Lay and Expert Models of Gene-Environment Interaction

描述(申请人提供)：人类基因组计划预计的健康红利之一是使用个性化的多基因测试来确定个人的易感性，以便个人能够采取预防行动。其中，要想取得成功，医务人员必须能够在不制造宿命论的情况下，以外行人可以理解和可信的方式传达这一信息。为了促进这样的健康信息，这个项目将描述与常见复杂疾病(成人型糖尿病、心脏病、抑郁症和肺癌)相关的基因与非遗传因素(通常称为“环境”因素)之间的相互作用。它将把这些与医学研究和推广中使用的模型进行比较，找出和谐和不和谐的领域。然后，它将启动研究，探索在健康信息中使用特定模式的有效性。将使用定性方法来生成对模型的扎实、丰富的分析，并将使用定量方法来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出版的科学期刊和基于网络的临床表现进行评估。外行人的理解将分两个阶段进行评估。将对业外人士进行深入的面谈。然后，这些成绩单将被用来制定一项封闭式问题调查，对全国随机人口样本进行管理，以确定各种模式的频率和分布。在分析了外行模型和专家模型的共同点后，将测试初步的“最佳信息策略”，以评估1)交互模型是否比非交互模型产生更低的宿命论，2)辅音模型的使用是否增加了信念、身份一致性、感知有效性和遵守处方的意图，以及3)某些模型是否在增强信念、身份一致性、感知有效性和遵守处方意图方面比其他模型更有效。这个项目将确定外行人如何看待基因在常见疾病中的作用。它将开发出告诉人们个性化基因测试结果的方法，而不增加他们的宿命论。这将有助于受试者采取更好地避免测试确定的风险的行为。

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.