Effects of health literacy skills, educational attainment, and level of melanoma risk on responses to personalized genomic testing

Kaphingst, Kimberly A.; Khan, Erva; White, Karen E.; Sussman, Andrew L.; Guest, Dolores D.; Schofield, Elizabeth; Dailey, Yvonne; Robers, Erika; Schwartz, Matthew; Li, Yuelin; Buller, David B.; Hunley, Keith; Berwick, Marianne; Hay, Jennifer L.

doi:10.1016/j.pec.2020.07.019

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…As such, the impact of offering MC1R testing, completing testing, and receiving risk feedback results may have been suppressed due to ceiling effects, creating reduced opportunity for behavioral impact. In previous analyses, participants who completed testing reported high levels of interest and engagement in their test feedback results and reported determination to improve sun protection behavior after receiving feedback, and such determination was significantly higher in those who received higher risk feedback, compared to average risk feedback two weeks after test receipt [55]. Those with a sunburn history were more likely to complete testing [69].…”

Section: Discussionmentioning

confidence: 89%

“…Participants who chose testing were mailed a kit to obtain their DNA, and if they so desired, provided a saliva sample for genetic testing. Those participants who sent in their sample received a report with their results in the form of genetic risk feedback stating that they were at either average risk, based on the presence of no MC1R variants associated with melanoma risk, or higher risk, based on the presence of at least one MC1R variant associated with risk of developing melanoma [55]. The design of this risk feedback, using plain language and clear communication guidelines, was adapted from the Multiplex Initiative study [57].…”

Section: Methodsmentioning

confidence: 99%

“…The design of this risk feedback, using plain language and clear communication guidelines, was adapted from the Multiplex Initiative study [57]. Participants who opted for testing received a follow-up telephone call two weeks after receipt of their results, for an assessment of comprehension, satisfaction with risk information, and distress level; these findings are reported elsewhere [55]. Primary outcomes were assessed at three months.…”

Section: Methodsmentioning

confidence: 99%

“…Second, were there significant moderators of the relationship between the receipt of higher vs. average genetic risk findings and the 3 month outcomes (i.e., overall sun protection, skin cancer screening, cancer worry)? Potential moderators included participant health literacy, perceived importance of genetic information, cancer risk perceptions, demographics, and skin cancer risk factors, all of which may influence behavioral and psychosocial outcomes associated with skin cancer genetic testing [48][49][50][51][52][53][54][55].…”

Section: Introductionmentioning

confidence: 99%

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Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing in Albuquerque Primary Care

Hay

Kaphingst

Buller

et al. 2021

Cancers

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Public availability of genetic information is increasing; thus, efforts to improve diversity in basic and translational research in genomics is a top priority. Given the increasing U.S. incidence and mortality of melanoma, and the prevalence of common melanocortin-1 receptor (MC1R) gene melanoma risk variants in the general population, we examined genomic testing of MC1R for skin cancer risk in a randomized controlled trial in Albuquerque, New Mexico primary care. Participants were 48% Hispanic and were randomized 5:1 to a MC1R test invitation or usual care. We assessed 3 month sun protection, skin cancer screening, and skin cancer worry outcomes associated with testing, and key effect moderators (e.g., cancer risk perceptions, and skin cancer risk factors). Our findings indicate that the primary outcomes were unchanged by the MC1R test offer, test acceptance, and level of risk feedback. Moderator analyses showed that those with lower risk perception, and those with skin that readily tans, significantly increased their sun protection in response to higher than average risk feedback. Risk feedback did not prompt cancer worry, and average risk feedback did not erode existing sun protection. This study paves the way for the development of tailored strategies to address low skin cancer risk awareness in this understudied context of public health genomics.

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Section: Discussionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing in Albuquerque Primary Care

Hay

Kaphingst

Buller

et al. 2021

Cancers

Self Cite

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“…Interestingly, college-educated non-Hispanic white were significantly more prone to read information about MC1R testing while subjects experiencing sunburns were significantly more likely to request the test [ 214 ]. Importantly, a recent study showed that people with lower health literacy skills or education may need support to understand genetic test results, while higher skills were related to reduced distress after receiving the results of MC1R testing [ 215 ].…”

Section: Mc1r and The Impact Of Skin Cancer Genetic Testingmentioning

confidence: 99%

Behind the Scene: Exploiting MC1R in Skin Cancer Risk and Prevention

Manganelli

Guida

Ferretta

et al. 2021

Genes

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Melanoma and non-melanoma skin cancers (NMSCs) are the most frequent cancers of the skin in white populations. An increased risk in the development of skin cancers has been associated with the combination of several environmental factors (i.e., ultraviolet exposure) and genetic background, including melanocortin-1 receptor (MC1R) status. In the last few years, advances in the diagnosis of skin cancers provided a great impact on clinical practice. Despite these advances, NMSCs are still the most common malignancy in humans and melanoma still shows a rising incidence and a poor prognosis when diagnosed at an advanced stage. Efforts are required to underlie the genetic and clinical heterogeneity of melanoma and NMSCs, leading to an optimization of the management of affected patients. The clinical implications of the impact of germline MC1R variants in melanoma and NMSCs’ risk, together with the additional risk conferred by somatic mutations in other peculiar genes, as well as the role of MC1R screening in skin cancers’ prevention will be addressed in the current review.

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Ethical, Legal, and Social Implications of Gene‐Environment Interaction Research

Calluori,

Heimke,

Caga‐anan

et al. 2024

Genetic Epidemiology

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Many complex disorders are impacted by the interplay of genetic and environmental factors. In gene‐environment interactions (GxE), an individual's genetic and epigenetic makeup impacts the response to environmental exposures. Understanding GxE can impact health at the individual, community, and population levels. The rapid expansion of GxE research in biomedical studies for complex diseases raises many unique ethical, legal, and social implications (ELSIs) that have not been extensively explored and addressed. This review article builds on discussions originating from a workshop held by the National Institute of Environmental Health Sciences (NIEHS) and the National Human Genome Research Institute (NHGRI) in January 2022, entitled: “Ethical, Legal, and Social Implications of Gene‐Environment Interaction Research.” We expand upon multiple key themes to inform broad recommendations and general guidance for addressing some of the most unique and challenging ELSI in GxE research. Key takeaways include strategies and approaches for establishing sustainable community partnerships, incorporating social determinants of health and environmental justice considerations into GxE research, effectively communicating and translating GxE findings, and addressing privacy and discrimination concerns in all GxE research going forward. Additional guidelines, resources, approaches, training, and capacity building are required to further support innovative GxE research and multidisciplinary GxE research teams.

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Effects of health literacy skills, educational attainment, and level of melanoma risk on responses to personalized genomic testing

Cited by 17 publications

References 31 publications

Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing in Albuquerque Primary Care

Behavioral and Psychological Outcomes Associated with Skin Cancer Genetic Testing in Albuquerque Primary Care

Behind the Scene: Exploiting MC1R in Skin Cancer Risk and Prevention

Ethical, Legal, and Social Implications of Gene‐Environment Interaction Research

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