BIOBEHAVIORAL RESEARCH IN PUBLIC HEALTH GENETICS

描述（由申请人提供）：这个短期的研究职业发展奖解决了与公众就常见复杂疾病的遗传基础进行更多知情和参与对话的需要。拟议的工作将促进深入了解患者和专业对话风格的过程和内容，并交流8种健康状况（糖尿病，骨质疏松症，心脏病，高胆固醇血症，高血压，肺癌，结肠癌和皮肤癌）的15种遗传标记的基因检测结果，并讨论其对家庭健康的影响。具体目标将严格且经过充分验证的患者-提供者沟通行为编码和分析系统（Roter互动分析系统）应用于有关这些“多重”基因检测结果的对话（目标1）;确定常用的患者-提供者沟通策略（例如，情感和信息沟通）（目标2），并评估其对关键患者报告结果的影响（目标3）。行为编码具有高度的功能性和生态有效性。在这里，它将被用来识别先行刺激和控制医疗对话的后果。这项工作将通过申请人（Kenneth Tercyak，肿瘤学和儿科学副教授）的行为编码和对接受多重基因检测的患者的提供者主导的教育课程的录音进行分析来完成。在遗传性乳腺癌/卵巢癌遗传咨询/检测方面的成功研究生涯的基础上，他和该项目的导师们（Debra Roter，健康，行为与社会，医学和护理教授，Colleen McBride，公共卫生遗传学社会与行为研究的首席和高级研究员）要求1年的保护时间，以加速转变和深化患者的研究重点。提供者沟通和公共卫生遗传学。这样做需要额外的课程，培训和指导行为互动理论，评估和分析方法，健康传播和常见复杂疾病的遗传学。对公众健康的影响：人们对基因在健康中的作用所知的变化为人们预防疾病和过上更健康的生活创造了新的机会。伴随这些机遇而来的是以明确、安全和有效的方式传达遗传风险信息的挑战。该奖项为临床导向的行为科学家提供特殊培训，专注于健康促进，以实现从罕见疾病向更常见疾病的转变，并计划和实施根据患者和提供者之间对话中的更多现实需求和要求而制定的干预措施。利用新的研究工具和方法，这项工作将推动发现更清晰的遗传健康沟通渠道。 公共卫生相关性：作为K18的一部分，我将在健康传播和遗传学的背景下接受基本行为和社会科学研究的额外培训，并将此培训应用于对流行健康状况的遗传教育和咨询的过程，分析和结果的试点调查。我将在这一领域的思想领袖的2个高影响力研究机构接受指导，并获得可应用于公共卫生遗传学紧迫问题的关键技能。

DESCRIPTION (provided by applicant): This short-term Research Career Development Award addresses the need for more informed and engaging dialogs with the public about the genetic basis of common complex diseases. The proposed work will foster insights into the process and content of patient and professional conversational styles and exchanges about genetic test results from a panel of 15 genetic markers for 8 health conditions (diabetes, osteoporosis, heart disease, hypercholesterolemia, high blood pressure, and lung, colon, and skin cancer), and discussion of its implications for family health. The Specific Aims apply a rigorous and well-validated behavioral coding and analytic system for patient-provider communication (the Roter Interaction Analysis System) to conversations about these 'multiplex' genetic test results (Aim 1); identify frequently used patient-provider communication strategies (e.g., emotional and informational communications) (Aim 2), and; assess their influence on key patient-reported outcomes (Aim 3). Behavioral coding is highly functional and ecologically valid. Here, it will be used to identify antecedent stimuli and controlling consequences of medical dialog. This work will be accomplished through the Applicant's (Kenneth Tercyak, Associate Professor of Oncology and Pediatrics) behavioral coding and analysis of audio-recordings of provider-led education sessions with patients who underwent multiplex genetic testing. Building off of a successful research career in genetic counseling/testing for hereditary breast/ovarian cancer, he and the Mentors for this project (Debra Roter, Professor of Health, Behavior, & Society, Medicine, and Nursing, and Colleen McBride, Chief and Senior Investigator of Social & Behavioral Research in Public Health Genetics) request 1 year of protected time to accelerate the shift and deepen the research focus in patient-provider communication and public health genetics. Doing so requires additional coursework, training, and mentoring in behavioral interaction theory, assessment, and analytic methods, health communication, and the genetics of common complex diseases. PUBLIC HEALTH IMPACT: Changes in what is known about the role of genes in heath creates new opportunities for people to prevent disease and lead healthier lives. With these opportunities come challenges in communicating genetic risk information in ways that are clear, safe, and effective. This award provides special training to a clinically- oriented behavioral scientist focusing on health promotion to achieve a shift away from rare diseases toward more common diseases, and to plan and implement interventions that are informed by more real-world needs and demands in conversations among patients and providers. Using new research tools and methodologies, the work will advance the discovery of clearer genetic health communication channels. PUBLIC HEALTH RELEVANCE: As part of this K18, I will take additional training in basic behavioral and social science research in the context of health communication and genetics, and apply this training to a pilot investigation of process, analysis, and outcomes of genetic education and counseling for prevalent health conditions. I will be mentored at 2 high impact research institutions that are thought leaders in this area, and gain critical skills that can be applied to pressing concerns in public health genetics.