Vanderbilt University School of Medicine, Nashville, TN, United States of America.
Meharry-Vanderbilt Alliance, Nashville, TN, United States of America.
PLoS One. 2020 Nov 11;15(11):e0234833. doi: 10.1371/journal.pone.0234833. eCollection 2020.
Precision medicine holds great promise for improving health and reducing health disparities that can be most fully realized by advancing diversity and inclusion in research participants. Without engaging underrepresented groups, precision medicine could not only fail to achieve its promise but also further exacerbate the health disparities already burdening the most vulnerable. Yet underrepresentation by people of non-European ancestry continues in precision medicine research and there are disparities across racial groups in the uptake of precision medicine applications and services. Studies have explored possible explanations for population differences in precision medicine participation, but full appreciation of the factors involved is still developing. To better inform the potential for addressing health disparities through PM, we assessed the relationship of precision medicine knowledge and trust in biomedical research with sociodemographic variables. Using a series of linear regression models applied to survey data collected in a diverse sample, we analyzed variation in both precision medicine knowledge and trust in biomedical research with socioeconomic factors as a way to understand the range of precision medicine knowledge (PMK) in a broadly representative group and its relationship to trust in research and demographic characteristics. Our results demonstrate that identifying as Black, while significantly PMK, explains only 1.5% of the PMK variance in unadjusted models and 7% of overall variance in models adjusted for meaningful covariates such as age, marital status, employment, and education. We also found a positive association between PMK and trust in biomedical research. These results indicate that race is a factor affecting PMK, even after accounting for differences in sociodemographic variables. Additional work is needed, however, to identify other factors contributing to variation in PMK as we work to increase diversity and inclusion in precision medicine applications.
精准医学在改善健康和减少健康差距方面具有巨大的潜力,而通过在研究参与者中推进多样性和包容性,这一潜力可以得到最大程度的实现。如果不吸引代表性不足的群体,精准医学不仅无法实现其承诺,还可能进一步加剧已经困扰最弱势群体的健康差距。然而,在精准医学研究中,非欧洲血统的人群代表性仍然不足,而且在精准医学应用和服务的接受程度上,不同种族群体之间存在差异。已经有研究探讨了精准医学参与方面的人群差异的可能原因,但对相关因素的全面理解仍在发展中。为了更好地了解通过精准医学解决健康差距的潜力,我们评估了精准医学知识和对生物医学研究的信任与社会人口变量之间的关系。我们使用一系列线性回归模型,对在多样化样本中收集的调查数据进行分析,研究了精准医学知识和对生物医学研究的信任与社会经济因素之间的关系,以此来了解广泛代表性群体中精准医学知识的范围及其与对研究和人口特征的信任之间的关系。研究结果表明,虽然黑人身份与精准医学知识显著相关,但在未调整的模型中,这一身份仅能解释精准医学知识差异的 1.5%,在调整了年龄、婚姻状况、就业和教育等有意义的协变量的模型中,也仅能解释整体差异的 7%。我们还发现精准医学知识与对生物医学研究的信任之间存在正相关关系。这些结果表明,即使考虑到社会人口变量的差异,种族也是影响精准医学知识的一个因素。然而,在我们努力增加精准医学应用中的多样性和包容性的过程中,还需要做更多的工作来确定导致精准医学知识差异的其他因素。