Abstract
The effect of disease-specific cognitions on interest in clinic-based and direct-to-consumer (DTC) genetic testing was assessed. Participants (N = 309) responded to an online hypothetical scenario and received genetic testing-related messages that varied by risk probability (25, 50, 75 %) and disease type (Alzheimer’s disease vs. Type 2 Diabetes). Post-manipulation interest increased for both testing types, but was greater for clinic-based testing. Interest was greater for Type 2 Diabetes than for Alzheimer’s disease, the latter perceived as more severe and likely, and less treatable and preventable. For DTC testing only, participants allocated to the high risk condition (75 %) had greater testing interest than those in the low (25 %) category. DTC testing is perceived as a viable, but less preferred, option compared with clinic-based testing. Particularly when considering DTC genetic testing, there is a need to emphasize subjective disease-related perceptions, including risk probability.
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References
Barlow-Stewart, K. (2007). DNA genetic testing—Screening for genetic conditions and genetic susceptibility [Fact sheet]. In Centre for Genetics Education (Ed.), The Australasian genetics resource book. Retrieved 16th October, 2014 from http://www.nhmrc.gov.au/_files_nhmrc/file/your_health/egenetics/FS21-dna-genetic-testing.pdf
Barnoy, S. (2007). Genetic testing for late-onset diseases: effect of disease controllability, test predictivity, and gender on the decision to take the test. Genetic Testing, 11, 187–192. doi:10.1089/gte.2006.0509
Browne, J. L., Ventura, A., Mosely, K., & Speight, J. (2013). ‘I call it the blame and shame disease’: A qualitative study about perceptions of social stigma surrounding type 2 diabetes. British Medical Journal Open, 3. doi:10.1136/bmjopen-2013-003384
Burt, R., & Neklason, D. W. (2005). Genetic testing for inherited colon cancer. Gastroenterology, 128, 1696–1716.
Cameron, L. D., Marteau, T. M., Brown, P. M., Klein, W. M., & Sherman, K. A. (2011). Communication strategies for enhancing understanding of the behavioral implications of genetic and biomarker tests for disease risk: The role of coherence. Journal of Behavioral Medicine, 35, 286–298. doi:10.1007/s10865-011-9361-5
Cameron, L. D., & Muller, C. (2009). Psychosocial aspects of genetic testing. Current Opinion in Psychiatry, 22, 218–223. doi:10.1097/YCO.0b013e3283252d80
Cameron, L. D., Sherman, K. A., Marteau, T. M., & Brown, P. M. (2009). Impact of genetic risk information and type of disease on perceived risk, anticipated affect, and expected consequences of genetic tests. Health Psychology, 28, 307–316. doi:10.1037/a0013947
Caulfield, T., Ries, N. M., Ray, P. N., Shuman, C., & Wilson, B. (2010). Direct-to-consumer genetic testing: Good, bad or benign? Clinical Genetics, 77, 101–105. doi:10.1111/j.1399-0004.2009.01291.x
de Bruin, W. B., Fischhoff, B., Millstein, S. G., & Halpern-Felsher, B. L. (2000). Verbal and numerical expressions of probability: “It’s a fifty–fifty chance”. Organizational Behavior and Human Decision Processes, 81, 115–131. doi:10.1006/obhd.1999.2868
Diabetes Australia. (2013). Type 2 diabetes. http://www.diabetesaustralia.com.au/Understanding-Diabetes/What-is-Diabetes/Type-2-Diabetes/#Preventing. Type 2 Diabetes.
easyDNA. (2014). Genetic predisposition test. http://www.easydna.com.au/content/index.php?section_id=37
Edwards, K. T., & Huang, C. J. (2014). Bridging the consumer-medical divide: How to regulate direct-to-consumer genetic testing. Hastings Center Report, 44, 17–19. doi:10.1002/hast.310
Egglestone, C., Morris, A., & O’Brien, A. (2013). Effect of direct-to-consumer genetic tests on health behaviour and anxiety: A survey of consumers and potential consumers. Journal of Genetic Counseling, 22, 565–575. doi:10.1007/s10897-013-9582-6
Etchegary, H. (2014). Public attitudes toward genetic risk testing and its role in healthcare. Personalized Medicine, 11, 509–522.
