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Kite J, Chan L, MacKay K, Corbett L, Reyes-Marcelino G, Nguyen B, Bellew W, Freeman B. A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review. J Med Internet Res 2023; 25:e46345. [PMID: 37450325 PMCID: PMC10382952 DOI: 10.2196/46345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/27/2023] [Accepted: 04/19/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal. OBJECTIVE This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes. METHODS We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects. RESULTS We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. "Engagement" is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages. CONCLUSIONS Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of "engagement." TRIAL REGISTRATION PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287257.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Lilian Chan
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Kathryn MacKay
- Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Lucy Corbett
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Gillian Reyes-Marcelino
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia
- The Daffodil Centre, The University of Sydney and Cancer Council New South Wales, Camperdown, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - William Bellew
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Becky Freeman
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
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Reyes-Marcelino G, McLoughlin K, Harrison C, Watts CG, Kang YJ, Aranda S, Aitken JF, Guitera P, Cust AE. Skin cancer-related conditions managed in general practice in Australia, 2000-2016: a nationally representative, cross-sectional survey. BMJ Open 2023; 13:e067744. [PMID: 37142316 PMCID: PMC10186445 DOI: 10.1136/bmjopen-2022-067744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE Skin cancer is Australia's most common and costly cancer. We examined the frequency of Australian general practice consultations for skin cancer-related conditions, by patient and general practitioner (GP) characteristics and by time period. DESIGN Nationally representative, cross-sectional survey of general practice clinical activity. SETTING, PARTICIPANTS Patients aged 15 years or older having a skin cancer-related condition managed by GPs in the Bettering the Evaluation And Care of Health study between April 2000 and March 2016. PRIMARY OUTCOME MEASURES Proportions and rates per 1000 encounters. RESULTS In this period, 15 678 GPs recorded 1 370 826 patient encounters, of which skin cancer-related conditions were managed 65 411 times (rate of 47.72 per 1000 encounters, 95% CI 46.41 to 49.02). Across the whole period, 'skin conditions' managed were solar keratosis (29.87%), keratinocyte cancer (24.85%), other skin lesion (12.93%), nevi (10.98%), skin check (10.37%), benign skin neoplasm (8.76%) and melanoma (2.42%). Over time, management rates increased for keratinocyte cancers, skin checks, skin lesions, benign skin neoplasms and melanoma; but remained stable for solar keratoses and nevi. Skin cancer-related encounter rates were higher for patients aged 65-89 years, male, living in Queensland or in regional or remote areas, with lower area-based socioeconomic status, of English-speaking background, Veteran card holders and non-healthcare card holders; and for GPs who were aged 35-44 years or male. CONCLUSION These findings show the spectrum and burden of skin cancer-related conditions managed in general practice in Australia, which can guide GP education, policy and interventions to optimise skin cancer prevention and management.
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Affiliation(s)
- Gillian Reyes-Marcelino
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Kirstie McLoughlin
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Christopher Harrison
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Caroline G Watts
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Kirby Institute, UNSW, Sydney, NSW, Australia
| | - Yoon-Jung Kang
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Sanchia Aranda
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
- Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Anne E Cust
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
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Zhang R, Smit AK, Espinoza D, Allen M, Reyes-Marcelino G, Kimlin MG, Lo SN, Sharman AR, Law MH, Kanetsky PA, Mann GJ, Cust AE. Validation of self-reported sun exposure against electronic ultraviolet radiation dosimeters. Int J Epidemiol 2023; 52:324-328. [PMID: 36153755 DOI: 10.1093/ije/dyac179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 09/14/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ran Zhang
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Amelia K Smit
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Martin Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology, Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
| | - Gillian Reyes-Marcelino
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Michael G Kimlin
- School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Serigne N Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - Ashleigh R Sharman
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Queensland University of Technology (QUT), Brisbane, Australia
| | | | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia.,The John Curtin School of Medical Research, ANU College of Health and Medicine, ANU, Canberra, Australia
| | - Anne E Cust
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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So C, McCarthy D, Watts CG, Kearney C, Reyes-Marcelino G, Goldsbury DE, McLoughlin K, Emery J, Cust AE. Diagnostic biopsies of suspected skin cancer in general practice from 2010 to 2017 in Victoria, Australia. Br J Dermatol 2022; 188:560-561. [PMID: 36689340 DOI: 10.1093/bjd/ljac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Chi So
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Caroline G Watts
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | | | - Gillian Reyes-Marcelino
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,The Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - David E Goldsbury
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Kirstie McLoughlin
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Jon Emery
- Department of General Practice.,Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Services, The University of Melbourne, Melbourne, VIC, Australia
| | - Anne E Cust
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,The Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
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Lee Solano M, Robinson S, Allen MW, Reyes-Marcelino G, Espinoza D, Beswick B, Tse DH, Ding L, Humphreys L, Van Kemenade C, Dobbinson S, Smit AK, Cust AE. Effect of an interactive educational activity using handheld ultraviolet radiation dosimeters on sun protection knowledge among Australian primary school students. Prev Med Rep 2022; 25:101690. [PMID: 35127364 PMCID: PMC8800069 DOI: 10.1016/j.pmedr.2021.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/17/2021] [Accepted: 12/26/2021] [Indexed: 11/24/2022] Open
Abstract
This interactive educational activity incorporated handheld UV dosimeters. The intervention improved UV-related knowledge among primary school students. Knowledge about the UV Index improved the most. Knowledge about UV harms, sun protective clothing and behaviours also improved.
