Sanderson Saskia C, Diefenbach Michael A, Zinberg Randi, Horowitz Carol R, Smirnoff Margaret, Zweig Micol, Streicher Samantha, Jabs Ethylin Wang, Richardson Lynne D
Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY, 10029, USA,
J Community Genet. 2013 Oct;4(4):469-82. doi: 10.1007/s12687-013-0154-0. Epub 2013 Jun 22.
Patients from traditionally underrepresented communities need to be involved in discussions around genomics research including attitudes towards participation and receiving personal results. Structured interviews, including open-ended and closed-ended questions, were conducted with 205 patients in an inner-city hospital outpatient clinic: 48 % of participants self-identified as Black or African American, 29 % Hispanic, 10 % White; 49 % had an annual household income of <$20,000. When the potential for personal results to be returned was not mentioned, 82 % of participants were willing to participate in genomics research. Reasons for willingness fell into four themes: altruism; benefit to family members; personal health benefit; personal curiosity and improving understanding. Reasons for being unwilling fell into five themes: negative perception of research; not personally relevant; negative feelings about procedures (e.g., blood draws); practical barriers; and fear of results. Participants were more likely to report that they would participate in genomics research if personal results were offered than if they were not offered (89 vs. 62 % respectively, p < 0.001). Participants were more interested in receiving personal genomic risk results for cancer, heart disease and type 2 diabetes than obesity (89, 89, 91, 80 % respectively, all p < 0.001). The only characteristic consistently associated with interest in receiving personal results was disease-specific worry. There was considerable willingness to participate in and desire for personal results from genomics research in this sample of predominantly low-income, Hispanic and African American patients. When returning results is not practical, or even when it is, alternatively or additionally providing generic information about genomics and health may also be a valuable commodity to underrepresented minority and other populations considering participating in genomics research.
来自传统上代表性不足社区的患者需要参与围绕基因组学研究的讨论,包括对参与研究和接收个人结果的态度。在内城区医院门诊对205名患者进行了结构化访谈,包括开放式和封闭式问题:48%的参与者自我认定为黑人或非裔美国人,29%为西班牙裔,10%为白人;49%的家庭年收入低于2万美元。当未提及返回个人结果的可能性时,82%的参与者愿意参与基因组学研究。愿意参与的原因分为四个主题:利他主义;对家庭成员有益;对个人健康有益;个人好奇心和增进理解。不愿意参与的原因分为五个主题:对研究的负面看法;与个人无关;对程序(如抽血)的负面感受;实际障碍;以及对结果的恐惧。与不提供个人结果相比,参与者更有可能表示如果提供个人结果他们会参与基因组学研究(分别为89%和62%,p<0.001)。参与者对获得癌症、心脏病和2型糖尿病的个人基因组风险结果比对肥胖症更感兴趣(分别为89%、89%、91%、80%,所有p<0.001)。与对接收个人结果感兴趣始终相关的唯一特征是特定疾病的担忧。在这个主要为低收入、西班牙裔和非裔美国患者的样本中,有相当大的意愿参与基因组学研究并渴望获得个人结果。当返回结果不切实际时,或者即使可行时,另外或额外提供有关基因组学和健康的一般信息,对于考虑参与基因组学研究的代表性不足的少数群体和其他人群来说,也可能是有价值的。