Young Smoker's Reactions to Genetic Risk for Lung Cancer

描述（由申请人提供）：遗传易感性测试已被预示为个性化风险评估和医疗保健服务的未来。遗传易感性反馈可能对增加年轻吸烟者的健康风险的显著性非常有用，这些年轻吸烟者虽然承认吸烟的健康风险，但对吸烟的危害持不切实际的乐观态度。然而，个性化的风险可能会促使年轻吸烟者产生认知和情感反应，这可能会削弱吸烟的可能性。 易感性反馈，以激励戒烟。基因检测的护理标准是一个多步骤的过程，其间穿插着等待和预期的时间，它提供了一个框架，用于测试易感性反馈的传递是否与易感性反馈的防御性和乐观信息处理有关。我们检查这些过程是否发生在两个时间：1）在等待时间内，结果是未知的，2）在收到的结果。在这两种情况下，我们认为认知和情感过程可能会影响防御和乐观的反应，反过来，可能会影响风险认知和戒烟倾向，为此，提出了一项为期四年的前瞻性随机试验。总体目标是了解大学吸烟者对遗传易感性反馈（GSTM 1）的认知和情感反应，以及它们对下游肺癌风险和担忧的看法以及戒烟的初步步骤的影响。主动招募的同意参加的学生将以2：1的比例随机接受基因检测或等待名单对照组。认知和情绪反应的措施将从同意在四个时间点进行测试的学生中收集：基线，测试时，收到测试结果之前和之后。将在每个时间点收集拒绝测试和等待名单对照组的类似措施。在收到反馈后收集的主要因变量是：个人肺癌风险和肺癌的看法 担心此外，我们将研究几个认知和情感预期因素（例如，测试 预期），对测试反馈的中等初始反应（目标1）。我们进一步研究了对测试结果的认知和情感反应（例如反驳）如何介导肺癌风险和担忧的感知（目标2）。

DESCRIPTION (provided by applicant): Genetic susceptibility testing has been heralded as the future of personalized risk assessments and health care delivery. Genetic susceptibility feedback may be very useful for increasing the salience of health risks to young smokers who while acknowledging the health risks of smoking, are unrealistically optimistic about experiencing the harms of smoking. However, personalizing risk could prompt young smokers' to have cognitive and emotional reactions that could attenuate the potential for susceptibility feedback to motivate smoking cessation. The standard of care for genetic testing, a multi-step process interspersed with periods of waiting and anticipation, offers a framework for testing whether delivery of susceptibility feedback is related to defensive and optimistic information processing of susceptibility feedback. We examine whether these processes occur at two times: 1) during the waiting time in which results are unknown, and 2) upon receipt of the result. At both times, we posit that cognitive and emotional processes may influence defensive and optimistic reactions and, in turn, may affect risk perceptions and inclinations to quit smoking, To this end, proposed is a four-year prospective randomized trial. The overarching aim is to understand college smokers' cognitive and emotional responses to genetic susceptibility feedback (GSTM1) and their influence on downstream perceptions of lung cancer risks and worry and initial steps towards cessation. Proactively recruited students who consent to participate will be randomized in a 2:1 ratio to undergo genetic testing or to a wait list control group. Measures of cognitive and emotional reactions will be collected from students who agree to be tested at four time points: baseline, at the time of testing, immediately prior to and after receipt of the test result. Similar measures will be collected at each time point for those declining testing and the wait-list control group. The primary dependent variables collected after receipt of feedback are: perceptions of personal lung cancer risks and lung cancer worry. In addition, we will examine how several cognitive and emotional anticipatory factors (e.g., test expectation) assessed immediately prior to receipt of result, moderate initial reactions to test feedback (Aim 1). We further examine how the cognitive and emotional reactions (e.g. counter-arguing) to the test result mediate perceptions of lung cancer risks and worry (Aim 2).