title: A community survey on knowledge of the impact of environmental and epigenetic factors on health and disease.
abstract: OBJECTIVE
  An outreach effort was designed to survey breast cancer survivors, supporters and their families and friends with respect to their interest in, and knowledge of, the potential impact of the environment and epigenetics on health.
  
  
  METHODS
  Two nearly identical questionnaires (one for adolescents and one for adults) were designed to gauge the perception of this community as to whether the environment impacts health and cancer risk through processes other than genetics. The questionnaires were filled out at casual social gatherings, fundraisers and wellness campaigns as well as in schools (730 participants). The differences among correct (scientific consensus) versus other responses (incorrect and not known) were evaluated. Each answer was first analysed individually and then grouped into one of three categories (diet, inheritance and environment) with age, race and gender. Differences for each response, question or group were compared by repeated measures analysis of variance.
  
  
  RESULTS
  Respondents generally acknowledged that many factors could be associated with breast cancer although answers to key questions related to epigenetics based on diet, inheritance and environment were often incorrect or not known. The adult participants tended to answer more questions correctly than adolescents did. The majority of participants preferred the Internet as a major source for obtaining further information.
  
  
  CONCLUSIONS
  The growing awareness and educational needs for adolescents may bring new paradigm-related environmental risk factors, which may minimise negative epigenetic outcome in subsequent generations. There is an educational opportunity, especially using electronic media, for public education concerning the impact of the environment on human health.
authors.affiliation: Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Marian
authors.initials: M
authors.lastname: Miller
authors.affiliation: Pink Ribbon Girls, Cincinnati, OH, USA.
authors.forename: Banita
authors.initials: B
authors.lastname: Bailey
authors.affiliation: Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Vinothini
authors.initials: V
authors.lastname: Govindarajah
authors.affiliation: Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Levin
authors.affiliation: Pink Ribbon Girls, Cincinnati, OH, USA.
authors.forename: Traci
authors.initials: T
authors.lastname: Metzger
authors.affiliation: Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati, Center for Environmental Genetics, Cincinnati, OH, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Pinney
authors.affiliation: Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, Center for Environmental Genetics, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Yuet-Kin
authors.initials: YK
authors.lastname: Leung
authors.affiliation: Division of Environmental Genetics and Molecular Toxicology, Department of Environmental Health, USA; Center for Environmental Genetics, University of Cincinnati, University of Cincinnati Cancer Center, Cincinnati, OH, USA; Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA shuk-mei.ho@uc.edu.
authors.forename: Shuk-Mei
authors.initials: SM
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology*; D004777:Environment; D004782:Environmental Health; D057890:Epigenomics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D012307:Risk Factors; D012574:Schools; D011795:Surveys and Questionnaires
keywords: breast cancer; diet; education; environment; epigenetic; outreach