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

项目摘要/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 了解前列腺癌的生物学和预后。国家综合癌症网络 (NCCN)在2016年建议患者和临床医生考虑本地化的基于组织的基因测试 前列腺癌。然而，尽管目前人们对快速增长的基因组领域存在很大的热情 医学上，多基因mRNA表达板的使用增加了前列腺癌进一步分化的可能性 癌症治疗结果受种族和低社会经济地位的影响。我们知道，健康差距持续存在 低收入群体，尽管存在以证据为基础的指导方针并通过了最先进的 在这些群体中，方法往往落后于人。 这个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和他们的 护理者理解预测预后的基因技术，并(2)研究一段关于 遗传学影响预后基因技术的患者与照顾者之间的沟通。研究的基本原理是 如果不直接关注基因组理解，存在于快速增长的 前列腺癌基因药物可能不会为前列腺癌局限性男性带来健康益处 癌症。中心假设是(1)受教育程度较低的男性和照顾者将表现出 对局限性前列腺癌的基于组织的基因检测严重缺乏基因组理解； 量身定做的前列腺癌教育、沟通指导和基因组素养教育视频将 在低识字率人群中显著改善患者与护理者之间的沟通。 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 探索非洲裔美国人和患有局限性前列腺癌的农村白人男性如何， 理解和解释基因技术产生的数据。这项拟议的研究具有重要意义 因为它有可能通过以下方式改善公共健康：(1)提高对预后遗传学的理解 少数民族、低收入和农村人口，以及(2)让这些不同的社区参与并教育他们 基因组学。拟议的研究与结构化的指导和培训计划相结合，包括 授课课程和研讨会，旨在促进尤恩·科布伦博士制定 独立资助的前列腺癌差异研究计划，与 美国国家情报局。

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.