Educational Needs of Primary Care Physicians Regarding Direct-to-Consumer Genetic Testing

To assess the educational needs of North Carolina primary care physicians (PCPs) about direct-to-consumer (DTC) genetic testing, surveys were mailed to 2,402 family and internal medicine providers in North Carolina. Out of 382 respondents, 323 (85%) felt unprepared to answer patient questions and 282 (74%) reported wanting to learn about DTC genetic testing. A total of 148 (39%) were aware of DTC genetic testing. Among these, 63 (43%) thought DTC genetic testing was clinically useful. PCPs who felt either unprepared to answer patient questions (OR = 0.354, p = 0.01) or that DTC genetic testing was clinically useful (OR = 5.783, p = 0.00) were more likely to want to learn about DTC genetic testing. PCPs are interested in learning about DTC genetic testing, but are mostly unaware of DTC testing and feel unprepared to help patients with DTC testing results. Familiar and trusted channels that provide the information and tools PCPs need to help answer patient’s questions and manage their care should be used when creating educational programs.     

Primary Care Physicians’ Awareness, Experience and Opinions of Direct-to-Consumer Genetic Testing

The purpose of this study was to assess primary care physicians’ awareness, experience, opinions and preparedness to answer patients’ questions regarding direct-to-consumer (DTC) genetic testing. An anonymous survey was mailed to 2,402 family and internal medicine providers in North Carolina. Of the 382 respondents, 38.7% (n = 148) were aware of and 15% (n = 59) felt prepared to answer questions about DTC genetic tests. Respondents aged 50 or older were more likely to be aware of DTC genetic testing than those less than 40 years old (OR = 2.42). Male providers were more likely to feel prepared to answer questions than female providers (OR = 2.65). Among respondents who reportedly were aware, family practitioners were more likely than internists (OR = 3.30) to think DTC testing was clinically useful, and 18.9% had patients ask questions or bring in test results. The small percent of physicians who were aware of DTC genetic testing or felt prepared to answer questions about it suggests that education of providers will be necessary if testing becomes more widespread.     

Awareness and Preferences Regarding <Emphasis Type="Italic">BRCA1/2</Emphasis> Genetic Counseling and Testing Among Latinas and Non-Latina White Women at Increased Risk for Hereditary Breast and Ovarian Cancer

This study was an investigation of awareness, cognitions, and psychosocial and educational needs related to genetic counseling and testing among Latinas and non-Latina whites at increased risk for having a BRCA1/2 mutation. Sixty-three Latina and eighty-four non-Latina white women completed telephone surveys employing a mixture of quantitative and qualitative questions assessing awareness, benefits, risks, barriers, and genetic counseling communication preferences regarding BRCA1/2 testing. Among participants who had not previously had genetic counseling/testing, 56.9% of Latinas (29/51) and 34.8% of non-Latina white participants (24/69) were unaware of the availability of BRCA1/2 testing. In multivariate logistic regression analysis, Latina ethnicity was the only statistically significant independent factor associated with lack of awareness (OR = 0.42; 95% CI = 0.19–0.35). No appreciable differences were noted between ethnic groups regarding perceived benefits of BRCA1/2 testing or desired genetic counseling topics. These findings underscore the importance of increasing awareness of cancer genetic counseling and genetic testing among both Latina and non-Latina white populations.     

Examining Race and Ethnicity in the Context of General Strain Theory,Depression, and Delinquency

The current study draws on general strain theory (GST) to explore the relationship between strain, race, and delinquent behavior. White, black, and Hispanic youth were examined to assess the effect of strain on nonserious and serious delinquency. Results indicate mixed support for GST in that indicators of strain to varying degrees predicted depression and youth involvement in delinquency. However, depression did not mediate the strain–delinquency relationship, and race and ethnicity were still directly related to delinquent coping. While white, black, and Hispanic youth experienced certain types of strain, these groups overall were not statistically different from one another.     

