Communication of genomic information in clinical and online contexts

我的工作调查了基因组信息扩散到临床和公共卫生背景下的影响。我对健康差异特别感兴趣，因此研究与被污名化和/或未得到充分服务的疾病或人群相关的基因组通信。我在模拟临床环境中和通过社交媒体平台在线研究这些问题。我目前有几项最近完成的研究，这些研究都有助于实现这些目标。 在临床背景下，我和我的同事开展了一项研究，以评估医生将肥胖基因组学信息引入临床体重管理会议的益处和/或风险(体重管理交互研究；NHGRI方案#11-HG-0238)。我们感兴趣的是，这些信息将如何影响患者与健康相关的态度、信念、行为和患者对污名化的看法。该项目还旨在确定医生以病人为中心与以医生为中心的医疗接触方法是否可以缓解或放大基因组信息提供的潜在消极和积极后果。这项研究是在沉浸式虚拟环境测试单元中基于沉浸式虚拟现实的临床模拟中进行的。在本报告年度，我们又出版了一份手稿。 另一项准备中的研究检查了提供者的表观体重对潜在患者对她提供的与体重相关的基因组信息的反应的影响。这是本报告年度计划进行的一项试验，目前仍在继续收集数据。 从提供者的角度来看，与体重相关的基因组信息被讨论的情况，在本报告年，我们参与了医学生和虚拟患者之间的咨询编码，探索与体重污名和偏见相关的言语行为。这一进程的一份手稿已在今年提交并接受。 除了我在临床上与基因组信息传播相关的实验研究外，我还调查了关于在线和公共卫生相关背景下基因组信息传播的问题。我进行了一项调查，评估了个人对体重控制和基因组信息的兴趣和寻求信息的行为。该项目发表了一篇论文，两篇正在准备中。 这方面的另一项研究评估了遗传属性，它们与糖尿病理解、耻辱和糖尿病背景下的健康结果的联系。这项研究的数据已经收集完毕，编码工作已经完成。该项目的两篇论文被接受，另外两篇正在审查中。一项后续研究正在计划中。

My work investigates the impact of the diffusion of genomic information into clinical and public health contexts. I am particularly interested in health disparities, and thus studying genomic communication relevant to diseases or populations that are stigmatized and/or underserved. I examine these issues both in simulated clinical contexts, and online through social media platforms. I currently have several recently completed studies that contribute to these aims. In the clinical context, my colleagues and I mounted a study to assess the benefits and/or risks of a physician introducing obesity genomics information into clinical weight-management encounters (Weight Management Interaction Study; NHGRI protocol # 11-HG-0238). We are interested in how this information will influence patients' health-related attitudes, beliefs, behavior, and patient perceptions of stigmatization. The project also aims to determine whether a physician's patient-centered versus doctor-centered approach to a health care encounter could mitigate or amplify the potential negative and positive consequences of genomic information provision. This study is being conducted in an immersive virtual reality-based clinical simulation in the Immersive Virtual Environment Testing Unit. During this reporting year, we have published an additional manuscript. Another study in preparation examines the influence of the provider's apparent weight on potential patients' reaction to the weight-related genomic information she provides. This is an experiment that was planned during this reporting year, for which data continues to be collected. Looking at encounters where genomic information relevant to body weight is discussed from the provider's perspective, during this reporting year we have engaged in coding of a consultation between a medical student and virtual patient exploring verbal behavior relevant to weight stigma and bias. A manuscript from this process was submitted and accepted during this year. In addition to my experimental research related to communication about genomic information in the clinic, I also investigate issues around dissemination of genomic information in online and public health-related contexts. I have fielded a survey assessing individuals' interest in and information seeking behaviors with respect to weight management and genomic information. One paper is published from this project, and two are in preparation. An additional study in this vein assesses genetic attributions, their connection with diabetes understanding, stigma, and health outcomes in the context of diabetes. Data for this study have been collected and coding has been completed. Two papers from the project were accepted and two more are under review. A follow-up study is being planned.