID: 22165568 PMCID: PMC3439996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The National Institutes of Health mandates the inclusion of ancestrally diverse populations into federally funded biomedical and clinical trials research. However, low participation of ethnic minorities in genetics-genomics research continues to be one of the most difficult aspects of conducting human subjects research. OBJECTIVE This systematic review was conducted to document effective recruitment strategies that increase participation in genetics-genomics studies. METHODS Extensive literature search strategies were employed to locate and appraise relevant literature reporting original data in which strategies to recruit African American adults into genetics-genomics research studies had been evaluated. RESULTS Six studies published up to July, 2011 were included. Informal recruitment strategies for initial contact appeared to have a more positive impact on increasing recruitment and participation numbers than formal mailings of letters and postcards. Another key stratagem identified was participant-recruiter like-ancestry. Other methods such as monetary incentives and support of the research project by community leaders were not as effective. CONCLUSIONS Some strategies bolstered recruitment rates while others did not. More research is needed to determine the efficacy of recruitment strategies with African Americans.
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Affiliation(s)
- Vanessa A Johnson
- College of Nursing, University of Oklahoma Health Sciences Center, Tulsa 74135, USA.
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