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Wong H, Sheehan J, Sung V, Best S, Leigh G. Cultural diversity in early hearing detection and intervention: service provider perspectives. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2025:enaf002. [PMID: 40073445 DOI: 10.1093/jdsade/enaf002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 10/22/2024] [Accepted: 12/02/2024] [Indexed: 03/14/2025]
Abstract
This study investigated service providers' perspectives on the barriers experienced by families from culturally and linguistically diverse backgrounds along the Early Hearing Detection and Intervention (EHDI) pathway in Victoria, Australia. Twelve service providers (i.e., hearing screening program staff and diagnostic audiologists) participated in semi-structured interviews. Data were analyzed using inductive content analysis. Service providers identified differences in service delivery, communication, and support needs between families from culturally and linguistically diverse backgrounds and those from majority cultural and linguistic (predominantly English-speaking) backgrounds. Perceived barriers included communication difficulties, lack of access to interpreters and translated written resources, cultural factors, and practical barriers to attending appointments. Clarifying the roles of service providers, providing access to resources to support communication, and requiring service providers to participate in cultural responsiveness training are suggested as strategies to improve services for families from culturally and linguistically diverse backgrounds. Findings from this study inform service provision throughout the EHDI pathway to improve care for families from culturally and linguistically diverse backgrounds.
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Affiliation(s)
- Hayley Wong
- NextSense Institute, Sydney, Australia
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Prevention Innovation, Population Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jane Sheehan
- Prevention Innovation, Population Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre of Community Child Health, Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Valerie Sung
- Prevention Innovation, Population Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre of Community Child Health, Royal Children's Hospital Melbourne, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Stephanie Best
- Australian Genomics, Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Greg Leigh
- NextSense Institute, Sydney, Australia
- Macquarie School of Education, Macquarie University, Sydney, Australia
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2
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Nankya H, Alibu VP, Wamala E, Matovu E, Barugahare J. Understanding of Key Considerations for Effective Community Engagement in Genetics and Genomics Research: A Qualitative Study of the Perspectives of Research Ethics Committee Members and National Research Regulators in a low Resource Setting. J Empir Res Hum Res Ethics 2024; 19:197-207. [PMID: 39431418 DOI: 10.1177/15562646241289015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2024]
Abstract
To attain effective community engagement (CE) for genetics and genomics research (GGR) is a challenge. This study aimed to analyzed participants' perspectives on how to attain effective CE for GGR in Uganda. A cross-sectional qualitative study involving in-depth interviews with twenty research ethics committee members and three national research regulators was conducted. GGR is faced with; low genetic literacy among stakeholders, social implications, cultural attitudes towards GGR, and lack of specific guidelines for CE in GGR. Attaining effective CE in GGR should involve; development of guidelines for GGR streamlining CE; boosting stakeholders' Knowledge in GGR and CE; engagement beyond sensitization; and consensus decision-making. Overall, attaining effective CE in GGR requires addressing the key aspects unique to GGR.
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Affiliation(s)
- Harriet Nankya
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Vincent Pius Alibu
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Edward Wamala
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Enock Matovu
- Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - John Barugahare
- Department of Philosophy, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
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Dall G, Harris K, Chan N, Luen SJ, Frentzas S, Day D, Barrett M, Kilgour A, Buzza M. Equitable Access to Genomic Molecular Testing for Australian Cancer Patients: Insights from the Victorian Precision Oncology Summit. Curr Oncol 2024; 31:4519-4530. [PMID: 39195320 PMCID: PMC11352575 DOI: 10.3390/curroncol31080337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/26/2024] [Accepted: 07/31/2024] [Indexed: 08/29/2024] Open
Abstract
The Victorian Precision Oncology Summit, convened in 2023, was a joint initiative between the Victorian Comprehensive Cancer Centre Alliance (VCCC Alliance) and the Monash Partners Comprehensive Cancer Consortium (MPCCC) and was proposed to guide a coordinated state-wide conversation about how the oncology sector can overcome some of the current obstacles in achieving equity of access to clinical cancer genomics for Victorian patients. Themes that emerged from discussion groups at the Summit include standardisation, centralisation, funding, education and communication and insights across those themes are outlined in this manuscript. The event served as a large consultation piece for the development of a broader precision oncology roadmap, which explores equitable access to molecular testing for Victorian patients, currently in development by the VCCC Alliance and MPCCC in collaboration with other key Victorian and national stakeholders. While this symposium was a Victorian initiative, it is felt that the insights garnered from this consultation piece will be of interest to consumer groups, clinicians, researchers, educators, policy makers and other key stakeholders in other states of Australia as well as in other countries implementing comprehensive genomic profiling within complex health systems.
