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社会心理因素在黑种女性接受基因咨询和检测的自我效能感中的作用。

The role of psychosocial factors in Black women's self-efficacy in receiving genetic counseling and testing.

机构信息

Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

出版信息

J Genet Couns. 2021 Dec;30(6):1719-1726. doi: 10.1002/jgc4.1439. Epub 2021 Jun 4.

Abstract

Higher self-efficacy in receiving genetic counseling and testing (GCT) has been associated with greater participation in GCT for women at risk of hereditary breast and ovarian cancer (HBOC), but little is known about correlates of self-efficacy in Black women eligible for GCT. The goal of this secondary analysis was to identify sociodemographic and psychosocial factors regarding GCT. Multivariable regression analysis was conducted to assess the relationship between self-efficacy and correlates of interest. Of the 100 Black women surveyed, most women had a college degree (64%), were employed (84%), and had health insurance (93%). In the multivariable model, greater self-efficacy was associated with more positive attitudes toward GCT (Β = 0.126; CI = 0.01 to 0.25; p = 0.039), greater confidence in the Genetic Information Nondiscrimination Act (GINA) (Β = 0.250; CI = 0.04 to 0.46; p = 0.019), and lower ratings of perceived difficulty obtaining GCT (Β = -0.219; CI = -0.46 to -0.10; p = 0.003). Community-level interventions to promote self-efficacy are needed that address perceived barriers to GCT, with the goals of increasing GINA Law awareness in the general public, increasing accessibility to genetic counseling (e.g., telemedicine), and promoting more positive attitudes about GCT.

摘要

较高的接受遗传咨询和检测(GCT)的自我效能感与增加高危遗传性乳腺癌和卵巢癌(HBOC)女性的 GCT 参与率相关,但关于有资格接受 GCT 的黑人女性的自我效能感的相关因素知之甚少。本二次分析的目的是确定与 GCT 相关的社会人口统计学和心理社会因素。多变量回归分析用于评估自我效能感与相关因素之间的关系。在接受调查的 100 名黑人女性中,大多数女性拥有大学学历(64%)、有工作(84%)和医疗保险(93%)。在多变量模型中,对 GCT 的更积极的态度(β=0.126;CI=0.01 至 0.25;p=0.039)、对遗传信息非歧视法案(GINA)的更大信心(β=0.250;CI=0.04 至 0.46;p=0.019)和对获得 GCT 的难度的感知较低(β=-0.219;CI=-0.46 至-0.10;p=0.003)与更高的自我效能感相关。需要进行社区层面的干预措施来提高自我效能感,这些干预措施需要解决对 GCT 的感知障碍,目标是提高公众对 GINA 法律的认识,增加遗传咨询的可及性(例如远程医疗),并促进对 GCT 的更积极态度。

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