Acculturation and Familiarity With, Attitudes Towards and Beliefs about Genetic Testing for Cancer Risk Within Latinas in East Harlem, New York City

Recent research underscores the need for increasing use of genetic testing for cancer risk in Latinos. This study examined the influence of acculturation on attitudes, beliefs about and familiarity with genetic testing for cancer risk in a community-based sample of Latinas in East Harlem, New York City (N = 103). Multivariate linear regression models analyzed the relationship of acculturation to: (1) familiarity (2) perceived benefits (3) perceived barriers and (4) concerns about abuses of genetic testing for cancer risk. Controlling for sociodemographic factors, results revealed that with increasing acculturation Latinas were more familiar with genetic testing (β = 1.62, SE = 0.72, p = 0.03), more likely to cite perceived benefits (β = 1.67, SE = 0.79, p = 0.04), and less likely to report perceived barriers related to genetic testing (β = −2.76, SE = 1.64, p = 0.10). Study results may help inform the development of culturally-appropriate health education outreach materials and programs targeted to increase awareness, knowledge and understanding about genetic testing for cancer risk within Latinas.     

Awareness,Perceptions, and Provider Recommendation Related to Genetic Testing for Hereditary Breast Cancer Risk among At-Risk Hispanic Women: Similarities and Variations by Sub-Ethnicity

This study explored awareness of risk factors for hereditary breast and ovarian cancer (HBOC), awareness, knowledge and concerns about genetic testing, and preference for how to have genetic testing recommended by a care provider among at-risk Hispanic women. Differences in these factors among Mexican, Cuban, and Puerto Rican women were also examined. Women with a personal or family history of breast or ovarian cancer from the Tampa Bay Area participated in a qualitative interview (N = 53). Data were analyzed using a combination of open and axial coding with a grounded theory approach. Study participants in all groups reported: being aware that family history was a breast cancer risk factor, limited knowledge of genetic testing, fear of test results, concerns about children’s risks, and no physician referral for genetic testing. Noteworthy sub-ethnic differences included preferences for physician recommendation and information about genetic testing. This study provides important preliminary information about areas related to HBOC that require additional education in the Hispanic community as a whole and by sub-ethnicity.     

Awareness and Attitudes Regarding Prenatal Testing among Texas Women of Childbearing Age

Despite increased visibility and availability of prenatal testing procedures, very little is known about the attitudes among the populace toward these procedures. Using a computer assisted telephone interview of pregnant and non-pregnant women of childbearing age we analyze awareness and attitudes regarding prenatal tests among a diverse group of women of childbearing age in Texas. We also examine maternal characteristics associated with awareness and the willingness to undergo these procedures. While 89% were aware that such tests are available, younger, black and less educated women were less likely to know about prenatal tests for birth defects. Seventy-two percent of respondents said they would want their baby tested while Hispanic and black women were significantly more likely to express an interest than non-Hispanic whites. This study demonstrates the variability of knowledge and beliefs and confirms the importance of taking time to understand an individual’s personal beliefs, knowledge and attitudes about prenatal diagnosis.     

Youth Developmental Assets and Perceived Life Satisfaction: Is There a Relationship?

This study explored associations between youth developmental assets (i.e., support by parents/other adults; accountability to adults; empowerment; school support; values regarding risk behaviors; quantity of other adult support; empathetic relationships) and adolescents’ perceptions of overall life satisfaction. Public high school students (N = 3,477) completed a self-report questionnaire. Analyses were conducted to examine relationships between developmental assets and perceived life satisfaction while controlling for socioeconomic status. Results indicated that significant (p ≤ .05) associations were established for perceived support by parents/other adults for all four race/gender groups, self and peer values regarding risk behavior for black females, quality of other adult support for black males and white females and life satisfaction for adolescents. Significant (p ≤ .05) associations were also established for perceived support by parents/other adults for White males and Black males, accountability to parents/other adults for White females, quality of other adult support for White males and Black females and for empathetic relationships for all four race/gender groups. Results suggest that perceived life satisfaction is related to youth developmental assets, although moderated by gender and race differences. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with youth developmental assets in order to develop gender appropriate and culturally sensitive health promotion programs.     

