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Best LG, O’Leary M, O’Leary R, Lawrence W, Torgerson DG. Return of Participants' Incidental Genetic Research Findings: Experience from a Case-Control Study of Asthma in an American Indian Community. J Pers Med 2023; 13:1407. [PMID: 37763174 PMCID: PMC10532458 DOI: 10.3390/jpm13091407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
The proper communication of clinically actionable findings to participants of genetic research entails important ethical considerations, but has been challenging for a variety of reasons. We document an instance of the return of individual genetic results in the context of a very rural American Indian community, in hopes of providing insight to other investigators about potentially superior or inferior courses of action. This was a case/control study of asthma among 324 pediatric participants. Subsequently, microarray genotype data became available, providing over 2 million variants, incidentally including some conferring risk for conditions for which the American College of Medical Genetics recommends return of results. The study investigators engaged in extensive consultation with the IRB, the tribal government, and local clinicians to better inform our approach. We were able to notify the two participants heterozygous for the one clinically actionable variant identified. One participant welcomed this information and proceeded to obtain further clinical work-up; the other participant declined further follow-up. While demanding considerable time and effort, the return of clinically actionable genetic results is important from both an ethical perspective and to provide an improved trust relationship with the community of research participants.
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Affiliation(s)
- Lyle G. Best
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
- Missouri Breaks Industries Research Inc., Eagle Butte, SD 57625, USA; (M.O.); (R.O.); (W.L.)
| | - Marcia O’Leary
- Missouri Breaks Industries Research Inc., Eagle Butte, SD 57625, USA; (M.O.); (R.O.); (W.L.)
| | - Rae O’Leary
- Missouri Breaks Industries Research Inc., Eagle Butte, SD 57625, USA; (M.O.); (R.O.); (W.L.)
| | - Wendy Lawrence
- Missouri Breaks Industries Research Inc., Eagle Butte, SD 57625, USA; (M.O.); (R.O.); (W.L.)
| | - Dara G. Torgerson
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158, USA;
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Booth-LaForce C, Oxford ML, O’Leary R, Rees J, Petras A, Buchwald DS. Implementation fidelity of the Promoting First Relationships intervention program in a Native community. Transl Behav Med 2023; 13:34-41. [PMID: 36227860 PMCID: PMC9853091 DOI: 10.1093/tbm/ibac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Promoting First Relationship (PFR) is an evidence-based intervention designed to promote positive, supportive relationships between primary caregivers and their young children. Implementing and testing the efficacy of PFR in a remote Native community is especially challenging and requires methods and tools for ensuring implementation fidelity. Tribal members of a Native community were successfully trained and certified to deliver PFR by university-based personnel. During PFR delivery, they achieved very high scores on adherence to intervention content (M = 0.99, SD = 0.02), and their quality of delivery uniformly exceeded established criteria. High attrition occurred before PFR was delivered. However, participants who remained in the study completed all 10 sessions of PFR content. Participants' satisfaction with the program was very high (M = 3.90 [of 4 points], SD = 0.19). High implementation fidelity was attained in the face of many inherent challenges. The suite of methods and tools used for training, monitoring, and evaluating implementation fidelity in this study provides an example that may be useful in the evaluation of evidence-based programs more generally.
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Affiliation(s)
- Cathryn Booth-LaForce
- Department of Child, Family, and Population Health Nursing, University of Washington, Barnard Center for Infant Mental Health and Development, Box 357231, Seattle, WA 98195-7231, USA
| | - Monica L Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington, Barnard Center for Infant Mental Health and Development, Box 357231, Seattle, WA 98195-7231, USA
| | - Rae O’Leary
- Missouri Breaks Industries Research Inc., Eagle Butte, SD 57625, USA
| | - Jennifer Rees
- Department of Child, Family, and Population Health Nursing, University of Washington, Barnard Center for Infant Mental Health and Development, Box 357231, Seattle, WA 98195-7231, USA
| | - Anthippy Petras
- Elson S. Floyd College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Ste 1200, Seattle, WA 98101, USA
| | - Dedra S Buchwald
- Elson S. Floyd College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Ste 1200, Seattle, WA 98101, USA
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Mitchell CJ, Henry ET, Barnett JR, Banks EG, Hunt JM, Birchett TG, Robbins SD, Balfour WT, O’Leary R. The Vicksburg Physicians. South Med Rec 1879; 9:78. [PMID: 36023143 PMCID: PMC9089535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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