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Affiliation(s)
- Genevieve Dall
- Victorian Comprehensive Cancer Centre Alliance (VCCC Alliance), Victorian Comprehensive Cancer Centre, Parkville, VIC 3052, Australia; (G.D.); (M.B.)
| | - Karen Harris
- Monash Partners Comprehensive Cancer Consortium (MPCCC), Monash University, Clayton, VIC 3800, Australia
| | - Nonie Chan
- Victorian Comprehensive Cancer Centre Alliance (VCCC Alliance), Victorian Comprehensive Cancer Centre, Parkville, VIC 3052, Australia; (G.D.); (M.B.)
| | - Stephen J. Luen
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC 3052, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC 3052, Australia
| | - Sophia Frentzas
- Department of Medical Oncology, Monash Health and Monash University, Clayton, VIC 3168, Australia
| | - Daphne Day
- Department of Medical Oncology, Monash Health and Monash University, Clayton, VIC 3168, Australia
| | - Michelle Barrett
- Victorian Comprehensive Cancer Centre Alliance (VCCC Alliance), Victorian Comprehensive Cancer Centre, Parkville, VIC 3052, Australia; (G.D.); (M.B.)
| | - Anna Kilgour
- Monash Partners Comprehensive Cancer Consortium (MPCCC), Monash University, Clayton, VIC 3800, Australia
| | - Mark Buzza
- Victorian Comprehensive Cancer Centre Alliance (VCCC Alliance), Victorian Comprehensive Cancer Centre, Parkville, VIC 3052, Australia; (G.D.); (M.B.)
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Martyn M, Forbes E, Lee L, Kanga-Parabia A, Weerasuriya R, Lynch E, Gleeson P, Gaff C. Secondary use of genomic data: patients' decisions at point of testing and perspectives to inform international data sharing. Eur J Hum Genet 2024; 32:717-724. [PMID: 38528053 PMCID: PMC11153578 DOI: 10.1038/s41431-023-01531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/14/2023] [Accepted: 12/19/2023] [Indexed: 03/27/2024] Open
Abstract
International sharing of genomic data files arising from clinical testing of patients is essential to further improve genomic medicine. Whilst the general public are reluctant to donate DNA for research, the choices patients actually make about sharing their clinical genomic data for future re-use (research or clinical) are unknown. We ascertained the data-sharing choices of 1515 patients having genomic testing for inherited conditions or cancer treatment from clinical consent forms. To understand the experiences and preferences of these patients, surveys were administered after test consent (RR 73%). Almost all patients (98%) consented to share their data. Survey respondents' decision recall was high (90%), but poorer if English was an additional language (p < 0.001). Parents deciding on behalf of children were over-represented amongst data-sharing decliners (p = 0.047) and decliners were more likely to believe that stored data could be easily reidentified (p < 0.001). A quarter of respondents did not know if reidentification would be easy and 44% of them were concerned about this possibility. Of those willing to share data overseas (60%), 23% indicated the recipient researcher's country would affect their decision. Most respondents (89%) desired some ongoing control over research use of their data. Four preliminary data-sharing profiles emerged; their further development could inform tailored patient resources. Our results highlight considerations for establishment of systems to make clinical genomic data files available for reanalysis locally and across borders. Patients' willingness to share their data - and value of the resulting research - should encourage clinical laboratories to consider sharing data systematically for secondary uses.
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Affiliation(s)
- Melissa Martyn
- Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Emily Forbes
- Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia
| | - Ling Lee
- Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Anaita Kanga-Parabia
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia
- Victorian Clinical Genetics Services, Parkville, VIC, 3052, Australia
| | - Rona Weerasuriya
- Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia
| | - Elly Lynch
- Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia
- Victorian Clinical Genetics Services, Parkville, VIC, 3052, Australia
| | - Penny Gleeson
- Deakin Law school, Deakin University, Burwood, VIC, 3125, Australia
| | - Clara Gaff
- Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.
- Melbourne Genomics Health Alliance, Parkville, VIC, 3052, Australia.
