Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Public Health Genomics. 2023;26(1):90-102. doi: 10.1159/000533356. Epub 2023 Aug 4.
Early adopters play a critical role in the diffusion of medical innovations by spreading awareness, increasing acceptability, and driving demand. Understanding the role of race in the context of other characteristics of potential early adopters can shed light on disparities seen in the early implementation of genomic medicine. We aimed to understand the association between self-identified race and individual experience with genetic testing outside of the research context.
We assessed factors associated with the odds of having ever received genetic testing prior to enrollment in a genomic sequencing study among 674 self-identified white and 407 self-identified African, African American, or Afro-Caribbean ("Black") individuals.
Controlling for individual determinants of healthcare use (demographics, personality traits, knowledge and attitudes, and health status), identifying as Black was associated with lower odds of prior genetic testing (OR = 0.43, 95% CI [0.27-0.68], p < 0.001). In contrast, self-identified race was not associated with the use of non-genetic clinical screening tests (e.g., echocardiogram, colonoscopy). Black and white individuals were similar on self-reported personality traits tied to early adoption but differed by sociodemographic and resource facilitators of early adoption.
Persistent racial disparities among early adopters may represent especially-entrenched disparities in access to and knowledge of genomic technologies in clinical settings.
早期采用者在医疗创新的传播中起着至关重要的作用，他们可以提高意识、增加可接受性并推动需求。了解种族在其他潜在早期采用者特征背景下的作用，可以揭示在基因组医学早期实施方面存在的差异。我们旨在了解在参与基因组测序研究之前，自我认同的种族与个体在研究背景之外进行基因检测的经历之间的关联。
我们评估了在 674 名自我认定为白人的个体和 407 名自我认定为非裔、非裔美国人或 Afro-Caribbean（“黑人”）的个体中，与参加基因组测序研究之前接受过基因检测的几率相关的因素。
在控制个体医疗保健使用的决定因素（人口统计学、人格特质、知识和态度以及健康状况）后，自我认同为黑人与接受基因检测的几率较低相关（OR=0.43，95%CI[0.27-0.68]，p < 0.001）。相比之下，自我认定的种族与非基因临床筛查测试（例如，超声心动图、结肠镜检查）的使用无关。在与早期采用相关的自我报告人格特质方面，黑人个体和白人个体相似，但在早期采用的社会人口统计学和资源促进因素方面存在差异。
早期采用者中持续存在的种族差异可能反映了在临床环境中获得和了解基因组技术方面存在的特别根深蒂固的差异。
