Dataset Information

Attitudes toward Genetic Testing for Hypertension among African American Women and Girls.

ABSTRACT: Introduction. Although African American (AA) women have the highest prevalence of hypertension and many genetic studies have been conducted to examine this disparity, no published studies have investigated their attitudes toward genetic testing for hypertension. The purpose of the present study was to use the health belief model as a guide to examine attitudes toward perceived barriers and benefits of genetic testing held by AA multigenerational triads and to determine whether they differed by generation, age, education, or income level. Methods. A descriptive correlational research design were used with 183 African American women and girls from Detroit. Correlations between triad membership, age, income, and education level were examined for association with attitudes toward genetic testing. Results. Increasing age and education were associated with significant differences in attitudes regarding benefits (F[2, 160] = 5.19, P = 0.007, d = 0.06) and awareness (F[2, 160] = 6.49, P = 0.002, d = 0.08). No statistically significant differences existed on the three subscales when compared by income levels or triad membership. Conclusions. This highlights the need for increased outreach to younger generations regarding benefits of genetic services. Further research is necessary to determine whether rural and male populations have similar beliefs.

SUBMITTER: Taylor JY

PROVIDER: S-EPMC3835880 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Attitudes toward Genetic Testing for Hypertension among African American Women and Girls.

Taylor Jacquelyn Y JY Peternell Bronwen B Smith Jennifer A JA

Nursing research and practice 20131102

Introduction. Although African American (AA) women have the highest prevalence of hypertension and many genetic studies have been conducted to examine this disparity, no published studies have investigated their attitudes toward genetic testing for hypertension. The purpose of the present study was to use the health belief model as a guide to examine attitudes toward perceived barriers and benefits of genetic testing held by AA multigenerational triads and to determine whether they differed by g ...[more]

PMID: 24303212

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Project description:Rationale & objectiveAfrican American live kidney donors ("donors") have a greater risk for kidney failure than European American donors. Apolipoprotein L1 gene (APOL1) variants in African Americans may be associated with this disparity.Study designCross-sectional mixed-methods design.Setting & participantsAfrican American donors at 1 transplantation center.Analytical approachSemistructured interviews assessed attitudes about APOL1 genetic testing, willingness to undergo APOL1 testing, hypothetical decisions about donating with 2 APOL1 variants, and demographics. Surveys assessed perceptions of ethnic identity and genetics knowledge. Interview transcriptions were analyzed using thematic analysis. Survey data were analyzed using descriptive statistics.Results23 donors participated in semistructured interviews. Most (96%) reported that transplantation centers should routinely offer APOL1 genetic testing to all African American potential donors. Most (87%) would have been willing to undergo APOL1 testing before donating. Although study participants noted that APOL1 testing may deter African American potential donors from donating, most (61%) would have donated even if they had 2 high-risk APOL1 variants. Several themes emerged. Study participants believed that APOL1 testing was beneficial for providing information to help donors make informed donation decisions. Participants expressed concern about APOL1 variants placing donors at harm for kidney failure, and therefore valued taking preventive health measures. Participants believed that potential donors would experience psychological distress from learning that they have 2 gene variants and could harm their recipients. Participants were apprehensive about insurance coverage and costs of APOL1 testing and feared that APOL1 genetic test results could discriminate against African Americans.LimitationsFindings may not be generalizable to African American potential donors.ConclusionsFindings suggest that African American donors support APOL1 genetic testing yet fear that APOL1 variants and genetic testing could adversely affect donors' health and ethnic identity. Transplantation centers using APOL1 genetic testing should address African American donors' concerns about APOL1 genetic testing to optimize future donors' informed consent practices.

Project description:BackgroundPreterm birth is considered a multifactorial condition; however, emerging evidence suggests that genetic variation among individuals may have an important role. Prior studies have suggested that single-nucleotide polymorphisms associated with genes related to the immune system, and particularly the maternal inflammatory response, may be associated with an increased risk of preterm delivery.ObjectiveThe objective of the study was to identify single-nucleotide polymorphisms associated with spontaneous preterm birth <37 weeks within a cohort of African-American women.Study designThis is a secondary analysis of a randomized trial that evaluated periodontal disease and preterm birth. Women were enrolled between 6 and 20 weeks' gestation at 3 prenatal care clinics between 2004 and 2007. Maternal DNA samples were collected and analyzed using a custom 1536 single-nucleotide polymorphismgenotyping array designed to assess genes involved in inflammation. Women were included in this study if they self-identified as African American. We excluded women with a multiple gestation or an indicated preterm delivery. We performed allele- and genotype-based analyses to evaluate the association between spontaneous preterm birth and tag single-nucleotide polymorphisms. We used a logistic regression to adjust for prior preterm birth in our genotype-based analysis. In a subgroup analysis, we compared women who delivered at <34 weeks' gestation to women who delivered at term. Within the microarray, we identified ancestry informative markers and compared global ancestry estimates among women who delivered preterm with those who delivered at term.ResultsOf the 833 African-American women in the study with genotype data, 77 women (9.2%) had a spontaneous preterm birth, whereas 756 women delivered at term. In an allele-based analysis, 4 single-nucleotide polymorphisms related to the genes for protein kinase C-α (PRKCA) were associated with increased risk of spontaneous preterm birth <37 weeks, whereas a single single-nucleotide polymorphism related to fms-related tyrosine kinase 1 (FLT1) was associated with spontaneous preterm birth <34 weeks. A genotype-based analysis revealed similar associations between single-nucleotide polymorphisms related to the PRKCA genes and spontaneous premature delivery. Additionally, single-nucleotide polymorphisms related to matrix metalloproteinase-2 (MMP2), tissue inhibitor of matrix metalloproteinase-2 (TIMP2), and interleukin 16 (IL16) genes were associated with spontaneous preterm birth <37 weeks in genotype-based analysis. Genetic variants related to MMP2, matrix metalloproteinase-1 (MMP1), and leukemia inhibitory factor receptor antisense RNA 1 (LIFR-AS1) genes were associated with higher rates of preterm birth <34 weeks. Ancestry estimates were similar between the women who had a spontaneous preterm birth and those who delivered at term.ConclusionWe identified tag single-nucleotide polymorphisms related to 7 genes that are critical to inflammation, extracellular remodeling, and cell signaling that were associated with spontaneous preterm birth in African-American women. Specifically, we found a strong association with the PRKCA gene. Genetic variation in these regions of the genome may be important in the pathogenesis of preterm birth. Our results should be considered in the design of future genomic studies in prematurity.

Dataset Information

Attitudes toward Genetic Testing for Hypertension among African American Women and Girls.

Publications

Attitudes toward Genetic Testing for Hypertension among African American Women and Girls.

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