Ultraviolet radiation (UV) is the main cause of skin cancer, and children are a priority group for reducing UV exposure. We evaluated whether an interactive educational activity using handheld dosimeters improved UV-related knowledge among primary (elementary) school students. We conducted an uncontrolled before-after study among 427 students in grades 3–6 (ages 8–12 years) at five schools in the Greater Sydney region, Australia. Students used UV dosimeters to measure UV exposure, using the UV index scale, at different locations on their school grounds with and without different forms of sun protection, followed by an indoor classroom presentation and discussion. A 10-point anonymous questionnaire was completed by each student before and after the entire session (60–90 min). Before-after responses were compared using a generalised linear mixed model, adjusted for school, grade and gender. Overall, the mean raw scores increased from 6.3 (out of 10) before the intervention to 8.9 after the intervention, and the adjusted difference in scores was 2.6 points (95% confidence interval 2.4–2.8; p < 0.0001). Knowledge improved for all questions, with the greatest improvement for questions related to the UV Index (p < 0.05). The effect of the intervention was similar across different school, grade and gender groups. School and grade had no significant effect on mean survey scores, but girls scored an average 0.2 points higher than boys (95% confidence interval 0.1–0.4; p = 0.01). In conclusion, Australian primary school students had moderate knowledge about UV and sun protection, and knowledge improved significantly after a short interactive educational activity using handheld UV dosimeters.
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Smit AK, Allen M, Beswick B, Butow P, Dawkins H, Dobbinson SJ, Dunlop KL, Espinoza D, Fenton G, Kanetsky PA, Keogh L, Kimlin MG, Kirk J, Law MH, Lo S, Low C, Mann GJ, Reyes-Marcelino G, Morton RL, Newson AJ, Savard J, Trevena L, Wordsworth S, Cust AE. Impact of personal genomic risk information on melanoma prevention behaviors and psychological outcomes: a randomized controlled trial. Genet Med 2021; 23:2394-2403. [PMID: 34385669 PMCID: PMC8629758 DOI: 10.1038/s41436-021-01292-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023] Open
Abstract
Purpose We evaluated the impact of personal melanoma genomic risk information on sun-related behaviors and psychological outcomes. Methods In this parallel group, open, randomized controlled trial, 1,025 Australians of European ancestry without melanoma and aged 18–69 years were recruited via the Medicare database (3% consent). Participants were randomized to the intervention (n = 513; saliva sample for genetic testing, personalized melanoma risk booklet based on a 40-variant polygenic risk score, telephone-based genetic counseling, educational booklet) or control (n = 512; educational booklet). Wrist-worn ultraviolet (UV) radiation dosimeters (10-day wear) and questionnaires were administered at baseline, 1 month postintervention, and 12 months postbaseline. Results At 12 months, 948 (92%) participants completed dosimetry and 973 (95%) the questionnaire. For the primary outcome, there was no effect of the genomic risk intervention on objectively measured UV exposure at 12 months, irrespective of traditional risk factors. For secondary outcomes at 12 months, the intervention reduced sunburns (risk ratio: 0.72, 95% confidence interval: 0.54–0.96), and increased skin examinations among women. Melanoma-related worry was reduced. There was no overall impact on general psychological distress. Conclusion Personalized genomic risk information did not influence sun exposure patterns but did improve some skin cancer prevention and early detection behaviors, suggesting it may be useful for precision prevention. There was no evidence of psychological harm.