Variables Associated With Adolescent Alcohol Use: A Multiethnic Comparison

Abstract

The authors examined the influence of sociodemographic variables on the frequency and intensity of alcohol use among a nationally representative sample of Black, Hispanic, and White adolescents who had participated in the 1991 National Household Survey on Drug Abuse (U.S. Department of Health and Human Services, 1993). The sample consisted of 8,756 U.S. adolescents aged 12 to 18 years. The authors found that (a) approximately 19% of the respondents had used alcohol in the last 30 days; (b) among the respondents who had used alcohol, 21% had consumed 1 or more drinks per drinking episode; and (c) there were important similarities as well as important differences in variables that promoted alcohol use among Black, Hispanic, and White adolescents.     

Teacher and parent perceptions of behavior problems among a sample of African American,Hispanic, and non-Hispanic white studients

A multiracial/multiethnic sample of middle school adolescents and their teachers was used to assess whether teacher ratings of student behavior problems varied according to teacher-student racial/ethnic differences and students' perception of teachers' attitudes toward them. No significant mean score differences were found for Hispanic or non-Hispanic white students according to the race/ethnicity of the teachers doing the ratings. However, African American students rated by Hispanic and non-Hispanic white teachers had significantly higher mean total behavior problem scores than African American students rated by African American teachers. Teacher ratings were also compared to those made by parents. The percentage of students rated as cases by teachers but not by parents differed significantly by race/ethnicity of student. Other findings indicated highly significant relationships between student-perceived teacher disparagement and the assignment of high behavior problem scores to students by teachers. This research was supported by a grant from the National Institute on Drug Abuse, R01DA05912; William A. Vega, Principal Investigator. The authors express their appreciation to Superintendent Octavio Visiedo, Dr. James Mennes, Dr. Sylvia Rothfarb, and the cooperating staff and teachers of the Dade County Public Schools for their support in the conduct of this research.     

Anxiety Symptoms and Fears in Hispanic and European American Children: Cross-Cultural Measurement Equivalence

The cross cultural equivalence of child (n = 217) and parent (n = 283) versions of the revised children’s manifest anxiety scale (RCMAS), multidimensional anxiety scale for children (MASC), and the fear survey schedule for children—revised (FSSC-R) was examined in Mexican youth in Mexico, and Hispanic and white European American youth in the USA. The RCMAS, MASC, and FSSC-R showed cross ethnic measurement equivalence. The Mexican and Hispanic youth reported more worries, and the Mexican youth reported more somatic symptoms than the European American youth. Per mother report, Mexican and Hispanic youth express more somatic symptoms than European American youth who also show the least number of fears of the unknown and fears of danger and death. The results support the validity of commonly used child anxiety measures with these populations and accrue evidence for greater anxiety and fear expression by Hispanic and Mexican youth in certain domains.

Media Coverage of Direct-to-Consumer Genetic Testing

Media coverage of Direct-to-Consumer (DTC) genetic testing shapes public perception of such testing. The purpose of this study was to determine and assess the themes presented by U.S. news media regarding DTC genetic testing. We performed a Lexis-Nexis search with the keywords “Direct-to-Consumer” and “genetic test” for news stories published from 2006–2009. The sample was coded on themes of genetic determinism, privacy, discrimination, validity, regulation, the Genetic Information Nondiscrimination Act (GINA), utility, and cost. Ninety-two news stories were included. Stories displayed moderate genetic determinism and were neutral about validity and utility. Stories indicated that insurance and employers were the most likely sources of discrimination, yet identified the physicians and DTC companies as groups most likely to violate privacy. Stories claimed lack of regulation would harm consumers, but most post-GINA stories did not discuss the law. The costs of tests were frequently included. The results of this study show a broad range of views toward DTC genetic testing and its potential impacts. The genetics community should be aware that the public has been exposed to multiple views of DTC genetic testing when discussing these tests.     

