Patient Beliefs and Behaviors About Genomic Risk for Type 2 Diabetes: Implications for Prevention

Gallagher, Patrick; King, Heather A.; Haga, Susanne B.; Orlando, Lori A.; Joy, Scott V.; Trujillo, Gloria; Scott, William Michael; Bembe, M.; Creighton, Dana L.; Cho, Alex H.; Ginsburg, Geoffrey S.; Vorderstrasse, Allison

doi:10.1080/10810730.2015.1018563

Cited by 6 publications

(15 citation statements)

References 39 publications

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“…In this trial, we observed greater perception of control over CHD risk in those at lower T2D genetic risk who received HC. This replicates our earlier findings that participants are interested in their genetic information, are not afraid to receive it, and may be able to utilize it well (Cho et al, 2012; Gallagher et al, 2015).…”

Section: Discussionsupporting

confidence: 89%

“…In return, the increased potency of the threat may activate a coping plan to improve health behavior (Vorderstrasse et al, 2013). While this had not been directly tested yet, incorporating multimarker genetic risk information into an SRA focused on diabetes risk had increased motivation to change behavior (Gallagher et al, 2015; Wu et al, 2017) and altered perceptions about the seriousness of T2D risk in those with a positive family history (Wu et al, 2017). We hypothesized that SRA, HC, and GRT would synergize to impact behavior.…”

mentioning

confidence: 99%

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Health coaching and genetic risk testing in primary care: Randomized controlled trial.

Wolever¹,

Yang²,

Maldonado³

et al. 2022

Health Psychology

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Health coaching and genetic risk testing in primary care: Randomized controlled trial.

Wolever¹,

Yang²,

Maldonado³

et al. 2022

Health Psychology

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“…This may be explained by maladaptive coping in accordance with the 'common sense model of illness cognition', in which individuals' belief about disease threats guides their prevention behaviourthat is, people can cope with disease threats broadly in two ways, either they reduce the threat by adapting to healthy behaviours or they form maladaptive mechanisms including fatalistic responses dependent on the perceived controllability of the threat (50) . However, recent meta-analyses and qualitative studies together indicate a limited fatalistic response after genetic risk feedback, measured by perceived control and self-reported fatalism (51)(52)(53) . Hence, this finding raises concern and warrants further testing and monitoring.…”

Section: Actual Behaviour Changementioning

confidence: 99%

The effect of communicating the genetic risk of cardiometabolic disorders on motivation and actual engagement in preventative lifestyle modification and clinical outcome: a systematic review and meta-analysis of randomised controlled trials

Zheng

Whelan

et al. 2016

Br J Nutr

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Genetic risk prediction of chronic conditions including obesity, diabetes and CVD currently has limited predictive power but its potential to engage healthy behaviour change has been of immense research interest. We aimed to understand whether the latter is indeed true by conducting a systematic review and meta-analysis investigating whether genetic risk communication affects motivation and actual behaviour change towards preventative lifestyle modification. We included all randomised controlled trials (RCT) since 2003 investigating the impact of genetic risk communication on health behaviour to prevent cardiometabolic disease, without restrictions on age, duration of intervention or language. We conducted random-effects meta-analyses for perceived motivation for behaviour change and clinical changes (weight loss) and a narrative analysis for other outcomes. Within the thirteen studies reviewed, five were vignette studies (hypothetical RCT) and seven were clinical RCT. There was no consistent effect of genetic risk on actual motivation for weight loss, perceived motivation for dietary change (control v. genetic risk group standardised mean difference (smd) −0·15; 95 % CI −1·03, 0·73, P=0·74) or actual change in dietary behaviour. Similar results were observed for actual weight loss (control v. high genetic risk SMD 0·29 kg; 95 % CI −0·74, 1·31, P=0·58). This review found no clear or consistent evidence that genetic risk communication alone either raises motivation or translates into actual change in dietary intake or physical activity to reduce the risk of cardiometabolic disorders in adults. Of thirteen studies, eight were at high or unclear risk of bias. Additional larger-scale, high-quality clinical RCT are warranted.

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“…Beyond the potential impact on individuals’ anxiety or motivation, augmenting risk information through genomic profiling might eventually change implicit frameworks of understanding about disease causation [ 15 ], the perceived role of prevention and lifestyle [ 16 , 17 ], and the sense of personal responsibility for one’s own health [ 18 , 19 ]. Concerns have also been raised about the privacy of personal genomic information, and that genomic risk information could be used in the calculation of, or eligibility for, individual insurance premiums or employers’ screening requirements [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Attitudes to incorporating genomic risk assessments into population screening programs: the importance of purpose, context and deliberation

et al. 2016

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BackgroundThe use of an overall risk assessment based on genomic information is consistent with precision medicine. Despite the enthusiasm, there is a need for public engagement on the appropriate use of such emerging technologies in order to frame meaningful evaluations of utility, including the practical implementation and acceptability issues that might emerge. Doing so requires the involvement of the end users of these services, including patients, and sections of the public who are the target group for population based screening. In the present study we sought to explore public attitudes to the potential integration of personal genomic profiling within existing population screening programs; and to explore the evolution of these attitudes as part of a deliberative process.MethodsWe conducted a mixed methods study presented in the format of a deliberative workshop. Participants were drawn from communities in Ottawa, Ontario (ON) and St John’s, Newfoundland and Labrador (NL), Canada. Individuals were approached to take part in a workshop on the incorporation of genomic risk profiling for either colorectal cancer screening (CRC), or newborn screening for type 1 diabetes mellitus (T1DM).ResultsA total of N = 148 (N = 65 ON, N = 83 NL) participants provided data for analysis. Participants in both groups were supportive of public funding for genomic risk profiling, although participants in the T1DM groups expressed more guarded positive attitudes than participants in the CRC groups. These views were stable throughout the workshop (CRC, p = 0.15, T1DM, p =0.39). Participants were less positive about individual testing, with a significant decrease in support over the course of the workshop (CRC p = 0.02, T1DM, p = 0.003). Common concerns related to access to test results by third parties.ConclusionsThe findings of this study suggest that members of the target populations for potential genomic profiling tests (designed for screening or risk prediction purposes) can engage in meaningful deliberation about their general acceptability and personal utility. Evaluations of whether a test would be personally useful may depend on the experience of the participants in personal health decision making, the purpose of the test, and the availability of interventions to reduce disease risk.Electronic supplementary materialThe online version of this article (doi:10.1186/s12920-016-0186-5) contains supplementary material, which is available to authorized users.

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Patient Beliefs and Behaviors About Genomic Risk for Type 2 Diabetes: Implications for Prevention

Cited by 6 publications

References 39 publications

Health coaching and genetic risk testing in primary care: Randomized controlled trial.

Health coaching and genetic risk testing in primary care: Randomized controlled trial.

The effect of communicating the genetic risk of cardiometabolic disorders on motivation and actual engagement in preventative lifestyle modification and clinical outcome: a systematic review and meta-analysis of randomised controlled trials

Attitudes to incorporating genomic risk assessments into population screening programs: the importance of purpose, context and deliberation

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