Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.
Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.
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DOI：
10.1037/hea0000177
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发表时间：
2015-02
期刊：
影响因子：
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通讯作者：
Goodman MS
中科院分区：
文献类型：
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作者：
Kaphingst KA;Stafford JD;McGowan LD;Seo J;Lachance CR;Goodman MS
很少有研究探讨个人如何应对常见慢性疾病的基因组风险信息。这项随机研究检查了医疗服务不足的人群中基因组信息类型[基因测试/家族史]和疾病状况[糖尿病/心脏病]以及种族/民族的反应差异。 1057 名讲英语的成年人完成了一项调查，其中包含四个小插图之一（二乘二随机设计）。使用卡方检验和多变量回归分析检查实验条件和种族/民族的因变量（即对接受基因组评估的兴趣、与医生或家人讨论、改变健康习惯）的差异。根据基因组信息类型或疾病状况，因变量没有发现显着差异。在多变量模型中，西班牙裔比白人更愿意接受基因组评估（OR=1.93；p<0.0001）；健康素养处于边缘（OR=1.54；p=0.005）或有限（OR=1.85；p=0.009）的受访者比具有足够健康素养的受访者更感兴趣。黑人（OR=1.78；p=0.001）和西班牙裔（OR=1.85；p=0.001）比白人更有兴趣与家人讨论信息。非西班牙裔黑人（OR=1.45；p=0.04）比白人更有兴趣与医生讨论基因组信息。黑人（β= -0.41；p<0.001）和西班牙裔（β= -0.25；p=0.033）打算改变的健康习惯比白人少；健康素养与参与者打算改变的健康习惯数量呈负相关。研究结果表明，种族/民族可能会影响对基因组风险信息的反应。其他研究可以检验这些信息的认知表征在不同种族/族裔群体中有何不同。在开发基因组信息交流方法时，考虑健康素养也至关重要。
Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information [genetic test/family history] and disease condition [diabetes/heart disease] and by race/ethnicity in a medically underserved population. 1057 English-speaking adults completed a survey containing one of four vignettes (two-by-two randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR=1.93; p<0.0001); respondents with marginal (OR=1.54; p=0.005) or limited (OR=1.85; p=0.009) health literacy had greater interest than those with adequate health literacy. Blacks (OR=1.78; p=0.001) and Hispanics (OR=1.85; p=0.001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR=1.45; p=0.04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β= −0.41; p<0.001) and Hispanics (β= −0.25; p=0.033) intended to change fewer health habits than Whites; health literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.