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3052, Australia.
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Oladayo AM, Odukoya O, Sule V, Molobe I, Busch T, Akodu B, Adeyemo WL, Gowans LJJ, Eshete M, Alade A, Awotoye W, Adeyemo AA, Mossey PA, Prince AER, Murray JC, Butali A. Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research. BMC Public Health 2024; 24:507. [PMID: 38365612 PMCID: PMC10873930 DOI: 10.1186/s12889-024-17987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort. METHODS Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis. RESULTS Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI. CONCLUSIONS Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.
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Affiliation(s)
- Abimbola M Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - Lord J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- School of Medicine, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
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6
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Beauchesne R, Birch P, GenCOUNSEL Study, Elliott AM. Genetic counselling resources in non-english languages: A scoping review. PEC INNOVATION 2023; 2:100135. [PMID: 37214519 PMCID: PMC10194398 DOI: 10.1016/j.pecinn.2023.100135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 05/24/2023]
Abstract
Objective Genetic counselling is essential for individuals seeking genetic or genomic testing. Whereas innovative strategies for GC delivery are being explored to meet the growing demand on the clinical genetics workforce, it is essential to consider the unique needs of culturally and linguistically diverse populations. Methods We conducted a scoping review to examine the extent, range, and gaps in the body of non-English, patient-facing educational resources available for Limited English Proficient (LEP) patients accessing clinical genetics and genomics services. Results The literature search returned 246 unique resources, most available in several languages. Forty-six languages were represented, with Spanish, Russian, and French being the most common. Resources were in various formats and were of varying quality. Conclusions There is a lack of high-quality supplementary genetics education material available in languages other than English, which limits the quality-of-care that LEP families may receive compared to their English-speaking counterparts. Of equal concern is the difficulty in finding existing resources and in determining their quality. Innovation This research highlights the important need for genetics education material that is of good quality in languages other than English and the challenges associated with identifying this material. A central, curated repository, perhaps sponsored by a genetic counselling organization, would be of great benefit to help genetic counsellors meet the needs of their culturally and linguistically diverse patients.
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Affiliation(s)
- Rhea Beauchesne
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patricia Birch
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - GenCOUNSEL Study
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alison M. Elliott
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Women's Health Research Institute, Vancouver, British Columbia, Canada
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7
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Hardcastle F, Lyle K, Horton R, Samuel G, Weller S, Ballard L, Thompson R, De Paula Trindade LV, Gómez Urrego JD, Kochin D, Johnson T, Tatz-Wieder N, Redrup Hill E, Robinson Adams F, Eskandar Y, Harriss E, Tsosie KS, Dixon P, Mackintosh M, Nightingale L, Lucassen A. The ethical challenges of diversifying genomic data: A qualitative evidence synthesis. CAMBRIDGE PRISMS. PRECISION MEDICINE 2023; 2:e1. [PMID: 38549845 PMCID: PMC10953735 DOI: 10.1017/pcm.2023.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/28/2023] [Accepted: 08/17/2023] [Indexed: 09/07/2024]
Abstract
This article aims to explore the ethical issues arising from attempts to diversify genomic data and include individuals from underserved groups in studies exploring the relationship between genomics and health. We employed a qualitative synthesis design, combining data from three sources: 1) a rapid review of empirical articles published between 2000 and 2022 with a primary or secondary focus on diversifying genomic data, or the inclusion of underserved groups and ethical issues arising from this, 2) an expert workshop and 3) a narrative review. Using these three sources we found that ethical issues are interconnected across structural factors and research practices. Structural issues include failing to engage with the politics of knowledge production, existing inequities, and their effects on how harms and benefits of genomics are distributed. Issues related to research practices include a lack of reflexivity, exploitative dynamics and the failure to prioritise meaningful co-production. Ethical issues arise from both the structure and the practice of research, which can inhibit researcher and participant opportunities to diversify data in an ethical way. Diverse data are not ethical in and of themselves, and without being attentive to the social, historical and political contexts that shape the lives of potential participants, endeavours to diversify genomic data run the risk of worsening existing inequities. Efforts to construct more representative genomic datasets need to develop ethical approaches that are situated within wider attempts to make the enterprise of genomics more equitable.
