Suchergebnisse

<b><i>Purpose:</i></b> In this brief report, we ask whether women's interpretation of breast cancer risk based on their low likelihood of carrying a <i>BRCA1/2</i> mutation is associated with their information-sharing behavior, and whether misinterpretation is associated with motives for sharing the result. <b><i>Methods:</i></b> Women in mammography clinics who completed a brief family history assessment and deemed to be at low likelihood of carrying a <i>BRCA1/2</i> mutation were asked to complete a 1-time online survey between June 2016 and January 2017. <b><i>Results:</i></b> One-third (44/148) of women shared their family history screen result with someone in their social network. Result information was shared largely with a first-degree female relative to express feelings of relief (77%, 33/43). There were no differences in likelihood of sharing based on breast cancer risk interpretation. However, women who misinterpreted the implications of the result for general breast cancer risk reported more motives to share the result with their social network than those who accurately interpreted their breast cancer risk. <b><i>Conclusions:</i></b> As family history-based screening for hereditary breast cancer is broadly implemented, the communication needs of the majority of women who will be unlikely of carrying a <i>BRCA1/2</i> mutation must be considered. The motives of women who misinterpreted the implications of this result for breast cancer risk suggest the possibility that miscommunication could be spread to the broader family network.

<b><i>Background:</i></b> The past 20 years have witnessed successive and exponential advances in genomic discovery and technology, with a broad scientific imperative pushing for continual advancements. The most consistent critique of these advances is that they have vastly outpaced translation of new knowledge into improvements in public health and medicine. <b><i>Methods:</i></b> We employ a historical and epistemological analysis to characterize how prevailing scientific meta-narratives have shaped the pace and priorities of research applying genomics to health promotion. We use four 'pivotal events' - the genetic characterization of Down syndrome, the launch of the Human Genome Research Project, the discovery of BRCA1, and the emergence of direct-to- consumer genetic testing - to illustrate how these scientific meta-narratives have inhibited genomic translation research. <b><i>Results:</i></b> The notion that discovery should precede translation research has over-focused translation research on the latest genetic testing platform. The idea that genetic-related research has an exceptional potential for public harm has encouraged research on worst case scenarios. The perceived competition between genetics and social determinants of health has discouraged a unified research agenda to move genomic translation forward. <b><i>Conclusion:</i></b> We make a case for creating new scientific meta-narratives in which discovery and translation research agendas are envisioned as an interdependent enterprise.

<b><i>Introduction:</i></b> Public willingness to collect personal family health history (FHH) assessments is integral to implement population screening to identify those at high cancer risk who could benefit most from lifesaving interventions. Yet, surprisingly little consideration has been given to factors associated with the public's perceived importance of FHH in the context of cancer. <b><i>Methods:</i></b> Using data from the 2013 Health Information National Trends survey, we assessed the association of intrapersonal (e.g., cancer worry), sociodemographic (e.g., education), and interpersonal-level factors (e.g., family trust) associated with <i>not</i> perceiving FHH assessment to be very important for personal health. Associations were tested with bivariate analyses and hierarchical logistic regression. <b><i>Results:</i></b> Of the 3,007 respondents, 32.7% reported perceiving FHH as <i>not</i> very important to their health. Whites (<i>p</i> &#x3c; 0.001), males (<i>p</i> = 0.003), and those born in the United States (<i>p</i> = 0.004) were most likely to perceive FHH as not very important. Those who were least worried about cancer and perceived that cancer risk could not be lowered also viewed FHH as not very important (<i>p</i> = 0.002, <i>p</i> = 0.018, respectively). In hierarchical regression analyses, the association of low cancer worry remained significant after accounting for sociodemographic and interpersonal factors. The addition of sociodemographic factors modestly improved the model; the addition of interpersonal factors did not improve the model. <b><i>Conclusions:</i></b> A sizable proportion of the public does not perceive FHH to be very important, may be hard to reach, and impede implementation of population screening guidelines for inherited cancers. Campaigns to increase the perceived value of FHH assessment may need to be tailored to demographic subgroups, emphasize cancer prevention, and encourage family communication.

<b><i>Background/Aims:</i></b> National guidelines endorse using evidence-based tools to identify those at risk for hereditary breast and ovarian cancer (HBOC). This study aimed to evaluate whether women deemed not to be at increased risk of being a <i>BRCA</i> mutation carrier; the majority of those screened, recall, understand and accept the implications of these results for breast cancer risk. <b><i>Methods:</i></b> We conducted an online survey with women (<i>n</i> = 148) who screened negative on a brief HBOC screener. <b><i>Results:</i></b> While women tended to accept HBOC screener as accurate (range 9–45; mean 32, SD 5.0), less than half (43%) accurately recalled their result. Only 52% understood that they were at low risk of carrying a mutation, and just 34% correctly understood their breast cancer risk. African American women were less likely to recall (33 vs. 53% respectively, OR 0.5, <i>p</i> = 0.03), understand (42 vs. 63% respectively, OR 0.4, <i>p</i> = 0.02), and accept (mean 31 vs. 33 respectively, β –2.1, <i>p</i> = 0.02) the result compared to Whites. <b><i>Conclusions:</i></b> Our findings show that those at low risk of carrying a <i>BRCA1/2</i> mutation had limited understanding of the distinction between mutation risk and breast cancer risk. Theory-based communication strategies are needed to increase the understanding of the implications of being at low risk for hereditary cancers.

