Bunn Janice Yanushka, Bosompra Kwadwo, Ashikaga Takamaru, Flynn Brian S, Worden John K
Department of Medical Biostatistics, University of Vermont, Burlington 05405, USA.
Prev Med. 2002 Jun;34(6):567-77. doi: 10.1006/pmed.2002.1031.
The availability of genetic testing for cancer risk has prompted an examination of the intention of the general public to undergo testing. This study expands a previous psychosocial model of factors influencing intention to undergo genetic testing for cancer in general to the context of colon cancer.
A sample of 1,836 adult residents of Vermont, New Hampshire, and Maine were interviewed via telephone. The survey instrument included measures derived from the Health Belief Model and additional psychosocial measures adapted from the literature. Structural Equation Modeling techniques were used to examine factors associated with the likelihood to undergo genetic testing.
Perceived barriers and benefits of testing, and perceived susceptibility to colon cancer had direct associations with likelihood. Optimism and pessimism had both direct and indirect effects. Age, socioeconomic status, family history, and awareness of genetic testing had indirect effects, and acted through the other factors. The model explained 22% of the variance in likelihood.
Perceived barriers, benefits, susceptibility, optimism, and pessimism directly influenced likelihood, and may also mediate the effect of background factors examined in this study. These findings suggest effective educational strategies to improve decision-making concerning genetic testing for colon cancer risk in the general population.
癌症风险基因检测的可及性促使人们对普通公众进行检测的意愿进行审视。本研究将先前关于影响一般人群进行癌症基因检测意愿的心理社会模型扩展至结肠癌背景。
通过电话访谈了佛蒙特州、新罕布什尔州和缅因州的1836名成年居民。调查工具包括源自健康信念模型的测量指标以及从文献中改编的其他心理社会测量指标。采用结构方程建模技术来检验与进行基因检测可能性相关的因素。
对检测的感知障碍和益处以及对患结肠癌易感性的感知与可能性直接相关。乐观和悲观情绪既有直接影响也有间接影响。年龄、社会经济地位、家族史和基因检测知晓度有间接影响，并通过其他因素起作用。该模型解释了可能性变异的22%。
感知障碍、益处、易感性、乐观和悲观情绪直接影响可能性，也可能介导本研究中所考察的背景因素的作用。这些发现提示了有效的教育策略，以改善普通人群关于结肠癌风险基因检测的决策。
