My work investigates the impact of the diffusion of genomic information into clinical and public health contexts. I am particularly interested in health disparities, and thus studying genomic communication relevant to diseases or populations that are stigmatized and/or underserved. I examine these issues both in simulated clinical contexts, and online through social media platforms. I currently have several recently completed studies that contribute to these aims. In the clinical context, my colleagues and I mounted a study to assess the benefits and/or risks of a physician introducing obesity genomics information into clinical weight-management encounters (Weight Management Interaction Study; NHGRI protocol # 11-HG-0238). We are interested in how this information will influence patients' health-related attitudes, beliefs, behavior, and patient perceptions of stigmatization. The project also aims to determine whether a physician's patient-centered versus doctor-centered approach to a health care encounter could mitigate or amplify the potential negative and positive consequences of genomic information provision. This study is being conducted in an immersive virtual reality-based clinical simulation in the Immersive Virtual Environment Testing Unit. During this reporting year, we have published an additional manuscript. Another study in preparation examines the influence of the provider's apparent weight on potential patients' reaction to the weight-related genomic information she provides. This is an experiment that was planned during this reporting year, for which data continues to be collected. Looking at encounters where genomic information relevant to body weight is discussed from the provider's perspective, during this reporting year we have engaged in coding of a consultation between a medical student and virtual patient exploring verbal behavior relevant to weight stigma and bias. A manuscript from this process was submitted and accepted during this year. In addition to my experimental research related to communication about genomic information in the clinic, I also investigate issues around dissemination of genomic information in online and public health-related contexts. I have fielded a survey assessing individuals' interest in and information seeking behaviors with respect to weight management and genomic information. One paper is published from this project, and two are in preparation. An additional study in this vein assesses genetic attributions, their connection with diabetes understanding, stigma, and health outcomes in the context of diabetes. Data for this study have been collected and coding has been completed. Two papers from the project were accepted and two more are under review. A follow-up study is being planned.
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