Investigating Latinx populations’ attitudes, perceptions, and use of genomic testing

项目总结 基因组医学通过里程碑改变了预防、护理和靶向医疗团 人类基因组计划的成就和以健康为目的的基因测试的到来。生殖系 侧重于遗传风险的基因检测是这项提案的重点，可以包括各种类型和有目的的 像携带者筛查、新生儿筛查和癌症易感性测试等测试。 已经使遗传提供者能够通过增加筛查来改善许多人的健康结果 建议、预防努力(化学预防)和行为改变建议。然而， 向服务不足的群体，特别是拉丁裔群体推广基因检测(拉丁裔的性别中立使用/a/e) 这仍然是一项重大挑战。尽管人们对使用基因检测有着浓厚的兴趣，但仍然缺乏 拉丁裔人口的促进因素和障碍因素研究。因此，这项提议的目标是 经验性地检查拉丁裔个体在基因测试方面的经验，他们的态度，并识别所感知的 测试的促进者和障碍。特别是，我将描述以下方面的突出态度、促进者和障碍 使用顺序解释性混合方法对拉丁裔个体进行健康目的基因检测 设计(目标1)。研究的第一阶段(目标1A)将描述突出的态度、促进者和 20名拉丁裔个体使用半结构启发式进行健康基因检测的障碍 采访。样本将根据以前的基因测试经验和没有进行过基因测试的人进行分层 按原样进行测试，以更好地描述这些群体之间不同的态度、促进者和障碍。 面谈将围绕态度、可感知的规范和包括主持人在内的个人代理等问题展开 和障碍。然后，结果将指导下一阶段的研究(目标1B)。在本阶段中，我将研究 与携带者筛查和癌症相关的态度、促进者和障碍与意图的关联 拉丁裔人群的易感测试。具体地说，使用采访中的措辞，我将设计一份调查 专注于态度、促进者和障碍，并在由500名Latinx组成的Qualtrics小组上管理调查 个人。使用结构方程模型，然后我将测试态度、促进者、 以及对携带者筛查和癌症易感性测试具有行为意图的障碍因素 确定哪些因素可能是最好的干预因素。在F99结果的基础上，在博士后 第一阶段将利用关于态度、促进者和障碍的调查结果来开发翻译干预 让拉丁裔人口参与基因测试的研究(目标2)。我博士后研究培训的目标是 开发适合文化的沟通策略，以提高拉丁裔的遗传学参与度 人口。通过更有力地了解态度、促进者和障碍，基因组可以 研究人员更好地与拉丁裔人群接触，从而减少基因组学中的健康不平等。

PROJECT SUMMARY Genomic medicine has transformed prevention, care, and targeted medical regiments through the milestone achievements of Human Genome Project and the advent of genetic testing for health purposes. Germline genetic testing focused on hereditary risk, the focus of this proposal, can include various types and purposeful testing like carrier screening, newborn screening, and cancer predisposition testing, etc. This tests have already enabled genetic providers to improve health outcomes for many with increased screening recommendations, prevention efforts (chemoprevention), and behavioral change recommendations. However, the diffusion of genetic testing for underserved groups, specifically Latinx (gender neutral use of Latino/a/e) groups, remains a major challenge. Despite a strong interest in using genetic testing, there remains a dearth of research on facilitating and barrier factors for Latinx populations. Thus, the goal of this proposal is to empirically examine Latinx individuals' experiences with genetic testing, their attitudes, and identify perceived facilitators and barriers to testing. In particular, I will characterize salient attitudes, facilitators, and barriers of Latinx individuals towards genetic testing for health purposes using a sequential explanatory mixed-methods design (Aim 1). The first phase of the study (Aim 1A) will characterize salient attitudes, facilitators, and barriers of 20 Latinx individuals towards genetic testing for health purposes using semistructured elicitation interviews. The sample will be stratified by previous experience with genetic testing, and those who have not tested as was to better characterize attitudes, facilitators and barriers that differ between these groups. Interviews will center on questions of attitudes, perceived norms, and personal agency inclusive of facilitators and barriers. Results will then guide the next phase of the research (Aim 1B). In this phase, I will examine the associations of attitudes, facilitators, and barriers with intentions related to carrier screening and cancer predisposition testing for a Latinx population. Specifically, using wording from interviews, I will design a survey focused on attitudes, facilitators, and barriers and administer the survey on a Qualtrics Panels with 500 Latinx individuals. Using Structural Equation Modeling, I will then test the associations between attitude, facilitators, and barrier factors with behavioral intention to both carrier screening and cancer predisposition testing to determine which may be the best factors for intervention. Building upon the F99 results, in the postdoctoral phase I will utilize findings about attitudes, facilitators, and barriers to develop translational intervention research to engage Latinx populations in genetic testing (Aim 2). The goal of my postdoctoral research training developing culturally appropriate communication strategies to improve genetics engagement for Latinx populations. Through a more robust understanding of attitudes, facilitators, and barriers can genomic researchers better engage with Latinx populations and therein reduce health inequities within genomics.