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Affiliation(s)
- Amelia K Smit
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Martin Allen
- Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
| | - Brooke Beswick
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Hugh Dawkins
- Division of Genetics, School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,School of Medicine, The University of Notre Dame, Notre Dame, NSW, Australia
| | | | - Kate L Dunlop
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
| | - Georgina Fenton
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia
| | - Peter A Kanetsky
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Louise Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael G Kimlin
- Queensland University of Technology, School of Biomedical Sciences, Brisbane, QLD, Australia
| | - Judy Kirk
- Westmead Clinical School and Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Serigne Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Cynthia Low
- Consumer representative, Brisbane, QLD, Australia
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,The John Curtin School of Medical Research, ANU College of Health and Medicine, ANU, ACT, Canberra, Australia
| | - Gillian Reyes-Marcelino
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia
| | - Rachael L Morton
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
| | - Ainsley J Newson
- Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Jacqueline Savard
- School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Lyndal Trevena
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Wordsworth
- Health Economics Research Centre, The University of Oxford, Oxford, UK
| | - Anne E Cust
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, NSW, Sydney, Australia. .,Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.
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Reyes-Marcelino G, Tabbakh T, Espinoza D, Sinclair C, Kang YJ, McLoughlin K, Caruana M, Fernández-Peñas P, Guitera P, Aitken JF, Canfell K, Dobbinson S, Cust AE. Prevalence of skin examination behaviours among Australians over time. Cancer Epidemiol 2020; 70:101874. [PMID: 33341599 DOI: 10.1016/j.canep.2020.101874] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND We aimed to examine the prevalence and correlates of opportunistic skin check behaviours among Australians and whether changes over time might explain increasing underlying rates of melanoma in situ. METHODS The National Sun Protection Survey involved periodic telephone-based cross-sectional surveys during summer since 2003. Skin checks by a doctor in the past 12 months was asked in four summers over 2006-2017, and responses from 23,374 Australians aged 12-69 years were analysed. Prevalence estimates were weighted to be representative of the Australian population. Chi-square tests compared the prevalence over time and by characteristics. RESULTS The overall proportion reporting whole-body skin checks in the past 12 months was 20 % in 2006-07 and 2010-11, 21 % in 2013-14, and 22 % in 2016-17; but increased from 29 % in 2006-07 to 37 % in 2016-17 for those aged 45-69 years (p < 0.0001). In 2016-17, 5% reported a skin check of part-body and 9% for a specific mole or spot. The proportion reporting no skin checks increased from 61 % to 64 % over time (p < 0.0001). Whole-body skin checks were more common among older respondents, females, and also varied by residence location, skin sensitivity, skin colour, risk perception, and socio-economic index (all p < 0.001). CONCLUSION Approximately one third of Australians had their skin checked by a doctor within a 12-month period, but this varied across population sub-groups. Skin check behaviours were relatively stable over time, with modest increases in the prevalence of skin checks for those aged 45-69 years. These findings do not explain underlying large increases in rates of melanoma in situ.
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Affiliation(s)
- Gillian Reyes-Marcelino
- Sydney School of Public Health, Building A27, The University of Sydney, NSW 2006, Australia.
| | - Tamara Tabbakh
- Cancer Council Victoria, 615St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, NSW 2006, Australia.
| | - Craig Sinclair
- Cancer Council Victoria, 615St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - Yoon-Jung Kang
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Kirstie McLoughlin
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Michael Caruana
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Pablo Fernández-Peñas
- Department of Dermatology, Westmead Clinical School, The University of Sydney, NSW 2006, Australia.
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, 40 Rocklands Rd, Wollstonecraft, NSW 2065, Australia; Department of Dermatology, Central Clinical School, The University of Sydney, NSW 2006, Australia; Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, NSW 2050, Australia.
| | - Joanne F Aitken
- Cancer Council Queensland, 553 Gregory Terrace, Fortitude Valley, QLD 4006, Australia.
| | - Karen Canfell
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Suzanne Dobbinson
- Cancer Council Victoria, 615St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - Anne E Cust
- Sydney School of Public Health, Building A27, The University of Sydney, NSW 2006, Australia; Melanoma Institute Australia, The University of Sydney, 40 Rocklands Rd, Wollstonecraft, NSW 2065, Australia.
