Effect of communicating phenotypic and genetic risk of coronary heart disease alongside web-based lifestyle advice: the INFORM Randomised Controlled Trial

Abstract

ObjectiveTo determine whether provision of web-based lifestyle advice and coronary heart disease risk information either based on phenotypic characteristics or phenotypic plus genetic characteristics affects changes in objectively measured health behaviours.MethodsA parallel-group, open randomised trial including 956 male and female blood donors with no history of cardiovascular disease (mean [SD] age=56.7 [8.8] years) randomised to four study groups: control group (no information provided); web-based lifestyle advice only (lifestyle group); lifestyle advice plus information on estimated 10-year coronary heart disease risk based on phenotypic characteristics (phenotypic risk estimate) (phenotypic group) and lifestyle advice plus information on estimated 10-year coronary heart disease risk based on phenotypic (phenotypic risk estimate) and genetic characteristics (genetic risk estimate) (genetic group). The primary outcome was change in physical activity from baseline to 12 weeks assessed by wrist-worn accelerometer.Results928 (97.1%) participants completed the trial. There was no evidence of intervention effects on physical activity (difference in adjusted mean change from baseline): lifestyle group vs control group 0.09 milligravity (mg) (95% CI −1.15 to 1.33); genetic group vs phenotypic group −0.33 mg (95% CI −1.55 to 0.90); phenotypic group and genetic group vs control group −0.52 mg (95% CI −1.59 to 0.55) and vs lifestyle group −0.61 mg (95% CI −1.67 to 0.46). There was no evidence of intervention effects on secondary biological, emotional and health-related behavioural outcomes except self-reported fruit and vegetable intake.ConclusionsProvision of risk information, whether based on phenotypic or genotypic characteristics, alongside web-based lifestyle advice did not importantly affect objectively measured levels of physical activity, other health-related behaviours, biological risk factors or emotional well-being.Trial registration numberISRCTN17721237; Pre-results.

Communicating polygenic and non-genetic risk for atherosclerotic cardiovascular disease - An observational follow-up study

“…However, our results are in contrast with a previous study of a selected sample of blood donors, where disclosing genetic information did not affect physical activity of the participants 17 .…”

A randomised controlled trial of the effect of providing online risk information and lifestyle advice for the most common preventable cancers

“…Our results show no evidence of this. They additionally support existing evidence that provision of disease risk does not increase disease-specific worry or general anxiety ( Silarova et al, 2019 ; Li et al, 2016 ; Godino et al, 2012 ).…”

Polygenic risk scores: from research tools to clinical instruments

“…The role that PRS will play in clinical care is currently unclear, and any use of PRS must be predicated on clear clinical utility, with a specific outcome activated by the score. For example, a PRS for coronary artery disease assessed in early adulthood may be useful to encourage healthy behaviour throughout life, although we still lack experience of how to use genetic data to motivate behaviour change [43][44][45]. Not all preventive strategies are so benign; pharmacological interventions or surgical procedures are more controversial.…”