1
|
Vidgen ME, Cutler K, Bean J, Bunker D, Fowles LF, Healy L, Hondow G, Istiko SN, McInerney-Leo AM, Pratt G, Robins D, Waddell N, Evans E. Community input in a genomic health implementation program: Perspectives of a community advisory group. Front Genet 2022; 13:892475. [PMID: 35938017 PMCID: PMC9355292 DOI: 10.3389/fgene.2022.892475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Consumer and community engagement (CCE) in the implementation of genomics into health services and associated research is needed to ensure that changes benefit the affected patients. Queensland Genomics was a program to implement genomics into a public health service. We describe its Community Advisory Group’s (CAG) structure and function and provide recommendations based on the CAG members’ perspectives. The CAG provided advice to the Queensland Genomics program and its projects in an advisory capacity. The CAG was also resourced to develop and lead community-focused activities. Key enablers for CAG included; diversity of CAG members’ skills and experience, adequate resourcing, and the CAG’s ability to self-determine their direction. The CAG experienced limitations due to a lack of mechanisms to implement CCE in the Program’s projects. Here, we provide insights and commentary on this CAG, which will be useful for other initiatives seeking to undertake CCE in genomic research and health care.
Collapse
Affiliation(s)
- Miranda E. Vidgen
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Correspondence: Miranda E. Vidgen, ; Nicola Waddell,
| | - Katrina Cutler
- Queensland Genomics, Herston, QLD, Australia
- Health Translation Queensland, Herston, QLD, Australia
| | - Jessica Bean
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - David Bunker
- Queensland Genomics, Herston, QLD, Australia
- Health Translation Queensland, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Lindsay F. Fowles
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Genetic Health Queensland, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Louise Healy
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Gary Hondow
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | | | - Aideen M. McInerney-Leo
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Dermatology Research Centre, University of Queensland Diamantina Institute, University of Queensland, Brisbane, QLD, Australia
| | - Gregory Pratt
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Deborah Robins
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Nicola Waddell
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Correspondence: Miranda E. Vidgen, ; Nicola Waddell,
| | - Erin Evans
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Health Consumers Queensland, Brisbane, QLD, Australia
| |
Collapse
|
2
|
Pysar R, Wallingford CK, Boyle J, Campbell SB, Eckstein L, McWhirter R, Terrill B, Jacobs C, McInerney-Leo AM. Australian human research ethics committee members' confidence in reviewing genomic research applications. Eur J Hum Genet 2021; 29:1811-1818. [PMID: 34446835 PMCID: PMC8633339 DOI: 10.1038/s41431-021-00951-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023] Open
Abstract
Human research ethics committees (HRECs) are evaluating increasing quantities of genomic research applications with complex ethical considerations. Genomic confidence is reportedly low amongst many non-genetics-experts; however, no studies have evaluated genomic confidence levels in HREC members specifically. This study used online surveys to explore genomic confidence levels, predictors of confidence, and genomics resource needs of members from 185 HRECs across Australia. Surveys were fully or partially completed by 145 members. All reported having postgraduate 94 (86%) and/or bachelor 15 (14%) degrees. Participants consisted mainly of researchers (n = 45, 33%) and lay members (n = 41, 30%), affiliated with either public health services (n = 73, 51%) or public universities (n = 31, 22%). Over half had served their HREC [Formula: see text]3 years. Fifty (44%) reviewed genomic studies [Formula: see text]3 times annually. Seventy (60%) had undertaken some form of genomic education. While most (94/103, 91%) had high genomic literacy based on familiarity with genomic terms, average genomic confidence scores (GCS) were moderate (5.7/10, n = 119). Simple linear regression showed that GCS was positively associated with years of HREC service, frequency of reviewing genomic applications, undertaking self-reported genomic education, and familiarity with genomic terms (p < 0.05 for all). Conversely, lay members and/or those relying on others when reviewing genomic studies had lower GCSs (p < 0.05 for both). Most members (n = 83, 76%) agreed further resources would be valuable when reviewing genomic research applications, and online courses and printed materials were preferred. In conclusion, even well-educated HREC members familiar with genomic terms lack genomic confidence, which could be enhanced with additional genomic education and/or resources.
