GENETIC ATTRIBUTIONS AND RACIALIZED PERCEPTIONS OF OBESITY

项目摘要。肥胖在美国很普遍，是慢性疾病的危险因素， 生活质量和死亡率。像美国的许多健康结果一样，其患病率和治疗 以明显的种族差异为特点。黑人患者患肥胖症的比例明显高于 白色患者和不太可能受益于领先的肥胖治疗。虽然这些差距是最 合理地归因于社会，经济和环境的不平等，错误的建议，他们 可能反映了不同种族群体成员之间的遗传差异 反复地这已经发生在趋势的背景下，其中肥胖作为生物医学的概念化， 近年来，具有遗传病因的疾病日益增多。拟议的研究将 研究初级保健提供者在多大程度上认可种族差异的遗传解释， 肥胖以及这种信念是否与缺乏遗传学知识有关（目标1）。它还将 测试初级保健医生是否更有可能将肥胖归因于遗传原因， 黑人（与白色）患者，以及这种种族差异的遗传属性的认可是否可能导致 对病人的态度和对病人护理的临床判断的差异（目标2）。此外该 研究将检查美国肥胖成年人对医疗保健中肥胖的遗传解释的反应， 以及这种反应在黑人和白色人之间是否不同（目标3）。这将是完成 通过一项实验，测试肥胖的黑人和白色美国人对描述一个 医生谁做（与不）赞同遗传解释（目标3a），以及通过焦点小组， 其中黑人和白色成年肥胖者将讨论他们对肥胖相关基因的使用的看法。 保健（目标3b）。这项研究将阐明与信仰有关的伦理重要问题， 遗传学在肥胖症中的作用可能会影响肥胖症的临床护理和种族间的医患关系， 不同的方式，可能导致种族健康差异。它将为今后的努力提供参考，以确定如何 肥胖的遗传学可以教授给临床医生，并以文化敏感的方式与患者讨论， 避免助长有关种族差异的问题态度和信念，或损害重要的关系， 病人和他们的医疗服务提供者之间的关系。

Project Summary. Obesity is widespread in the United States and is a risk factor for chronic illness, impaired quality of life, and mortality. Like many health outcomes in the US, its prevalence and treatment are characterized by stark racial disparities. Black patients experience obesity at significantly higher rates than White patients and are less likely to benefit from leading obesity treatments. While these disparities are most plausibly attributed to social, economic, and environmental inequalities, the misguided suggestion that they might instead reflect genetic differences between members of different racial groups has been made repeatedly. This has occurred in the context of trends in which the conceptualization of obesity as a biomedical disease with a genetic etiology has been increasingly ascendant in recent years. The proposed research will examine the extent to which primary care providers endorse genetic explanations for racial disparities in obesity and whether such beliefs might be related to a dearth of knowledge about genetics (Aim 1). It will also test whether primary care physicians are more likely to attribute obesity to genetic causes when it occurs in a Black (vs. White) patient, and whether such racially disparate endorsement of genetic attributions might lead to differences in attitudes toward patients and in clinical judgments regarding patient care (Aim 2). In addition, the research will examine how American adults with obesity react to genetic explanations for obesity in healthcare, and whether such reactions differ between Black and White individuals (Aim 3). This will be accomplished through an experiment testing how Black and White Americans with obesity respond to a description of a physician who does (vs. does not) endorse genetic explanations (Aim 3a), as well as through focus groups in which Black and White adults with obesity will discuss their views about the use of genetics in obesity-related healthcare (Aim 3b). This research will shed light on ethically significant questions related to how beliefs about the role of genetics in obesity may shape clinical care for obesity and physician-patient relationships in racially disparate ways, potentially contributing to racial health disparities. It will inform future efforts to determine how the genetics of obesity can be taught to clinicians and discussed with patients in culturally sensitive ways, to avoid fueling problematic attitudes and beliefs about racial disparities or harming the important relationship between patients and their healthcare providers.