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健康感知和知识对健康信念模型指导下的基因检测决策的影响。

Impact of Health Perception and Knowledge on Genetic Testing Decisions Using the Health Belief Model.

机构信息

Stevens Institute of Technology, School of Systems and Enterprises, Hoboken, NJ.

出版信息

JCO Clin Cancer Inform. 2022 Jan;6:e2100117. doi: 10.1200/CCI.21.00117.

Abstract

PURPOSE

Early detection of cancer risk is essential as it is associated with a higher chance of survival, more successful treatment, and improved quality of life. Genetic testing helps at-risk patients estimate the likelihood of developing cancer in a lifetime. This study aims to indentify the factors (perceived susceptibility, severity, benefits, and self-efficacy) that impact one's decision to take the genetic test.

METHODS

We examined the impacts of different factors of the health belief model on the engagement of patients in genetic testing using data from the National Cancer Institute's 2020 cross-sectional nationally representative data published in 2021. Complete surveys were answered by 3,865 participants (weighted population size = 253,815,197). All estimates were weighted to be nationally representative of the US population using the jackknife weighting method for parameter estimation. We used multivariable logistic regression to test our hypotheses for patients who have taken the genetic test for cancer risk detection. We adjusted the multivariate model for age, education, income, race, sex, cancer history, familial cancer history, and education.

RESULTS

We tested five hypotheses using the health belief model. Respondents who had genetic testing were more likely to rely on their health care providers and genetic counselors to make their decisions. Respondents who had genetic tests also reported less reliability on other sources than doctors: for the internet and social media (odds ratio = 0.33; < .001) and for journals and magazines (odds ratio = 0.48; = .007).

CONCLUSION

The findings show that patients generally rely on suggestions from their health care providers and counselors in genetic testing decisions. These findings also indicate that health care providers play a critical role in helping patients decide whether to use genetic testing to detect cancer risk in the early stages.

摘要

目的

早期发现癌症风险至关重要,因为它与更高的生存率、更成功的治疗和更高的生活质量有关。基因检测可以帮助高危患者估计一生中患癌症的可能性。本研究旨在确定影响患者决定进行基因检测的因素(感知易感性、严重程度、益处和自我效能)。

方法

我们使用美国国家癌症研究所 2020 年横断面全国代表性数据中 2021 年发布的数据,检验了健康信念模型的不同因素对患者参与基因检测的影响。共有 3865 名参与者完成了完整的调查(加权人口规模=253815197)。所有估计值均采用刀切加权法进行参数估计,加权后在全国范围内代表美国人口。我们使用多变量逻辑回归检验了我们对已进行癌症风险基因检测的患者的假设。我们调整了多变量模型,以适应年龄、教育、收入、种族、性别、癌症史、家族癌症史和教育等因素。

结果

我们使用健康信念模型检验了五个假设。接受基因检测的受访者更有可能依赖他们的医疗保健提供者和遗传咨询师做出决策。接受基因检测的受访者也报告说,他们不太依赖医生以外的其他来源获取信息:互联网和社交媒体(比值比=0.33;<.001)和期刊和杂志(比值比=0.48;<.007)。

结论

研究结果表明,患者通常在基因检测决策中依赖医疗保健提供者和咨询师的建议。这些发现还表明,医疗保健提供者在帮助患者决定是否使用基因检测来早期发现癌症风险方面发挥着关键作用。

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