Comparison of the PPVT, PPVT-R, and intelligence tests used for the placement of black, white and hispanic EMR students

Comparisons of the revised PPVT (PPVT-R), the PPVT, and placement IQ tests were made with 114 EMR students, 46 white, 44 black, and 24 Hispanic. The PPVT and PPVT-R correlate substantially for all three ethnic groups, but neither the PPVT nor PPVT-R, correlates to a significant degree with the placement IQ tests. Sizeable mean score differences were obtained on the PPVT, PPVT-R, and placement IQ tests as a function of test differences and text x race interactions.     

Health-Related Hindrance of Personal Goals of Adolescents with Cancer: The Role of the Interaction of Race/Ethnicity and Income

This study examined the interaction of race/ethnicity and income to health-related hindrance (HRH) of personal goals of adolescents with cancer. Adolescents (N = 94) receiving treatment for cancer completed a measure of HRH, (including identification of personal goals, rating the impact of health on goal pursuit, and ratings of goal appraisals). The interaction of race/ethnicity and income on HRH was examined. Goal content and appraisal were compared by race/ethnic groups. The interaction between race/ethnicity and income was significant in predicting HRH, with HRH increasing for minority adolescents as income increases and HRH decreasing for white adolescents as income increases. Higher income minority adolescents reported the most goals. Low income minorities reported the least difficult goals. Goal content did not differ between groups. Sociodemographic factors contribute to HRH in adolescents with cancer. Structural and psychosocial support during treatment to maintain goal pursuit may improve psychosocial outcomes.     

Variables associated with adolescent alcohol use: a multiethnic comparison

The authors examined the influence of sociodemographic variables on the frequency and intensity of alcohol use among a nationally representative sample of Black, Hispanic, and White adolescents who had participated in the 1991 National Household Survey on Drug Abuse (U.S. Department of Health and Human Services, 1993). The sample consisted of 8,756 U.S. adolescents aged 12 to 18 years. The authors found that (a) approximately 19% of the respondents had used alcohol in the last 30 days: (b) among the respondents who had used alcohol, 21% had consumed 1 or more drinks per drinking episode; and (c) there were important similarities as well as important differences in variables that promoted alcohol use among Black. Hispanic, and White adolescents.     

Expanding Roles: A Survey of Public Health Genetic Counselors

According to the 2008 National Society of Genetic Counselors (NSGC) Professional Status Survey (PSS), 31 genetic counselor respondents reported spending at least 50% of their time in the area of public health. The NSGC Public Health Special Interest Group (PHSIG) had 49 dues-paying members in 2009. The purpose of this study was to identify the work settings and public health activities in which genetic counselors participate. A novel online survey was disseminated over the NSGC PHSIG Listserv. Forty-one percent (n = 13) of public health genetic counselor respondents worked in a university medical system, while 53% (n = 17) were grant-funded and held a non-clinical appointment. The most common public health activities included educating healthcare professionals (82%) and community members (61%), research (55%), grant writing (55%) and grant administration (36%). Most respondents (82%) reported learning certain public health skills outside of their genetic counseling training programs. Differences in work settings were found, with a significantly greater percentage of public health genetic counselors working in government agencies. Genetic counselors have opportunities to become involved in public health activities as the scope of public health genetics grows. Furthermore, genetic counseling competencies are compatible with the Institute of Medicine’s “10 Essential Public Health Services.” The NSGC and genetic counseling training programs are encouraged to offer more public health learning opportunities for genetic counselors and genetic counseling students interested in this specialty area.     

Differences in Sexual Behaviors and Teen Dating Violence among Black,Hispanic, and White Female Adolescents

We examined differences in sexual behaviors among White, Black, and Hispanic adolescent females exposed to dating or sexual violence (DSV) using the 2009 Youth Risk Behavior Survey. We also examined the interaction effect of exposure to DSV and race or ethnicity on sexual behaviors. Sexual behaviors were significantly associated with both race or ethnicity and DSV; DSV was a stronger predictor of sexual behaviors than race or ethnicity; and the effect of DSV on condom use was more pronounced among Hispanic adolescents, whereas the effect of DSV on birth control use was more pronounced among both Black and Hispanic adolescents. Adolescent health programs should simultaneously address DSV and sexual risk reduction, with particular emphasis on birth control and condom use among ethnic minority populations.