Communicating Genetic Information for Obesity

描述（由申请人提供）：近几十年来，美国的肥胖率不断上升，对公共卫生预防工作提出了越来越大的挑战。基因组学的进步已经开始揭示遗传对肥胖的影响。目前，尚不清楚有关个人肥胖遗传倾向的信息是否会增加传统风险沟通工作的价值，并增加个人采取健康行为以降低肥胖风险的可能性。这些信息的临床效用以及对心理、行为和健康结果的影响尚未确定。迫切需要进行研究来确定向个人提供有关肥胖风险的遗传信息的最佳实践，这可以作为了解常见疾病 SNP 测试的行为反应的模型。拟议的研究将探讨提供肥胖遗传风险信息对人们对肥胖、健康行为和体重结果的态度和信念的影响。我们将使用 2x2 析因设计进行随机对照可行性试验，以检验风险反馈对肥胖的短期影响。这两个因素将是遗传风险反馈（否/是）和生活方式风险反馈（否/是），从而导致四种情况：1）既没有遗传风险反馈也没有生活方式风险反馈（候补名单控制），2）仅遗传风险反馈，3）仅生活方式风险反馈，以及4）遗传和生活方式风险反馈相结合。该研究的具体目的是：1）检查提供创新遗传风险反馈（单独或与生活方式风险反馈结合）对参与者行为意图、健康行为（体力活动、饮食、电视观看）和体重结果的影响，2）确定遗传和/或生活方式风险反馈的影响随风险状态（升高与未升高）变化的程度。我们还将在自我调节理论的指导下研究遗传和/或生活方式风险信息可能影响生活方式行为的机制。这项研究将是第一个获得关于提供肥胖基因型反馈对超重和非超重个体的实际行为结果的短期（以机制为重点）影响的试点数据。由于这是一项试点研究，数据将用于确定效应大小和方差估计，以用于规划更大规模的随机试验。我们将确定遗传信息与生活方式风险反馈相结合时的“附加值”，以及它是否增强了从事健康生活方式行为的动力。此外，我们还将确定提供“低风险”遗传反馈是否会产生任何不利影响（例如，虚假保证）。最后，这项研究的独特之处在于提供了重要数据，说明个人如何解释不同来源的风险信息以及他们如何得出对某种疾病风险的总体看法。总而言之，研究结果将用作未来干预工作的整体模型，以有效传达遗传风险信息，以改善体重管理和整体人口健康。 1 公共健康相关性：尽管公众可以通过直接面向消费者的公司广泛获得肥胖基因检测，但人们对这些信息对人们对肥胖的态度、健康行为和体重结果的影响知之甚少。这项研究将探讨利用与肥胖相关的遗传信息来激励个体降低肥胖风险的可行性。研究结果将作为未来干预工作的总体模型，以有效传达遗传风险信息，以改善体重管理和整体人口健康为目标。

DESCRIPTION (provided by applicant): Obesity rates in the United States have escalated in recent decades and present a growing challenge in public health prevention efforts. Advances in genomics have begun to shed light on the genetic contributions to obesity. At present, it is unknown whether information about one's personal genetic predisposition to obesity will add value to traditional risk communication efforts and increase the likelihood that individuals will engage in health behaviors to reduce obesity risk. The clinical utility and impact of this information on psychological, behavioral, and health outcomes have yet to be determined. Research is critically needed to identify the best practices for providing genetic information to individuals regarding their risk for obesity, which may serve as a model for understanding the behavioral responses to SNP testing for common diseases. The proposed study will examine the impact of providing genetic risk information for obesity on people's attitudes and beliefs about obesity, health behaviors and weight outcomes. We will conduct a randomized controlled feasibility trial to examine the short-term impact of risk feedback for obesity, using a 2x2 factorial design. The two factors will be genetic risk feedback (no/yes) and lifestyle risk feedback (no/yes), resulting in four conditions: 1) neither genetic or lifestyle risk feedback (wait-list control), 2) genetic risk feedback only, 3) lifestyle risk feedback only, and 4) both genetic and lifestyle risk feedback combined. The specific aims of the study are to: 1) examine the effects of providing innovative genetic risk feedback, alone or in combination with lifestyle risk feedback, on participants' behavioral intentions, health behaviors (physical activity, diet, television viewing), and weight outcomes, and 2) determine the extent to which the effects of genetic and/or lifestyle risk feedback vary as a function of risk status (elevated versus non-elevated). We will also examine the mechanisms by which genetic and/or lifestyle risk information may influence lifestyle behaviors, guided by self-regulation theory. This study will be the first to obtain pilot data on the short-term (mechanism-focused) impact of providing obesity genotype feedback on actual behavioral outcomes among both overweight and non-overweight individuals. Because this is a pilot study, data will be used to develop effect sizes and variance estimates to be used in planning a larger randomized trial. We will determine the "value added" of genetic information when combined with lifestyle risk feedback, and whether it enhances motivation to engage in healthy lifestyle behaviors. Moreover, we will also determine whether providing "low risk" genetic feedback has any adverse effects (e.g., false reassurance). Finally, this study is uniquely situated to provide important data on how individuals interpret different sources of risk information and how they arrive at an overall perception of risk for a condition. Taken altogether, study findings will be used to serve as an overall model for future intervention efforts to effectively communicate genetic risk information with the goal of improving weight management and overall population health. 1 PUBLIC HEALTH RELEVANCE: Although genetic testing for obesity is widely available to the public through direct-to-consumer companies, little is known about the impact of this information on people's attitudes towards obesity, health behaviors, and weight outcomes. This study will examine the feasibility of using obesity-related genetic information to motivate individuals to reduce their risk for obesity. Study findings will serve as an overall model for future intervention efforts to effectively communicate genetic risk information with the goal of improving weight management and overall population health.