Background: Latinos, whose views are infrequently examined in genomic research, may be at risk of missing out on the benefits of genomic medicine. Aims: To explore this possibility, we conducted a qualitative study of awareness and attitudes about genetic testing among Latinos with lower acculturation in New York City. Methods: We conducted four focus groups (7 English-speaking men, 5 Spanish-speaking men, 13 English-speaking women and 13 Spanish-speaking women) to explore factors that influence the adoption of new innovations through the discussion of genetic testing in general, and a hypothetical vignette describing a genetic test for skin cancer risk, in particular. Results: Through inductive thematic text analysis of focus group transcripts, our multidisciplinary team identified themes within knowledge and attitudes, communication and sources of information, anticipated responses, factors that may increase adoption, and barriers to adoption of genetic testing. Specifically, a majority of participants expressed some degree of uncertainty regarding the purpose of genetic tests and information these tests provide, rarely discussed genetic testing with others in their social networks, and expressed concerns about the misuse of and possible adverse emotional responses to genetic information. However, participants also expressed high levels of interest in receiving a skin cancer genetic test in response to the vignette and believed that receiving actionable health information was a primary reason to consider testing. Gender-based differences in perceived barriers to testing emerged. Conclusions: The results highlight beliefs and barriers that future interventions could target to help ensure that Latinos have adequate understanding of and access to genomic medicine advances.
Latinos have the highest rate of skin cancers among U.S. minorities. Despite a rising incidence of melanoma – the deadliest form of skin cancer – and greater disease burden, Latinos tend to have poor awareness of skin cancer risk factors which may inhibit preventive action. We expanded on prior work by qualitatively examining potential moderators (i.e., gender, acculturation) of skin cancer perceptions among Latinos from El Barrio in Harlem, New York. Four focus groups stratified by language (English/Spanish) and gender were conducted. Discussions were recorded, transcribed, and coded using thematic analysis. Thirty-eight self-identified Latinos (32% male) participated. Across groups, median age was 35 years; 50% completed < high school degree, 82% had annual incomes ≤$29,999, and 55% were born in Mexico. Mean acculturation level was 8.5 (SD=3.9, range=4–20). Major themes included: (1) knowledge of common skin cancer risk factors, (2) acknowledgment of personal risk although lighter skin individuals are at greater risk, and (3) awareness of effective risk-reduction methods, despite presence of fatalistic beliefs. Compared to males, females discussed tanning norms and appearance-based factors; identified children as vulnerable; highlighted the benefits of sun-exposure; and, wanted more information. Few linguistic acculturation patterns were noted; English-speakers questioned the carcinogenic effect of sunscreen and reported more skin cancer-related physician discussions than Spanish-speakers. Despite generally low acculturation, Latinos correctly identified skin cancer risk factors and agreed that it is preventable with engagement in risk-reducing behaviors. Future educational interventions must capitalize upon and reinforce such beliefs and address fatalistic perceptions which may hinder prevention efforts.
Background In recent years, there have been dramatic increases in medical imaging use and increasing media attention to increased exposure to ionizing radiation in the United States. Patient perspectives on medical imaging radiation (MIR) use understudied, but could guide primary care discussions. This study examines prevalence of worry about the health harms from MIR in the United States general population. Methods This cross-sectional study used the 2012–2013 Health Information National Trends Survey conducted by the National Cancer Institute. A nationally representative sample (N=3532) was drawn from the United States general population to observe prevalence of worry about MIR as well as potential covariates including demographic, medical and psychological factors, health information-seeking, physician trust in providing cancer information, and cancer fatalism. Results About 65% of the sample population reported experiencing at least some worry about MIR. Univariable and multivariable logistic regressions indicate higher rates of MIR worry among women, racial/ethnic minorities, those with lower educational attainment, foreign-born Americans, those who self-report poorer health, and those with a personal history of cancer. Lower trust in cancer information from physicians and greater attention to cancer information from popular media were each associated with higher rates of worry about health harms of MIR. Conclusions An accurate assessment of public worry about MIR will aid primary care providers’ efforts to understand patient responses to medical imaging and identify addressable knowledge gaps regarding benefits and risks of medical imaging. These data may improve risk communication regarding medical imaging among referring primary care physicians, radiologists and patients.
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