Collapse
Affiliation(s)
- Ryan Pysar
- grid.117476.20000 0004 1936 7611Genetic Counseling, Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia ,grid.414009.80000 0001 1282 788XCentre for Clinical Genetics, Sydney Children’s Hospital, Randwick, NSW Australia
| | - Courtney K. Wallingford
- grid.1003.20000 0000 9320 7537University of Queensland Diamantina Institute, University of Queensland, Dermatology Research Centre, Woolloongabba, QLD Australia
| | - Jackie Boyle
- grid.511220.50000 0005 0259 3580NSW Genetics of Learning Disability (GOLD) Service, Hunter Genetics, Waratah, NSW Australia
| | - Scott B. Campbell
- grid.412744.00000 0004 0380 2017Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, QLD Australia
| | - Lisa Eckstein
- grid.1009.80000 0004 1936 826XFaculty of Law University of Tasmania, Hobart, TAS Australia
| | - Rebekah McWhirter
- grid.1021.20000 0001 0526 7079School of Medicine, Faculty of Health, Deakin University, Geelong, VIC Australia
| | - Bronwyn Terrill
- grid.415306.50000 0000 9983 6924Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW Australia ,grid.1005.40000 0004 4902 0432St Vincent’s Clinical School, UNSW Sydney, Sydney, NSW Australia
| | - Chris Jacobs
- grid.117476.20000 0004 1936 7611Genetic Counseling, Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Aideen M. McInerney-Leo
- grid.1003.20000 0000 9320 7537University of Queensland Diamantina Institute, University of Queensland, Dermatology Research Centre, Woolloongabba, QLD Australia
| |
Collapse
|
3
|
Queensland Genomics: an adaptive approach for integrating genomics into a public healthcare system. NPJ Genom Med 2021; 6:71. [PMID: 34408148 PMCID: PMC8373904 DOI: 10.1038/s41525-021-00234-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
The establishment of genomics in health care systems has been occurring for the past decade. It is recognised that implementing genomics within a health service is challenging without a system-wide approach. Globally, as clinical genomics implementation programs have matured there is a growing body of information around program design and outcomes. Program structures vary depending on local ecosystems including the health system, politics and funding availability, however, lessons from other programs are important to the design of programs in different jurisdictions. Here we describe an adaptive approach to the implementation of genomics into a publicly funded health care system servicing a population of 5.1 million people. The adaptive approach enabled flexibility to facilitate substantial changes during the program in response to learnings and external factors. We report the benefits and challenges experienced by the program, particularly in relation to the engagement of people and services, and the design of both individual projects and the program as a whole.
Collapse
|
4
|
Speechly C, Stenhouse R, Berman Y, Barlow-Stewart K, Fleming J, Petrie D, Culling B. Genetic counselors, patients', and carers' views on an Australian clinical genetics service information system. J Genet Couns 2021; 30:1440-1451. [PMID: 33866647 DOI: 10.1002/jgc4.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/07/2022]
Abstract
The Genetic Information System (GIS) is an Australian database of family genetic information. This health information technology system has been used by all 31 publicly operated clinical genetics services across New South Wales (NSW) and the Australian Capital Territory (ACT) for over a decade. As these services are separated geographically, the linkage engendered by the GIS facilitates the services to operate as a virtual state-wide service. This study aimed to explore the views of genetic counselors, patients, and carers on the use and storage of family genetic information in the GIS. Data were collected using audio-recorded semi-structured telephone interviews with genetic counselors experienced with using the GIS and focus groups with past patients/carers of the services. Using thematic analysis, four themes were identified from genetic counselor participant interviews (n = 12): (a) Shared information is valuable; (b) inconsistent data entry provides a challenge; (c) perceived need for the GIS to be current and integrated with other health systems; and (d) future challenges and strategies for the GIS. Three themes were identified following three focus groups with consumer participants (n = 14): (a) access to family genetic information provides a 'clearer picture'; (b) support, but caution, concerning use of information for relatives' health care; and (c) stewardship of family information. Genetic counselors and consumers identified similar advantages and privacy concerns regarding the sharing of family genetic information and all participants wanted patients/carers to be better informed about the GIS early in the genetic counseling process. Consumers were reassured by genetics health professionals' stewardship of their information, but surprised the GIS was not available nationally or for private geneticists or certain non-genetic specialists. These findings may inform further development of the GIS and other clinical genetic databases and lead to increased patient/carer knowledge through education and resource development.
Collapse
Affiliation(s)
- Catherine Speechly
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Rachael Stenhouse
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Yemima Berman
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia.,Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Kristine Barlow-Stewart
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Jane Fleming
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | | | - Bronwyn Culling
- Clinical Applications Support, Service Delivery, eHealth NSW, Chatswood, NSW, Australia
| |
Collapse
|