Communication of Genetic and Environmental Risks in Colorectal Cancer Prevention

描述（由申请人提供）：本次职业奖励提案的总体目标是使王博士成为一名独立的研究人员，研究干预措施的设计，以传达有关遗传和环境风险的信息，重点是结肠直肠癌。遗传和环境风险因素信息的有效交流变得越来越重要，因为遗传技术的进步继续揭示它们对结直肠癌风险的贡献。迄今为止，对于如何最好地传达风险因素信息以增加行为动机知之甚少，从而限制了这些新技术对公共卫生利益的应用。关于癌症风险因素的沟通的影响部分取决于对所传达的疾病反馈所持有的先前信念和认知表征。特别是，因果归因——人们对结直肠癌病因的信念——是一个重要的，但尚未得到充分研究的决定因素，它决定了个人是否以及在多大程度上采取行为行动来减少患这种疾病的可能性。更好地了解普通人群中结直肠癌的因果归因是必不可少的，以便系统和全面地描述人们如何看待癌症的原因，并确定那些促进或破坏筛查依从性和生活方式改变的归因。采用调查和实验研究相结合的方法，正在提出两项研究，它们以逻辑顺序相互建立，以1)描述结直肠癌因果归因的性质及其与筛查和生活方式行为的关联，以及2)开始实验测试遗传和环境为重点的风险沟通信息对因果归因模式和健康行为的影响。建议的培训计划通过提供传播科学、心理测量方法、干预策略和高级统计学方面的必要高级指导和课程来支持这项研究。这将使PI能够有效地进行研究，并根据所获得的发现为结直肠癌筛查和预防提供更精确的信息，为5年的R01提交做好准备。这个培训和研究的协同项目对于了解个体如何对结直肠癌以及其他癌症部位的风险沟通信息作出反应至关重要。也许最重要的是，从这些研究中获得的知识对于制定和评估以理论为指导的量身定制干预措施至关重要，这些干预措施的重点是向一般人群传达遗传和/或环境风险信息，以促进行为改变，并最终造福公众健康。

DESCRIPTION (provided by applicant): The overall goal of this career award proposal is to enable Dr. Wang to become an independent investigator n the design of interventions to communicate messages about genetic and environmental risk, with a focus on colorectal cancer. The effective communication of genetic and environmental risk factor information has grown increasingly important as advances in genetic technology continue to shed new light on their contributions to colorectal cancer risk. To date, little is known about how best to communicate risk factor information to increase behavioral motivation, thus limiting the application of these new technologies for public health benefit. The impact of communication about cancer risk factors depends, in part, on the prior beliefs and cognitive representations held about the disease feedback being conveyed. In particular, causal attributions - the beliefs people have about the causes of colorectal cancer - are an important, but understudied, determinant of whether and to what extent individuals take behavioral action to reduce the likelihood of developing the disease. A better understanding of causal attributions for colorectal cancer among the general population is essential in order to systematically and comprehensively delineate how people think about the causes of cancer, and identify those attributions that facilitate, or undermine, screening adherence and lifestyle change. Using a combination of survey and experimental research methodologies, two studies are being proposed that build on each other in logical sequence to 1) describe the nature of causal attributions for colorectal cancer and their association with screening and lifestyle behaviors, and 2) begin to experimentally test the impact of genetic and environmentally-focused risk communication messages on patterns of causal attributions and health behaviors among unaffected individuals. The training plan proposed supports this research by providing the necessary advanced mentoring and coursework in communication science, psychometric methods, intervention strategies, and advanced statistics. This will enable the PI to effectively conduct the studies and prepare her for an R01 submission in year 5, building on the findings obtained to create more refined messages for colorectal screening and prevention. This synergistic program of training and research will be essential to understanding how individuals respond to risk communication messages for colorectal cancer, as well as other cancer sites. Perhaps most importantly, the knowledge gained from these studies will be critical to inform the development and evaluation of theory-guided tailored interventions that focus on conveying genetic and/or environmental risk information to the general population in efforts to promote behavior change and, ultimately, public health benefits.