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Smit AK, Reyes-Marcelino G, Keogh L, Dunlop K, Newson AJ, Cust AE. Implementation considerations for offering personal genomic risk information to the public: a qualitative study. BMC Public Health 2020; 20:1028. [PMID: 32600382 PMCID: PMC7325160 DOI: 10.1186/s12889-020-09143-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/18/2020] [Indexed: 12/17/2022] Open
Abstract
Background Genomic risk information, based on common genomic susceptibility variants associated with risk of complex diseases such as cancer, may be incorporated into personalised prevention and screening strategies. We aimed to engage with members of the public, who are important stakeholders in this process, to further inform program development and other implementation outcomes such as acceptability and appropriateness. Methods Semi-structured interviews were undertaken with 30 participants (aged 24–69 years, 50% female) recruited from a pilot trial in which they received personalised genomic risk information for melanoma. We explored participants’ views and attitudes towards offering general personal genomic risk information to the broader population. The data were analysed thematically. Results Two overarching themes relevant to implementation considerations were identified. Firstly, participants’ preferences for accepting an offer of genomic risk information were based on family history, disease incidence and the possibility of prevention. Secondly, participants felt that the processes for offering risk information should be based on individual preferences, triaged according to risk and be supported by a health professional trained in genomics. Conclusions Participants felt that offering personal genomic risk information to the general population to inform prevention and early detection recommendations is acceptable, particularly for common, complex conditions such as cancer. Understanding participants’ preferences for receiving genomic risk information will assist with communication strategies and health workforce planning. We anticipate that these findings will contribute to the development of implementation strategies for incorporating genomic risk information into routine clinical practice.
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Affiliation(s)
- Amelia K Smit
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, Australia. .,Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, The University of Sydney, Sydney, Australia. .,Melanoma Institute Australia, The University of Sydney, Sydney, Australia.
| | - Gillian Reyes-Marcelino
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, Australia
| | - Louise Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Kate Dunlop
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, Australia
| | - Ainsley J Newson
- Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, The University of Sydney, Sydney, Australia
| | - Anne E Cust
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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Smit AK, Reyes-Marcelino G, Keogh L, Cust AE, Newson AJ. 'There is a lot of good in knowing, but there is also a lot of downs': public views on ethical considerations in population genomic screening. J Med Ethics 2020; 47:medethics-2019-105934. [PMID: 32434901 DOI: 10.1136/medethics-2019-105934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 06/11/2023]
Abstract
Publics are key stakeholders in population genomic screening and their perspectives on ethical considerations are relevant to programme design and policy making. Using semi-structured interviews, we explored social views and attitudes towards possible future provision of personalised genomic risk information to populations to inform prevention and/or early detection of relevant conditions. Participants were members of the public (n=30) who had received information on their personal genomic risk of melanoma as part of a research project. The focus of the analysis presented here is participants' views regarding ethical considerations relevant to population genomic screening more generally. Data were analysed thematically and four key themes related to ethical considerations were identified: (i) personal responsibility for health: 'forewarned is forearmed'; (ii) perceptions of, and responses to, genetic fatalism; (iii) implications for parenting and reproduction; (iv) divided views on choosing to receive genomic risk information. Ethical considerations underlying these themes include the valorisation of information and choice, paternalism, non-directiveness and increasing responsibilisation of individuals in health and healthcare. These findings arguably indicate a thin public conceptualisation of population genomic testing, which draws heavily on how these themes tend to be described in existing social discourses. Findings suggest that further public engagement is required to increase complexity of debate, to consider (for example) the appropriate place of individual and social interests in population genomic testing. Further discernment of relevant ethical approaches, drawing on ethical frameworks from both public health and clinical settings, will also assist in determining the appropriate implementation of population genomic screening for complex conditions.
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Affiliation(s)
- Amelia K Smit
- Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Gillian Reyes-Marcelino
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anne E Cust
- Faculty of Medicine and Health, Sydney School of Public Health, Cancer Epidemiology and Prevention Research, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Ainsley J Newson
- Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, The University of Sydney, Sydney, New South Wales, Australia
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Chau JY, Reyes-Marcelino G, Burnett ACR, Bauman AE, Freeman B. Hyping health effects: a news analysis of the ‘new smoking’ and the role of sitting. Br J Sports Med 2018; 53:1039-1040. [DOI: 10.1136/bjsports-2018-099432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 11/04/2022]
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