Primary care providers (PCPs), especially physicians, are becoming increasingly responsible for advising patients regarding common disease genetic testing. Genome-wide association studies (GWASs) have identified common gene variants which are associated with a range of common adult-onset diseases, such as age-related macular degeneration, prostate cancer and type II diabetes. The clinical significance of these GWAS results remains unclear and controversial. However, commercial companies are already offering direct-to-consumer genetic tests for common diseases using these findings. In order to be prepared for patient inquiries about these tests and perhaps the eventual integration of genomics into their clinical practice, PCPs need to be able to understand, evaluate and communicate with their patients about GWAS findings, genetic risk and genetic tests. At present, the evidence suggests that PCPs are not prepared for these genomic developments. The overall objectives of this study are to: (1) effectively educate PCPs to evaluate genetic information and incorporate it only when appropriate into their clinical practice;and (2) improve provider-patient communication about genomics and genetic testing. To achieve these goals, the specific aims are to: 1) conduct a survey of physicians through the American Association of Family Practitioners (AAFP) and the American Board of Internal Medicine (ABIM), interviews with PCPs, and meetings among expert consultants to inform the design, content and development of an intervention designed to educate PCPs about common disease genetics and genetic testing;2) develop and pilot the intervention components such as case study vignettes, communication videos, and handheld risk communication aids;and 3) plan a randomized controlled trial (RCT) using the educational and communication intervention to evaluate its effectiveness in improving PCPs'understanding and communication of common disease genetics. This planning grant will involve diverse healthcare settings at Mount Sinai School of Medicine, Mayo Clinic, and Duke University to understand PCPs'current beliefs, attitudes and understanding of genomics and genetic testing, and whether an innovative multimedia intervention can change their behavior and help them effectively communicate information about genetics of common diseases.
Genetic variations are being increasingly identified and associated with the common diseases, such as age- related macular degeneration, prostate cancer, and type II diabetes, which are seen every day in primary care. The aims of this planning grant are to develop and evaluate a multicomponent intervention to improve the education and communication skills of primary care physicians regarding the genetics of complex adult- onset diseases.
