Dataset Information

Interest in and reactions to genetic risk information: The role of implicit theories and self-affirmation.

ABSTRACT:

Rationale

Implicit theories reflect core assumptions about whether human attributes are malleable or fixed: Incremental theorists believe a characteristic is malleable whereas entity theorists believe it is fixed. People with entity theories about health may be less likely to engage in risk-mitigating behavior. Spontaneous self-affirmation (e.g., reflecting on one's values when threatened) may lessen defensiveness and unhealthy behaviors associated with fixed beliefs, and reduce the likelihood of responding to health risk information with fixed beliefs.

Method

Across two studies conducted in the US from 2012 to 2015, we investigated how self-affirmation and implicit theories about health and body weight were linked to engagement with genetic risk information. In Study 1, participants in a genome sequencing trial (n = 511) completed cross-sectional assessments of implicit theories, self-affirmation, and intentions to learn, share, and use genetic information. In Study 2, overweight women (n = 197) were randomized to receive genetic or behavioral explanations for weight; participants completed surveys assessing implicit theories, self-affirmation, self-efficacy, motivation, and intentions.

Results

Fixed beliefs about weight were infrequently endorsed across studies (10.8-15.2%). In Study 1, participants with stronger fixed theories were less interested in learning and using genetic risk information about medically actionable disease; these associations were weaker among participants higher in self-affirmation. In Study 2, among participants given behavioral explanations for weight, stronger fixed theories about weight were associated with lower motivation and intentions to eat a healthy diet. Among participants given genetic explanations, being higher in self-affirmation was associated with less fixed beliefs.

Conclusion

Stronger health-related fixed theories may decrease the likelihood of benefiting from genetic information, but less so for people who self-affirm.

SUBMITTER: Taber JM

PROVIDER: S-EPMC9318351 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Studies examining whether genetic risk information about common, complex diseases can motivate individuals to improve health behaviors and advance planning have shown mixed results. Examining the influence of different study recruitment strategies may help reconcile inconsistencies.Secondary analyses were conducted on data from the REVEAL study, a series of randomized clinical trials examining the impact of genetic susceptibility testing for Alzheimer's disease (AD). We tested whether self-referred participants (SRPs) were more likely than actively recruited participants (ARPs) to report health behavior and advance planning changes after AD risk and APOE genotype disclosure.Of 795 participants with known recruitment status, 546 (69%) were self-referred and 249 (31%) had been actively recruited. SRPs were younger, less likely to identify as African American, had higher household incomes, and were more attentive to AD than ARPs (all P?<?0.01). They also dropped out of the study before genetic risk disclosure less frequently (26% versus 41%, P?<?0.001). Cohorts did not differ in their likelihood of reporting a change to at least one health behavior 6 weeks and 12 months after genetic risk disclosure, nor in intentions to change at least one behavior in the future. However, interaction effects were observed where ?4-positive SRPs were more likely than ?4-negative SRPs to report changes specifically to mental activities (38% vs 19%, p?<?0.001) and diets (21% vs 12%, p?=?0.016) six weeks post-disclosure, whereas differences between ?4-positive and ?4-negative ARPs were not evident for mental activities (15% vs 21%, p?=?0.413) or diets (8% versus 16%, P?=?0.190). Similarly, ?4-positive participants were more likely than ?4-negative participants to report intentions to change long-term care insurance among SRPs (20% vs 5%, p?<?0.001), but not ARPs (5% versus 9%, P?=?0.365).Individuals who proactively seek AD genetic risk assessment are more likely to undergo testing and use results to inform behavior changes than those who respond to genetic testing offers. These results demonstrate how the behavioral impact of genetic risk information may vary according to the models by which services are provided, and suggest that how participants are recruited into translational genomics research can influence findings.ClinicalTrials.gov NCT00089882 and NCT00462917.