Lay and Expert Models of Gene-Environment Interaction

描述（由申请人提供）：人类基因组计划的预期健康红利之一是使用个性化的多基因检测来确定个人的易感性，以便个人可以采取预防措施。除其他事项外，为了成功，医务人员必须能够传达这一信息，而不创造宿命论，并以外行人可以理解和可信的方式。为了促进这些健康信息，本项目将描述非专业人员对基因与非遗传因素（通常称为“环境”因素）相互作用与常见复杂疾病（成人发病糖尿病、“心脏”病、抑郁症和肺癌）关系的理解。它将比较这些模型在医学研究和推广，确定和谐和不和谐的领域。然后，它将开展研究，探讨在健康信息中使用特定模式的有效性。定性方法将用于生成对模型的有根据的、丰富的分析，定量方法将用于评估各种模型的分布频率。医学研究和临床模型将通过检查已发表的科学期刊和基于网络的临床表现进行评估。外行的理解将在两个阶段的过程中进行评估。将与外行人进行深入的面对面访谈。然后，这些成绩单将被用来开发一个封闭式问题调查，以管理一个国家的随机人口样本，以确定频率和各种模型的分布。在分析了外行和专家模型的共同点之后，将测试初步的“最佳信息策略”，以评估1）交互式模型是否比非交互式模型产生更低的宿命论，2）使用和谐模型是否增加信念，身份和谐，感知功效和坚持处方的意图，以及3）某些模型是否比其他模型更有效地增强信念，认同一致性、感知功效和坚持处方的意图。该项目将确定外行人如何看待基因在常见疾病中的作用。它将开发告诉人们个性化基因检测结果的方法，而不会增加他们的宿命论。这将有助于接受者采取更好地避免测试所识别的风险的行为。

DESCRIPTION (provided by applicant): One of the projected health dividends of the Human Genome Project is the use of personalized multi-gene testing to identify individual susceptibilities, so that individuals can undertake preventive courses of action. Among other things, for this to be successful medical personnel must be able to convey this information without creating fatalism and in ways that are comprehensible and believable to lay people. To facilitate such health messages, this project will describe lay understandings of the interactions of genes with non- genetic factors (commonly referred to as "environmental" factors) in relationship to common complex diseases (adult onset diabetes, "heart" disease, depression, and lung cancer). It will compare these to the models employed in medical research and outreach, identifying areas of consonance and dissonance. It will then initiate studies to explore the effectiveness of use of particular models within health messages. Qualitative methods will be used to generate grounded, rich analyses of the models, and quantitative methods will be used to assess the frequency of distribution of various models. Medical research and clinical models will be assessed by examining published scientific journals and web-based clinical representations. Lay understandings will be assessed in a two stage process. In-depth, in-person interviews with lay people will be conducted. Then, these transcripts will be used to develop a closed question survey to be administered to a national random population sample to ascertain frequency and distributions of various models. After analysis of areas of commonalities in lay and expert models, preliminary "best message strategies" will be tested to assess 1) whether interactive models produce lower fatalism than non-interactive models, 2) whether use of consonant models increases belief, identity consonance, perceived efficacy, and intention to adhere to prescriptions and 3) whether some models are more effective than others at enhancing belief, identity consonance, perceived efficacy, and intention to adhere to prescriptions. This project will identify how lay people think about the role of genes in common diseases. It will develop ways of telling people the results of personalized genetic testing without increasing their fatalism. This will help recipients to adopt behaviors that will better stave off the risks identified by the tests.