GENETIC ATTRIBUTIONS AND RACIALIZED PERCEPTIONS OF OBESITY

遗传因素和肥胖的种族观念

• 批准号: 10743452
• 负责人: MATTHEW LEBOWITZ
• 金额: $ 56.77万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10743452
• 关键词: Affect; African American; American; Attitude; Behavior Therapy; Belief; Biological; Black American; Black race; Chronic Disease; Clinical; Clinical effectiveness; Cross-Sectional Studies; DNA; Data; Disease; Disparity; Economics; Educational process of instructing; Empathy; Ensure; Ethics; Faith; Focus Groups; Future; Genetic; Genetic Predisposition to Disease; Health; Health Personnel; Healthcare; Impairment; Individual; Intervention; Judgment; Knowledge; Lead; Learning; Mediating; Mediation; Mental disorders; Methodology; Minority Groups; Obesity; Outcome; Participant; Patient Agents; Patient Care; Patients; Perception; Persons; Physician-Patient Relations; Physicians; Prevalence; Primary Care Physician; Provider; Quality of life; Race; Reaction; Reading; Research; Respondent; Risk; Risk Factors; Role; Sampling; Shapes; Social Sciences; Stigmatization; Suggestion; Surveys; Testing; Treatment outcome; United States; Woman; adult obesity; black patient; black women; caucasian American; clinical care; clinical decision-making; environmental disparity; ethnoracial disparity; experience; experimental study; follow-up; health disparity; high risk; improved; member; mortality; obese patients; obesity genetics; obesity risk; obesity treatment; patient prognosis; primary care provider; prognostic; racial bias; racial disparity; racial health disparity; racial minority population; racial population; response; social; social health determinants; trend

Project Summary. Obesity is widespread in the United States and is a risk factor for chronic illness, impaired quality of life, and mortality. Like many health outcomes in the US, its prevalence and treatment are characterized by stark racial disparities. Black patients experience obesity at significantly higher rates than White patients and are less likely to benefit from leading obesity treatments. While these disparities are most plausibly attributed to social, economic, and environmental inequalities, the misguided suggestion that they might instead reflect genetic differences between members of different racial groups has been made repeatedly. This has occurred in the context of trends in which the conceptualization of obesity as a biomedical disease with a genetic etiology has been increasingly ascendant in recent years. The proposed research will examine the extent to which primary care providers endorse genetic explanations for racial disparities in obesity and whether such beliefs might be related to a dearth of knowledge about genetics (Aim 1). It will also test whether primary care physicians are more likely to attribute obesity to genetic causes when it occurs in a Black (vs. White) patient, and whether such racially disparate endorsement of genetic attributions might lead to differences in attitudes toward patients and in clinical judgments regarding patient care (Aim 2). In addition, the research will examine how American adults with obesity react to genetic explanations for obesity in healthcare, and whether such reactions differ between Black and White individuals (Aim 3). This will be accomplished through an experiment testing how Black and White Americans with obesity respond to a description of a physician who does (vs. does not) endorse genetic explanations (Aim 3a), as well as through focus groups in which Black and White adults with obesity will discuss their views about the use of genetics in obesity-related healthcare (Aim 3b). This research will shed light on ethically significant questions related to how beliefs about the role of genetics in obesity may shape clinical care for obesity and physician-patient relationships in racially disparate ways, potentially contributing to racial health disparities. It will inform future efforts to determine how the genetics of obesity can be taught to clinicians and discussed with patients in culturally sensitive ways, to avoid fueling problematic attitudes and beliefs about racial disparities or harming the important relationship between patients and their healthcare providers.

项目摘要。肥胖在美国很普遍，是慢性疾病、身体受损的危险因素 生活质量和死亡率。与美国的许多健康结果一样，其患病率和治疗方法 其特点是明显的种族差异。黑人患者的肥胖率明显高于黑人患者 白人患者不太可能从领先的肥胖治疗中受益。虽然这些差异是最 看似合理的归因于社会、经济和环境不平等，但错误的建议是， 相反，可能反映了不同种族群体成员之间的基因差异 反复。这是在将肥胖概念化为生物医学的趋势背景下发生的。 近年来，由遗传病因引起的疾病日益增多。拟议的研究将 检查初级保健提供者在多大程度上认可种族差异的遗传解释 肥胖以及这种信念是否可能与缺乏遗传学知识有关（目标 1）。它还将 测试当肥胖发生在家庭中时，初级保健医生是否更有可能将肥胖归因于遗传原因 黑人（与白人）患者，以及这种种族不同的基因归因认可是否可能导致 对患者的态度以及对患者护理的临床判断存在差异（目标 2）。此外， 研究将调查美国肥胖成年人对医疗保健中肥胖的遗传解释有何反应， 以及黑人和白人之间的此类反应是否不同（目标 3）。这将实现 通过一项实验测试肥胖的美国黑人和白人对描述的反应 认可（与不认可）遗传解释（目标 3a）的医生，以及通过焦点小组 患有肥胖症的黑人和白人成年人将讨论他们对遗传学在肥胖相关疾病中的应用的看法 医疗保健（目标 3b）。这项研究将揭示与信念如何相关的具有重大伦理意义的问题。 遗传学在肥胖中的作用可能会影响肥胖的临床护理和种族方面的医患关系 不同的方式，可能会导致种族健康差异。它将为未来的努力提供信息，以确定如何 可以向临床医生教授肥胖的遗传学知识，并以文化敏感的方式与患者讨论， 避免助长有关种族差异的有问题的态度和信念或损害重要的关系 患者与其医疗保健提供者之间。