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Affiliation(s)
- Faranak Hardcastle
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Kate Lyle
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Rachel Horton
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Gabrielle Samuel
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- King’s College London, London, UK
| | - Susie Weller
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Lisa Ballard
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Rachel Thompson
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Luiz Valerio De Paula Trindade
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - José David Gómez Urrego
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Daniel Kochin
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Tess Johnson
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | | | - Florence Robinson Adams
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Centre for Science and Policy, University of Cambridge, Cambridge, UK
| | - Yoseph Eskandar
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | | | - Padraig Dixon
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | - Anneke Lucassen
- Clinical Ethics, Law and Society group (CELS), and Centre for Personalised Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Clinical Ethics, Law and Society (CELS), The NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
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8
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Communicating Personal Melanoma Polygenic Risk Information: Participants’ Experiences of Genetic Counseling in a Community-Based Study. J Pers Med 2022; 12:jpm12101581. [PMID: 36294720 PMCID: PMC9605561 DOI: 10.3390/jpm12101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Personalized polygenic risk information may be used to guide risk-based melanoma prevention and early detection at a population scale, but research on communicating this information is limited. This mixed-methods study aimed to assess the acceptability of a genetic counselor (GC) phone call in communicating polygenic risk information in the Melanoma Genomics Managing Your Risk randomized controlled trial. Participants (n = 509) received personalized melanoma polygenic risk information, an educational booklet on melanoma prevention, and a GC phone call, which was audio-recorded. Participants completed the Genetic Counseling Satisfaction Survey 1-month after receiving their risk information (n = 346). A subgroup took part in a qualitative interview post-study completion (n = 20). Survey data were analyzed descriptively using SPSS, and thematic analysis of the qualitative data was conducted using NVivo 12.0 software. The survey showed a high level of acceptability for the GC phone call (mean satisfaction score overall: 4.3 out of 5, standard deviation (SD): 0.6) with differences according to gender (mean score for women: 4.4, SD: 0.6 vs. men: 4.2, SD: 0.7; p = 0.005), health literacy (lower literacy: 4.1, SD: 0.8; average: 4.3, SD: 0.6; higher: 4.4, SD: 0.6: p = 0.02) and polygenic risk group (low risk: 4.5, SD: 0.5, SD: average: 4.3, SD: 0.7, high: 4.3, SD: 0.7; p = 0.03). During the GC phone calls, the discussion predominately related to the impact of past sun exposure on personal melanoma risk. Together our findings point to the importance of further exploring educational and support needs and preferences for communicating personalized melanoma risk among population subgroups, including diverse literacy levels.
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Vidgen ME, Fowles LF, Istiko SN, Evans E, Cutler K, Sullivan K, Bean J, Healy L, Hondow G, McInerney-Leo AM, Pratt G, Robins D, Best S, Finlay K, Ramarao-Milne P, Waddell N. Evaluation of a Genetics Education Program for Health Interpreters: A Pilot Study. Front Genet 2022; 12:771892. [PMID: 35186003 PMCID: PMC8850313 DOI: 10.3389/fgene.2021.771892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/29/2021] [Indexed: 11/21/2022] Open
Abstract
Health Interpreters enable effective communication between health practitioners and patients with limited knowledge of the predominant language. This study developed and evaluated a training session introducing Health Interpreters to genetics. The online training was delivered multiple times as a single 2-h session comprising lectures and activities. Participants completed questionnaires (pre-, post-, and 6-months follow-up) to assess the impact of training on knowledge, attitude, self-efficacy, and self-reported practice behaviour. Questionnaires were analysed using descriptive statistics, Fisher’s Exact, or independent t-test. In total, 118 interpreters participated in the training sessions. Respondent knowledge improved, with gains maintained at 6-months (p < 0.01). There were no changes in self-efficacy, and attitudes. Training did not change self-reported practice behaviour, but there was notable pre-existing variability in participants’ methods of managing unknown genetic words. Most respondents agreed that training was useful (93%) and relevant (79%) to their work. More respondents reported learning more from the case study activity (86%) than the group activity (58%). Health Interpreters found the training acceptable and demonstrated sustained improvement in knowledge of genetic concepts. Increased delivery of this training and associated research is needed to assess findings in a larger cohort and to measure the impact on patients.
