Understanding the potential of state-based public health genomics programs to mitigate disparities in access to clinical genetic services.
Understanding the potential of state-based public health genomics programs to mitigate disparities in access to clinical genetic services.
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DOI：
10.1038/s41436-018-0056-y
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Lee R
中科院分区：
文献类型：
--
作者：
Senier L;Tan C;Smollin L;Lee R
国家卫生机构（SHA）已经开发了公共卫生基因组学（PHG）计划，在推进精准公共卫生方面发挥了重要作用，但对其方法的研究有限。本研究探讨了PHG计划如何试图减轻或阻止基因组医学利用中的健康差异和不公平。我们比较了三个州的PHG项目：康涅狄格州、密歇根州和犹他州。我们分析了85个与SHA内部和外部合作者和项目文件的深入访谈。我们采用了定性编码过程，以捕捉有关健康差距和不公平的主题。每个SHA都实施了人群水平的方法来识别携带增加遗传性癌症风险的遗传变异的个体。然而，每个SHA制定了一个独特的战略，我们标记为公共卫生行动剧目，以达到特定的亚组谁面临的障碍，在获得遗传服务。这些策略因州人口的人口统计、州一级的伙伴关系和医疗服务的可用性而异。我们的研究结果说明了量身定制PHG计划，以当地的人口特征和现有的社区资源的必要性。此外，我们的研究强调了如何将基因组学整合到精确的公共卫生中，需要多层次，多部门的合作，以优化效率和公平。
State Health Agencies (SHAs) have developed public health genomics (PHG) programs that play an instrumental role in advancing precision public health, but there is limited research on their approaches. This study examines how PHG programs attempt to mitigate or forestall health disparities and inequities in the utilization of genomic medicine. We compared PHG programs in three states: Connecticut, Michigan, and Utah. We analyzed 85 in-depth interviews with SHA internal and external collaborators and program documents. We employed a qualitative coding process to capture themes relating to health disparities and inequities. Each SHA implemented population-level approaches to identify individuals who carry genetic variants that increase risk of hereditary cancers. However, each SHA developed a unique strategy—which we label public health action repertoires—to reach specific subgroups who faced barriers in accessing genetic services. These strategies varied across states given demographics of the state population, state-level partnerships, and availability of healthcare services. Our findings illustrate the imperative of tailoring PHG programs to local demographic characteristics and existing community resources. Furthermore, our study highlights how integrating genomics into precision public health will require multilevel, multisector collaboration to optimize efficacy and equity.
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DOI：
10.1038/gim.2017.211
发表时间：
2018-06
期刊：
Genetics in medicine : official journal of the American College of Medical Genetics
影响因子：
--
作者：
Khoury MJ;Bowen MS;Clyne M;Dotson WD;Gwinn ML;Green RF;Kolor K;Rodriguez JL;Wulf A;Yu W
通讯作者：
Yu W
影响因子：
3.8
作者：
Cragun, D.;Bonner, D.;Pal, Tuya
通讯作者：
Pal, Tuya
影响因子：
12.7
作者：
Frohlich, Katherine L.;Potvin, Louise
通讯作者：
Potvin, Louise
影响因子：
--
作者：
Burton, Hilary;Sagoo, Gurdeep S.;Zimmern, Ron L.
通讯作者：
Zimmern, Ron L.
影响因子：
2.8
作者：
Senier, Laura;Shields, Michael;Wiecek, Elyssa
通讯作者：
Wiecek, Elyssa