Public Trust in Genomic Risk Assessment for Type 2 Diabetes Mellitus

Abstract

Patient trust in personal medical information is critical to increasing adherence to physician recommendations and medications. One of the anticipated benefits of learning of one’s genomic risk for common diseases is the increased adoption of screening, preventive care and lifestyle changes. However, the equivocal results thus far reported of the positive impact of knowledge of genomic risk on behavior change may be due to lack of patients’ trust in the results. As part of a clinical study to compare two methods of communication of genomic risk results for Type 2 diabetes mellitus (T2DM), we assessed patients’ trust and preferred methods of delivery of genomic risk information. A total of 300 participants recruited from the general public in Durham, NC were randomized to receive their genomic risk for T2DM in-person from a genetic counselor or online through the testing company’s web-site. Participants completed a baseline survey and three follow-up surveys after receiving results. Overall, participants reported high levels of trust in the test results. Participants who received their results in-person from the genetic counselor were significantly more likely to trust their results than those who reviewed their results on-line (p=0.005). There was not a statistically significant difference in levels of trust among participants with increased genetic risk, as compared to other those with decreased or same as population risk (p = 0.1154). In the event they undergo genomic risk testing again, 55% of participants overall indicated they would prefer to receive their results online compared to 28% that would prefer to receive future results in-person. Of those participants preferring to receive results online, 77% indicated they would prefer to have the option to speak to someone if they had questions with the online results (compared to accessing results online without the option of professional consultation). This is the first study to assess satisfaction with genomic risk testing by the method of delivery of the test result. The higher rate of trust in results delivered in-person suggests that online access reports may not result in serious consideration of results and lack of adoption of recommended preventive recommendations.

Information‐Seeking and Sharing Behavior Following Genomic Testing for Diabetes Risk

“…As previously reported (Haga et al 2013; Mills et al 2013), 300 participants from the general population of Durham, NC were enrolled in a randomized clinical study on genomic risk assessment for T2DM using recruitment methods such as advertising in newspapers, on public transportation, and online. The primary goal of the study was to assess the impact of the delivery approach (in-person with a genetic counselor or online through the testing company’s website) of genomic risk testing results for T2DM on risk comprehension and the impact of learning one’s risk on health behaviors.…”