The Impact of Family History and Genomics Based Risk Profiling on Primary Care

家族史和基于基因组学的风险分析对初级保健的影响

基本信息

批准号：
8141572
负责人：
Scott ROBERTS
金额：
$ 7.61万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2012-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8141572
关键词：
Acceleration Address Adult Affect Age Area Attitude Audiotape Behavior Breast Caring Centers for Disease Control and Prevention (U.S.)Chronic Disease Clinic Clinical Code Collection Colorectal Colorectal Cancer Communication Complex Coronary heart disease Data Development Diabetes Mellitus Disease Disease Association Evaluation Family Family health status Family history of Feedback Funding Future Genes Genetic Genetic Predisposition to Disease Genetic Risk Genetic screening method Genomics Health Health Personnel Health Services Health system Healthcare Heart Diseases Hypertension Individual Intervention Intervention Trial Laboratory Study Learning Maintenance Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of ovary Manuals Medicine Methods Motivation National Human Genome Research Institute Nature Non-Insulin-Dependent Diabetes Mellitus Online Systems Osteoporosis Outcome Participant Patients Physicians Pilot Projects Predisposition Prevention Preventive Preventive Medicine Primary Health Care Procedures Process Protocols documentation Provider Public Health Randomized Clinical Trials Recommendation Recording of previous events Recruitment Activity Research Research Infrastructure Research Personnel Resources Risk Risk Assessment Risk Reduction Sampling Scheme Screening procedure Self-Administered Services Single Nucleotide Polymorphism Skin Cancer Stroke Surgeon Test Result Testing Visit Work authority base caregiving commercialization design disorder risk evidence based guidelines genetic risk assessment hypercholesterolemia improved innovation multidisciplinary operation primary care setting programs prototype psychosocial response systematic review tool uptake

项目摘要

PROJECT SUMMARY The rapid acceleration of genomic discovery is engendering new tools (e.g., SNP-based genetic susceptibility tests) that enable personalized risk profiles for healthy individuals by disclosing their susceptibility to such common diseases such as diabetes, heart disease and cancer. One mechanism by which personalized risk assessments might improve health is motivating at-risk adults to adhere to annual health maintenance visits and engage in proven screening and risk reduction procedures. However, the utility of these visits for promoting health is likely to depend strongly on the discussions that result between patients and their care providers, and whether the procedures, tests, and referrals prompted by these visits are an appropriate use of resources. Building upon our prior work in this area (i.e., the CDC-funded Family Healthware Intervention trial and NHGRI's Multiplex Initiative), our multidisciplinary team of investigators is planning a multi-center randomized clinical trial (RCT) to examine primary care-based interventions that incorporate multiplex genetic susceptibility testing and family history-based risk information for common, complex diseases. In the RCT, we will examine the impact of these interventions on patients' uptake of health maintenance visits, interactions with health providers, and subsequent health service use. This pilot study will allow us to develop and test approaches that would eventually be implemented and evaluated in our proposed RCT. First we will develop a protocol to integrate our existing family history (Family Healthware) and genetic susceptibility testing (Multiplex Initiative) interventions into a protocol for use in a primary care setting. We will concurrently develop a coding scheme and operations manual for analyzing (via audiotaped health maintenance visits) how multiplex genetic testing and family health history information affect physician- patient encounters. The resulting intervention and coding scheme will then be implemented in a pilot study of a socially and racially diverse sample of 50 patients (age 35-65) recruited from primary care clinics within the Henry Ford Health System. Resulting study materials, infrastructure, and findings will be used to inform the design of the multisite RCT to test our interventions in a larger sample.

项目摘要基因组发现的快速加速正在生产新工具（例如，基于SNP 遗传敏感性测试），可以为健康个体提供个性化的风险概况通过揭示其对糖尿病等常见疾病的敏感性，心脏疾病和癌症。个性化的风险评估可能是一种机制改善健康正在激励高危成年人遵守年度健康维护访问并进行经过验证的筛查和降低风险程序。但是，这些促进健康的访问很可能很大程度上取决于讨论患者及其护理提供者之间的结果，以及程序，测试和是否这些访问提示的推荐是适当使用资源。建立我们先前在这一领域的工作（即CDC资助的家庭健康软件干预试验和 NHGRI的多重倡议），我们的跨学科研究人员正在计划多中心随机临床试验（RCT）检查基于初级保健的干预措施结合了多重遗传易感性测试和基于家族史的风险常见，复杂疾病的信息。在RCT中，我们将研究这些干预措施对患者的健康维持就诊，与卫生提供者以及随后的卫生服务使用。这项试验研究将使我们能够开发和测试方法最终将在我们的拟议的RCT。首先，我们将制定一项协议来整合我们现有的家族史（家庭健康软件）和遗传敏感性测试（多重计划）干预措施进入用于初级保健设置的协议。我们将同时开发一个编码用于分析的计划和操作手册（通过录音带健康维护访问）多重基因检测和家庭健康历史信息如何影响医师 - 病人遇到。然后，由此产生的干预和编码方案将是在一项针对50名患者的社会和种族不同样本的试点研究中实施的（年龄 35-65）从亨利·福特卫生系统内的初级保健诊所招募。由此产生的研究材料，基础设施和调查结果将用于告知设计多站点RCT测试我们在较大样本中的干预措施。