title: Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.
abstract: OBJECTIVE
  Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population.
  
  
  METHODS
  1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis.
  
  
  RESULTS
  No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p < .0001); respondents with marginal (OR = 1.54; p = .005) or limited (OR = 1.85; p = .009) health literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p < .001) and Hispanics (β = -0.25; p = .033) intended to change fewer health habits than Whites; health literacy was negatively associated with number of health habits participants intended to change.
  
  
  CONCLUSIONS
  Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kaphingst
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine.
authors.forename: Jewel D
authors.initials: JD
authors.lastname: Stafford
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine.
authors.forename: Lucy D'Agostino
authors.initials: LD
authors.lastname: McGowan
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine.
authors.forename: Joann
authors.initials: J
authors.lastname: Seo
authors.affiliation: Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Lachance
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine.
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
mesh_terms: D000328:Adult; D003466:Cultural Characteristics; D003625:Data Collection; D005006:Ethnicity; D005260:Female; D020022:Genetic Predisposition to Disease; D023281:Genomics; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D044469:Racial Groups; D011897:Random Allocation; D012044:Regression Analysis; D012306:Risk; D018570:Risk Assessment; D055815:Young Adult