Journal of Genetic Counseling

, Volume 27, Issue 5, pp 1302–1311 | Cite as

Identifying Factors Underlying the Decision for Sickle Cell Carrier Screening Among African Americans Within Middle Reproductive Age

  • Tilicia L. Mayo-GambleEmail author
  • Susan E. Middlestadt
  • Hsien-Chang Lin
  • Jennifer Cunningham-Erves
  • Priscilla Barnes
  • Pamela Braboy Jackson
Original Research


Guidelines recommend that African Americans know their sickle cell trait status to inform reproductive health decisions. Few studies have applied a behavioral theory to identify factors associated with sickle cell trait screening to inform intervention targets to increase this behavior. We applied a Sickle Cell Trait Screening Framework to identify factors associated with African Americans’ intention to ask for sickle cell trait screening. Participants (N = 300), ages 18 to 35, completed a cross-sectional survey. A three-step sequential ordinary least squares regression analysis identified factors influencing intention. Results indicated socio-demographic factors (age, education), knowledge and fear beliefs (screening knowledge, perceived threat), and reasoned action approach (RAA) constructs were associated with intention. RAA constructs influenced intention over knowledge and fear beliefs with an increase in R2 of .468. Perceived behavioral control was more predictive of intention (β = .576, p < .001). Attitude and perceived norm also had significant weights (β = .325 and β = .192, both p < .001, respectively). Findings from this study can inform strategies (e.g., eliminating costs associated with screening, reducing fear of painful tests) to increase sickle cell trait screening among African Americans. Ultimately, more sickle cell carriers will become aware of their trait status and be able to make informed reproductive health decisions.


Sickle cell trait Genetic screening Reasoned action approach Intention Health behavior Carrier 



This work was conducted in part to fulfill a degree requirement.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of Interest

Tilicia L. Mayo-Gamble, Susan E. Middlestadt, Hsien-Chang Lin, Jennifer Cunningham-Erves, Priscilla Barnes, and Pamela Braboy Jackson declare that they have no conflict of interest.

Human Studies and Inform Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.

Animal Studies

No animal studies were carried out by the authors for this article.


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Copyright information

© National Society of Genetic Counselors, Inc. 2018

Authors and Affiliations

  • Tilicia L. Mayo-Gamble
    • 1
    Email author
  • Susan E. Middlestadt
    • 2
  • Hsien-Chang Lin
    • 2
  • Jennifer Cunningham-Erves
    • 3
  • Priscilla Barnes
    • 2
  • Pamela Braboy Jackson
    • 4
  1. 1.Department of Community Health Behavior and EducationGeorgia Southern UniversityStatesboroUSA
  2. 2.Department of Applied Health ScienceIndiana UniversityBloomingtonUSA
  3. 3.Department of Internal MedicineMeharry Medical CollegeNashvilleUSA
  4. 4.Department of SociologyIndiana UniversityBloomingtonUSA

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