Investigating Latinx populations’ attitudes, perceptions, and use of genomic testing

项目摘要 基因组医学已经通过里程碑改变了预防，护理和有针对性的医疗团队 人类基因组计划的成就和用于健康目的的基因检测的出现。种系 基因检测的重点是遗传风险，这项建议的重点，可以包括各种类型和有目的的 检测，如携带者筛查，新生儿筛查，和癌症易感性测试等。这些测试有 已经使遗传提供者能够通过增加筛查来改善许多人的健康结果 建议，预防措施（化学预防）和行为改变建议。但是，在这方面， 为服务不足的群体，特别是拉丁裔（性别中立使用拉丁美洲人/a/e）的基因检测的扩散 这仍然是一个重大挑战。尽管人们对使用基因检测有浓厚的兴趣，但仍然缺乏 研究拉丁裔人口的促进和障碍因素。因此，本提案的目标是 经验性地检查拉丁裔个体对基因检测的经验，他们的态度，并识别感知 测试的促进者和障碍。特别是，我将描述突出的态度，促进者和障碍， 拉丁裔个人对基因检测的健康目的使用顺序解释的混合方法 设计（目标1）。研究的第一阶段（目标1A）将描述突出的态度，促进者， 使用半结构化诱导法对20名拉丁裔个体进行健康目的基因检测的障碍 采访样本将根据先前的基因检测经验进行分层， 测试是为了更好地描述这些群体之间不同的态度，促进因素和障碍。 访谈将集中在态度，感知规范和个人机构包括促进者的问题 和障碍。研究结果将指导下一阶段的研究（目标1B）。在这个阶段，我将检查 态度、促进者和障碍与携带者筛查和癌症相关意图的关联 拉丁裔人群的易感性测试具体来说，我将使用采访中的措辞设计一份调查 重点关注态度，促进者和障碍，并在500名拉丁美洲人的Qualtrics小组上进行调查 个体使用结构方程模型，我将测试态度，促进者， 和障碍因素与行为意图，以携带者筛查和癌症易感性测试， 确定哪些可能是最佳干预因素。基于F99结果，在博士后研究中， 第一阶段将利用关于态度、促进者和障碍的研究结果来发展翻译干预 研究让拉丁裔人口参与基因检测（目标2）。我博士后研究训练的目标 制定文化上适当的沟通策略，以改善拉丁美洲的遗传学参与 人口。通过对态度、促进因素和障碍的更深入了解， 研究人员更好地与拉丁裔人口接触，从而减少基因组学中的健康不平等。

PROJECT SUMMARY Genomic medicine has transformed prevention, care, and targeted medical regiments through the milestone achievements of Human Genome Project and the advent of genetic testing for health purposes. Germline genetic testing focused on hereditary risk, the focus of this proposal, can include various types and purposeful testing like carrier screening, newborn screening, and cancer predisposition testing, etc. This tests have already enabled genetic providers to improve health outcomes for many with increased screening recommendations, prevention efforts (chemoprevention), and behavioral change recommendations. However, the diffusion of genetic testing for underserved groups, specifically Latinx (gender neutral use of Latino/a/e) groups, remains a major challenge. Despite a strong interest in using genetic testing, there remains a dearth of research on facilitating and barrier factors for Latinx populations. Thus, the goal of this proposal is to empirically examine Latinx individuals' experiences with genetic testing, their attitudes, and identify perceived facilitators and barriers to testing. In particular, I will characterize salient attitudes, facilitators, and barriers of Latinx individuals towards genetic testing for health purposes using a sequential explanatory mixed-methods design (Aim 1). The first phase of the study (Aim 1A) will characterize salient attitudes, facilitators, and barriers of 20 Latinx individuals towards genetic testing for health purposes using semistructured elicitation interviews. The sample will be stratified by previous experience with genetic testing, and those who have not tested as was to better characterize attitudes, facilitators and barriers that differ between these groups. Interviews will center on questions of attitudes, perceived norms, and personal agency inclusive of facilitators and barriers. Results will then guide the next phase of the research (Aim 1B). In this phase, I will examine the associations of attitudes, facilitators, and barriers with intentions related to carrier screening and cancer predisposition testing for a Latinx population. Specifically, using wording from interviews, I will design a survey focused on attitudes, facilitators, and barriers and administer the survey on a Qualtrics Panels with 500 Latinx individuals. Using Structural Equation Modeling, I will then test the associations between attitude, facilitators, and barrier factors with behavioral intention to both carrier screening and cancer predisposition testing to determine which may be the best factors for intervention. Building upon the F99 results, in the postdoctoral phase I will utilize findings about attitudes, facilitators, and barriers to develop translational intervention research to engage Latinx populations in genetic testing (Aim 2). The goal of my postdoctoral research training developing culturally appropriate communication strategies to improve genetics engagement for Latinx populations. Through a more robust understanding of attitudes, facilitators, and barriers can genomic researchers better engage with Latinx populations and therein reduce health inequities within genomics.