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Affiliation(s)
- Miranda E. Vidgen
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- *Correspondence: Miranda E. Vidgen,
| | - Lindsay F. Fowles
- Genetic Health Queensland, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Satrio Nindyo Istiko
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Erin Evans
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
- Health Consumers Queensland, Brisbane, QLD, Australia
| | - Katrina Cutler
- Queensland Genomics, The University of Queensland, Brisbane, QLD, Australia
| | - Kate Sullivan
- Queensland Genomics, The University of Queensland, Brisbane, QLD, Australia
| | - Jessica Bean
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Louise Healy
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Gary Hondow
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Aideen M. McInerney-Leo
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Brisbane, QLD, Australia
| | - Gregory Pratt
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Deborah Robins
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
| | - Stephanie Best
- Australian Genomics, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Macquarie University, Sydney, NSW, Australia
| | - Keri Finlay
- Australian Genomics, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Genetic Support Network of Victoria, Melbourne, VIC, Australia
| | - Priya Ramarao-Milne
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Australian e-Health Research Centre, Health and Biosecurity, CSIRO, Brisbane, QLD, Australia
| | - Nicola Waddell
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Queensland Genomics Community Advisory Group, The University of Queensland, Brisbane, QLD, Australia
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10
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Bauss J, Morris M, Shankar R, Olivero R, Buck LN, Stenger CL, Hinds D, Mills J, Eby A, Zagorski JW, Smith C, Cline S, Hartog NL, Chen B, Huss J, Carcillo JA, Rajasekaran S, Bupp CP, Prokop JW. CCR5 and Biological Complexity: The Need for Data Integration and Educational Materials to Address Genetic/Biological Reductionism at the Interface of Ethical, Legal, and Social Implications. Front Immunol 2021; 12:790041. [PMID: 34925370 PMCID: PMC8674737 DOI: 10.3389/fimmu.2021.790041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023] Open
Abstract
In the age of genomics, public understanding of complex scientific knowledge is critical. To combat reductionistic views, it is necessary to generate and organize educational material and data that keep pace with advances in genomics. The view that CCR5 is solely the receptor for HIV gave rise to demand to remove the gene in patients to create host HIV resistance, underestimating the broader roles and complex genetic inheritance of CCR5. A program aimed at providing research projects to undergraduates, known as CODE, has been expanded to build educational material for genes such as CCR5 in a rapid approach, exposing students and trainees to large bioinformatics databases and previous experiments for broader data to challenge commitment to biological reductionism. Our students organize expression databases, query environmental responses, assess genetic factors, generate protein models/dynamics, and profile evolutionary insights into a protein such as CCR5. The knowledgebase generated in the initiative opens the door for public educational information and tools (molecular videos, 3D printed models, and handouts), classroom materials, and strategy for future genetic ideas that can be distributed in formal, semiformal, and informal educational environments. This work highlights that many factors are missing from the reductionist view of CCR5, including the role of missense variants or expression of CCR5 with neurological phenotypes and the role of CCR5 and the delta32 variant in complex critical care patients with sepsis. When connected to genomic stories in the news, these tools offer critically needed Ethical, Legal, and Social Implication (ELSI) education to combat biological reductionism.
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Affiliation(s)
- Jacob Bauss
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Michele Morris
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Rama Shankar
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Rosemary Olivero
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Infectious Disease, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - Leah N Buck
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Mathematics, University of North Alabama, Florence, AL, United States
| | - Cynthia L Stenger
- Department of Mathematics, University of North Alabama, Florence, AL, United States
| | - David Hinds
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Joshua Mills
- Department of Biology, Grand Valley State University, Allendale, MI, United States
| | - Alexandra Eby
- Department of Science, Davenport University, Grand Rapids, MI, United States
| | - Joseph W Zagorski
- Office of Research, Spectrum Health, Grand Rapids, MI, United States
| | - Caitlin Smith
- Department of Biology, Athens State University, Athens, AL, United States
| | - Sara Cline
- Department of Biology, Athens State University, Athens, AL, United States
| | - Nicholas L Hartog
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Allergy & Immunology, Spectrum Health, Grand Rapids, MI, United States
| | - Bin Chen
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
| | - John Huss
- Department of Philosophy, The University of Akron, Akron, OH, United States
| | - Joseph A Carcillo
- Department of Critical Care Medicine and Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Surender Rajasekaran
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Office of Research, Spectrum Health, Grand Rapids, MI, United States.,Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
| | - Caleb P Bupp
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Medical Genetics, Spectrum Health, Grand Rapids, MI, United States
| | - Jeremy W Prokop
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States
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