Goldsmith, L., Jackson, L., O’Connor, A., & Skirton, H. (2012). Direct-to-consumer genomic testing: Systematic review of the literature on user perspectives. European Journal of Human Genetics, 20, 811–816. doi:10.1038/ejhg.2012.18
Gollust, S. E., Hull, S., & Wilfond, B. S. (2002). Limitations of direct-to-consumer advertising for clinical genetic testing. Journal of the American Medical Association, 288, 1762–1767. doi:10.1001/jama.288.14.1762
Green, C. A., & Pope, C. R. (1999). Gender, psychosocial factors and the use of medical services: A longitudinal analysis. Social Science & Medicine, 48, 1363–1372. doi:10.1016/S0277-9536(98)00440-7
Hampel, H., & Peltomaki, P. (2000). Hereditary colorectal cancer: Risk assessment and management. Clinical Genetics, 58, 89–97. doi:10.1034/j.1399-0004.2000.580201.x
Harris, P. R., & Smith, V. (2005). When the risks are low: The impact of absolute and comparative information on disturbance and understanding in US and UK samples. Psychology & Health, 20, 319–330. doi:10.1080/08870440512331317689
Hock, K. T., Christensen, K. D., Yashar, B. M., Roberts, J. S., Gollust, S. E., & Uhlmann, W. R. (2011). Direct-to-consumer genetic testing: An assessment of genetic counselors’ knowledge and beliefs. Genetics in Medicine, 13, 325–332. doi:10.1097/GIM.0b013e3182011636
Javitt, G. (2008). Direct-to-consumer genetic testing: Empowering or endangering the public? [Issue brief]. Washington: Genetics and Public Policy Center. Retrieved 28th October, 2014 from http://www.dnapolicy.org/images/issuebriefpdfs/2006_DTC_Issue_Brief.pdf
Kovess-Masfety, V., Boyd, A., van de Velde, S., de Graaf, R., Vilagut, G., Haro, J. M., & Alonso, J. (2014). Are there gender differences in service use for mental disorders across countries in the European Union? Results from the EU-World Mental Health survey. Journal of Epidemiology and Community Health, 68, 649–656. doi:10.1136/jech-2013-202962
Lab Tests Online. (2014). Sample report. Retrieved 21st October, 2014 from http://labtestsonline.org/assets/static-pages/Sample.html
McBride, C. M., Alford, S. H., Reid, R. J., Larson, E. B., Baxevanis, A. D., & Brody, L. C. (2009). Characteristics of users of online personalized genomic risk assessments: Implications for physician-patient interactions. Genetics in Medicine, 11, 582–587. doi:10.1097/GIM.0b013e3181b22c3a
Mireskandari, S., Meiser, B., Sherman, K., Warner, B. J., Andrews, L., & Tucker, K. M. (2006). Evaluation of the needs and concerns of partners of women at high risk of developing breast/ovarian cancer. Psycho-oncology, 15, 96–108.
National Health and Medical Research Council. (2012). Direct-to-consumer DNA genetic testing: An information resource for consumers. Retrieved 5th November, 2014 from https://www.nhmrc.gov.au/guidelines-publications/ps4
National Human Genome Research Institute. (2014). Regulation of genetic tests. http://www.genome.gov/10002335
National Institutes of Health. (2013). Confused by genetic tests? NIH’s new online tool may help. Retrieved 17th October, 2014 from http://www.nih.gov/news/health/feb2012/od-29.htm
Roberts, J. (2000). Anticipating response to predictive genetic testing for Alzheimer’s disease: A survey of first-degree relatives. The Gerontologist, 40, 43–52.
Roberts, J. S., & Ostergren, J. (2013). Direct-to-consumer genetic testing and personal genomics services: A review of recent empirical studies. Current Genetic Medicine Reports, 1, 182–200.
Senior, V., Marteau, T. M., & Weinman, J. (2000). Impact of genetic testing on causal models of heart disease and arthritis: An analogue study. Psychology & Health, 14, 1077–1088. doi:10.1080/08870440008407368
Shaw, B., & Bassi, K. (2001). Lay attitudes toward genetic testing for susceptibility to inherited diseases. Journal of Health Psychology, 6, 405–423.
Shiloh, S., Ben-Sinai, R., & Keinan, G. (1999). Effects of controllability, predictability, and information-seeking style on interest in predictive genetic testing. Personality and Social Psychology Bulletin, 25, 1187.
Su, P. (2013). Direct-to-consumer genetic testing: A comprehensive view. Yale J Biol Med, 86, 359–365.
Sweeny, K., & Legg, A. M. (2011). Predictors of interest in direct-to-consumer genetic testing. Psychology & Health, 26, 1–14. doi:10.1080/08870446.2010.514607
The Cochrane Collaboration. (2010). Does communicating DNA‐based risk estimates motivate people to change their behaviour? Retrieved 3rd November, 2014 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014386/
The Genetics and Public Policy Center. (2012). GPPC releases updated list of DTC genetic testing companies. Retrieved 28th October, 2014 from http://www.dnapolicy.org/news.release.php?action=detail&pressrelease_id=145
Trent, R. (2014). Direct-to-consumer DNA testing and the general practitioner. Australian Family Physician, 43, 436–439.
Vassy, J. L., Donelan, K., Hivert, M. F., Green, R. C., & Grant, R. W. (2013). Genetic susceptibility testing for chronic disease and intention for behavior change in healthy young adults. Journal of Community Genetics, 4, 263–271.
Werner, P., Goldstein, D., & Heinik, J. (2011). Development and validity of the Family Stigma in Alzheimer’s disease Scale (FS-ADS). Alzheimer Disease and Associated Disorders, 25, 42–48. doi:10.1097/WAD.0b013e3181f32594
Werner, P., & Heinik, J. (2008). Stigma by association and Alzheimer’s disease. Aging Mental Health, 12, 92–99.
Wilde, A., Meiser, B., Mitchell, P. B., & Schofield, P. R. (2010). Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: Preliminary findings. European Journal of Human Genetics, 18, 47–51. doi:10.1038/ejhg.2009.138
Wolff, K., Nordin, K., Brun, W., Berglund, G., & Kvale, G. (2011). Affective and cognitive attitudes, uncertainty avoidance and intention to obtain genetic testing: An extension of the theory of planned behaviour. Psychology & Health, 26, 1–13. doi:10.1080/08870441003763253
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Kerry Sherman, Laura-Kate Shaw, Katrina Champion, Fernanda Caldeira and Margaret McCaskill declare that they have no conflict of interest.
Human and animal rights and Informed Consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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Sherman, K., Shaw, LK., Champion, K. et al. The effect of disease risk probability and disease type on interest in clinic-based versus direct-to-consumer genetic testing services. J Behav Med 38, 706–714 (2015). https://doi.org/10.1007/s10865-015-9630-9
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DOI: https://doi.org/10.1007/s10865-015-9630-9