Background: Genomic testing for common genetic variants associated with skin cancer risk could enable personalized risk feedback to motivate skin cancer screening and sun protection. Methods: In a cross-sectional study, we investigated whether skin cancer cognitions and behavioral factors, sociodemographics, family factors, and health information-seeking were related to perceived importance of learning about how (a) genes and (b) health habits affect personal health risks using classification and regression trees (CART). Results: The sample (n = 1,772) was collected in a large health maintenance organization as part of the Multiplex Initiative, ranged in age from 25–40, was 53% female, 41% Caucasian, and 59% African-American. Most reported that they placed somewhat to very high importance on learning about how genes (79%) and health habits (88%) affect their health risks. Social influence actors were associated with information-seeking about genes and health habits. Awareness of family history was associated with importance of health habit, but not genetic, information-seeking. Conclusions: The investment of family and friends in health promotion may be a primary motivator for prioritizing information-seeking about how genes and health habits affect personal health risks and may contribute to the personal value, or personal utility, of risk information. Individuals who seek such risk information may be receptive to interventions aimed to maximize the social implications of healthy lifestyle change to reduce their health risks.
Poor understanding of gene-environment contributors to health conditions can lead the public to misinterpretations that overemphasize genetics as determinants of health. The present commentary calls for engaging the national community health worker (CHW) workforce to use community elicitation methods such as mental models approaches as a means to enhance the public's literacy regarding genetic and environmental or genomic contributions to health. We discuss three needs related to genomic literacy and suggest how CHWs are uniquely positioned to address these needs among diverse target audiences. We conclude by offering directions for the future of CHWs working to build genomic literacy.
<b><i>Background:</i></b> Translational research in genomics has limited reach and requires efforts to broaden access and utility in diverse populations. Skin cancer is common and rates are rising, including among Hispanics. Germline variants in the melanocortin-1 receptor (<i>MC1R</i>) gene are common in the population and confer moderate risk for melanoma and basal cell cancers across skin types. Feedback about <i>MC1R</i> risk status may promote skin cancer risk awareness and risk reduction. <b><i>Aims:</i></b> We examined the level of interest in pursuing <i>MC1R</i> testing, and patterns of interest across skin cancer perceived threat and control attitudes, cultural beliefs (family influence on health, health system distrust, cancer fatalism, skin cancer misconceptions), and health literacy. <b><i>Methods:</i></b> We used a study website to inform primary care patients in Albuquerque, NM about the benefits and drawbacks of <i>MC1R</i> testing. Website logon, request of a saliva test kit, and return of the test kit (yes vs. no) were primary assessments of study interest and uptake. <b><i>Results:</i></b> Of 499 participants provided with a test offer, 33% requested and returned the test. Lower family influence on participants’ health was an important factor both overall and within ethnicity subgroups, and may indicate that primary care patients interested in skin cancer genetic testing see themselves as proactive health seekers, independent from family encouragement. Lower self-efficacy for skin cancer prevention was also an important characteristic of those who tested. <b><i>Conclusion:</i></b> As evidence for common genetic markers for skin cancer accumulates, these findings suggest characteristics of those most likely to pursue genetic testing for skin cancer risk.
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