title: A Qualitative Study of Anticipated Decision Making around Type 2 Diabetes Genetic Testing: the Role of Scientifically Concordant and Discordant Expectations.
abstract: Type 2 diabetes mellitus (T2DM) genetic testing is undergoing clinical trials to measure the efficacy of genetic counseling for behavior-based risk reduction. The expectations patients bring to the testing process may play an important role in individual outcomes. We conducted a qualitative exploration of anticipated decision-making and expectations around T2DM genetic testing. Semi-structured interviews were completed with Mexican Americans (n = 34), non-Hispanic Black Americans (n = 39), and non-Hispanic White Americans (n = 39) at risk for T2DM. Transcripts were analyzed for themes. Most participants would accept T2DM genetic testing in order to motivate risk-reducing behaviors or apprise family members of their risk. Participants who would decline testing wished to avoid emotional distress or believed the test would not reveal new risk information. Non-Hispanic Whites and those with college education declined genetic testing more often than other groups. Those without college education were more likely to have testing expectations that were discordant with current science, such as conflating genetic testing with common 'blood tests.' Understanding expectations and decision-making factors around T2DM genetic testing will better prepare healthcare professionals to counsel their patients. This may lead to a higher efficacy of T2DM genetic testing and counseling.
authors.affiliation: BioSocial Methods Collaborative, Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48109-1248, USA. almagior@umich.edu.
authors.forename: Alicia G
authors.initials: AG
authors.lastname: Carmichael
authors.affiliation: Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA.
authors.forename: Bailey B
authors.initials: BB
authors.lastname: Hulswit
authors.affiliation: Genetics and Genomics Program, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Moe
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Toby Epstein
authors.initials: TE
authors.lastname: Jayaratne
authors.affiliation: Department of Human Genetics, University of Michigan, Ann Arbor, USA.
authors.forename: Beverly M
authors.initials: BM
authors.lastname: Yashar
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology* / Q000235:genetics; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D036301:Qualitative Research; D012306:Risk; D014481:United States; D044465:White People / Q000523:psychology
keywords: Decision-making; Diabetes; Genetic testing; Qualitative research