Genetic Literacy and Patient-Caregiver Communication of Prognostic Genetic Technology for Localized Prostate Cancer

项目总结/摘要 新的基因组技术，如微阵列分析和下一代测序，已经改善了基因组的功能。 了解前列腺癌生物学和预后。美国国家综合癌症网络 （NCCN）在2016年建议患者和临床医生考虑基于组织的基因检测， 前列腺癌然而，尽管目前对快速增长的基因组学领域存在许多热情， 在医学上，多基因mRNA表达组的使用提高了前列腺疾病进一步分化的可能性。 按种族和低社会经济地位分类的癌症治疗结果。我们知道，健康差距持续存在， 低收入群体，尽管存在基于证据的指导方针， 这些群体的方法往往落后。 本NCI K01应用程序的目标是（1）探索患有局限性前列腺癌的男性及其 护理人员理解预后遗传技术，和（2）研究如何教育视频约 遗传学影响预后遗传技术的患者-护理者沟通。研究的基本原理是， 如果不直接关注基因组的理解，存在于快速增长的基因组学领域的热情， 前列腺癌基因组药物可能不会转化为局限性前列腺男性的健康益处 癌主要假设是：（1）教育水平较低的男子和照顾者将表现出 严重缺乏对局限性前列腺癌的基于组织的基因检测的基因组理解;和（2） 量身定制的前列腺癌教育，沟通辅导，和基因组扫盲教育视频将 显著改善低识字率人群中患者与护理人员之间的沟通。 研究方法是创新的，因为它采用了混合方法的社区参与研究 框架，以探索非洲裔美国人和农村白色男性与局限性前列腺癌， 理解和解释基因技术产生的数据。所提出的研究是有意义的 因为它有可能通过以下方式改善公共卫生：（1）提高对预后遗传学的理解， 少数民族，低收入和农村人口，（2）参与和教育这些不同的社区， 基因组学拟议的研究，结合结构化的指导和培训计划，其中包括 教学课程和研讨会，旨在促进博士伊万科布伦的长期目标，发展一个 独立资助的研究计划在前列腺癌的差异，符合使命的 NCI

Project Summary/Abstract Novel genomic technology, such as microarray analyses and next-generation sequencing, have improved the understanding of prostate cancer biology and prognosis. The National Comprehensive Cancer Network (NCCN), in 2016, recommended that patients and clinicians consider tissue-based genetic tests for localized prostate cancer. However, while much enthusiasm currently exits for the rapidly increasing field of genomic medicine, the use of multi-gene mRNA expression panels raises the potential for further divergence in prostate cancer treatment outcomes by race and low socioeconomic status. We know that health disparities persist in low income groups despite the existence of evidence-based guidelines and that adoption of state-of-the-art methods often lag behind in these groups. The goals of this NCI K01 application are to (1) explore how men with localized prostate cancer and their caregivers comprehend prognostic genetic technology, and (2) examine how an educational video about genetics impacts patient-caregiver communication of prognostic genetic technology. The study rationale is that without direct attention to genomic comprehension, the enthusiasm that exists in the rapidly increasing field of prostate cancer genomic medicine may not translate into health benefits for men with localized prostate cancer. The central hypotheses are (1) men and caregivers with lower levels of education will demonstrate a severe lack of genomic comprehension of tissue-based genetic tests for localized prostate cancer; and (2) tailored prostate cancer education, communication coaching, and a genomic literacy educational video will significantly improve patient-caregiver communication in a low literacy population. The study approach is innovative because it applies a mixed-methods community-engagement research framework to explore how African American and rural White men with localized prostate cancer, comprehend and interpret data generated from genetic technology. The proposed research is significant because of its potential to improve public health by (1) improving the understanding of prognostic genetics in minority, low income, and rural populations, and (2) engage and educate these diverse communities about genomics. The proposed research, in combination with a structured mentoring and training plan that includes didactic course and workshops, is designed to facilitate Dr. Ewan Cobran’s long term goal of developing an independently-funded research program in prostate cancer disparities, consistent with the mission of the NCI.