This short-term Research Career Development Award addresses the need for more informed and engaging dialogs with the public about the genetic basis of common complex diseases. The proposed work will foster insights into the process and content of patient and professional conversational styles and exchanges about genetic test results from a panel of 15 genetic markers for 8 health conditions (diabetes, osteoporosis, heart disease, hypercholesterolemia, high blood pressure, and lung, colon, and skin cancer), and discussion of its implications for family health.
The Specific Aims apply a rigorous and well-validated behavioral coding and analytic system for patient-provider communication (the Roter Interaction Analysis System) to conversations about these 'multiplex'genetic test results (Aim 1);identify frequently used patient-provider communication strategies (e.g., emotional and informational communications) (Aim 2), and;assess their influence on key patient-reported outcomes (Aim 3). Behavioral coding is highly functional and ecologically valid. Here, it will be used to identify antecedent stimuli and controlling consequences of medical dialog. This work will be accomplished through the Applicant's (Kenneth Tercyak, Associate Professor of Oncology and Pediatrics) behavioral coding and analysis of audio-recordings of provider-led education sessions with patients who underwent multiplex genetic testing. Building off of a successful research career in genetic counseling/testing for hereditary breast/ovarian cancer, he and the Mentors for this project (Debra Roter, Professor of Health, Behavior, &Society, Medicine, and Nursing, and Colleen McBride, Chief and Senior Investigator of Social &Behavioral Research in Public Health Genetics) request 1 year of protected time to accelerate the shift and deepen the research focus in patient-provider communication and public health genetics. Doing so requires additional coursework, training, and mentoring in behavioral interaction theory, assessment, and analytic methods, health communication, and the genetics of common complex diseases. PUBLIC HEALTH IMPACT: Changes in what is known about the role of genes in heath creates new opportunities for people to prevent disease and lead healthier lives. With these opportunities come challenges in communicating genetic risk information in ways that are clear, safe, and effective. This award provides special training to a clinically- oriented behavioral scientist focusing on health promotion to achieve a shift away from rare diseases toward more common diseases, and to plan and implement interventions that are informed by more real-world needs and demands in conversations among patients and providers. Using new research tools and methodologies, the work will advance the discovery of clearer genetic health communication channels.
As part of this K18, I will take additional training in basic behavioral and social science research in the context of health communication and genetics, and apply this training to a pilot investigation of process, analysis, and outcomes of genetic education and counseling for prevalent health conditions. I will be mentored at 2 high impact research institutions that are thought leaders in this area, and gain critical skills that can be applied to pressing concerns in public health genetics.