Introduction: Engaging youth as peer educators has yet to be considered to promote literacy concerning conjoint genetic and environmental (G × E) influences on health conditions. Whether youth living in low- and middle-income countries (LMICs) could and would be willing to serve as lay educators of G × E education is unclear. Methods: A cross-sectional survey of youth living in Southern Ethiopia was conducted from August to September 2017. Trained data collectors administered the survey on 377 randomly selected youth who ranged in age from 15 to 24; 52% were female and 95% reported having some formal education. Self-reported willingness and a constructed competency score were assessed. Bivariate analyses tested for factors associated with willingness and competency to serve as lay G × E literacy builders. Results: Competency and willingness were significantly greater (p &lt; 0.05) for youth who were male, had some formal education, and had civic or leadership experience. Differences in median willingness were significant for youth who scored as more competent versus those who scored as less competent (p &lt; 0.001). There were no characteristics that moderated the association of competency with willingness. Conclusion: Youth peer educator programs hold promise for disseminating improved G Χ E literacy and reducing stigma associated with deterministic misunderstandings. Thoughtful recruitment and training strategies will be needed to ensure that the broadest representation of youth in LMIC contexts has the opportunity to serve in this role, particularly girls and those without formal education.

Background.Tobacco related diseases remain the most important public health problem. Public policy approaches to tobacco control have been used historically, and remain a viable, though largely untested, tobacco control strategy. The purpose of this article is to report assessment of support for tobacco control policies among the general public.Methods.A random sample of 821 residents from seven Minnesota communities was surveyed by telephone to assess their support for 12 measures designed to restrict smoking behavior and curb demand for tobacco. Some of these policies were similar to those already in place, while others had not yet been adopted.Results.Over 50% of the respondents indicated that they strongly favored or some-what favored each of the measures, suggesting that a constituency exists for further regulation of tobacco. Measures that restrict tobacco advertising, prohibit smoking in public places, increase the penalties for selling tobacco to minors, and reduce access of young people to tobacco are especially popular. omen, nonsmokers, and older people form the basis of support for these measures.Conclusions.These results suggest that Minnesota citizens are more supportive of restrictive tobacco control policies than policy makers might believe, and that more aggressive lobbying on behalf of such measures at the state and local level is warranted.

<b><i>Aims:</i></b> Personal genomic testing (PGT) for common disease risk is becoming increasingly frequent, but little is known about people's array of emotional reactions to learning their genomic risk profiles and the psychological harms/benefits of PGT. We conducted a study of post-PGT affect, including positive, neutral, and negative states that may arise after testing. <b><i>Methods:</i></b> A total of 228 healthy adults received PGT for common disease variants and completed a semistructured research interview within 2 weeks of disclosure. The study participants reported how the PGT results made them feel in their own words. Using an iterative coding process, the responses were organized into three broad affective categories: negative, neutral, and positive affect. <b><i>Results:</i></b> Neutral affect was the most prevalent response (53.9%), followed by positive affect (26.9%) and negative affect (19.2%). We found no differences by gender, race, or education. <b><i>Conclusions:</i></b> While <20% of participants reported negative affect in response to learning their genomic risk profile for common diseases, a majority experienced either neutral or positive emotions. These findings contribute to the growing evidence that PGT does not impose significant psychological harms. Moreover, they point to a need to better link theories and assessments in both emotional and cognitive processing to capitalize on PGT information for healthy behavior change.

Greater attention towards genetics as a contributor to group health differences may lead to inappropriate use of race/ethnicity and gender as genetic heuristics and exacerbate health disparities. As part of a web-based survey, 1,035 family physicians (FPs) rated the contribution of genetics and environment to racial/ethnic and gender differences in health outcomes, and the importance of race/ethnicity and gender in their clinical decision-making. FPs attributed racial/ethnic and gender differences in health outcomes equally to environment and genetics. These beliefs were not associated with rated importance of race/ethnicity or gender in clinical decision-making. FPs appreciate the complexity of genetic and environmental influences on health differences by race/ethnicity and gender.

This article assesses the validity and reliability of the approach used to measure community mo bilization in the Seattle Minority Youth Health Project (MYHealth), a neighborhood-based pro gram to prevent drug use, violence, teen pregnancy, and sexually transmitted diseases (STDs). Two constructs were measured: neighborhood cooperation in solving problems, and sense of pride and identification with the neighborhood. The convergent validity of the measurement ap proach was assessed by comparing several independent measures of community mobilization generatedfrom surveys of key neighborhood leaders, youth, and parents. For the neighborhood cooperation construct, correlations were uniformly positive across measuresfrom different sur veys and statistically significant about a quarter of the time. The correlations for the neighbor hood pride construct were weaker and generally not statistically significant. Interrater reliabil ity was low for all of the surveys, possibly reflecting varying ideas about what community mobili zation meant among survey respondents.