Impact of Genetic Testing and Family Health History Based Risk Counseling on Behavior Change and Cognitive Precursors for Type 2 Diabetes.
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Family health history (FHH) in the context of risk assessment has been shown to positively impact risk perception and behavior change. The added value of genetic risk testing is less certain. The aim of this study was to determine the impact of Type 2 Diabetes (T2D) FHH and genetic risk counseling on behavior and its cognitive precursors. Subjects were non-diabetic patients randomized to counseling that included FHH +/- T2D genetic testing. Measurements included weight, BMI, fasting glucose at baseline and 12 months and behavioral and cognitive precursor (T2D risk perception and control over disease development) surveys at baseline, 3, and 12 months. 391 subjects enrolled of which 312 completed the study. Behavioral and clinical outcomes did not differ across FHH or genetic risk but cognitive precursors did. Higher FHH risk was associated with a stronger perceived T2D risk (pKendall < 0.001) and with a perception of "serious" risk (pKendall < 0.001). Genetic risk did not influence risk perception, but was correlated with an increase in perception of "serious" risk for moderate (pKendall = 0.04) and average FHH risk subjects (pKendall = 0.01), though not for the high FHH risk group. Perceived control over T2D risk was high and not affected by FHH or genetic risk. FHH appears to have a strong impact on cognitive precursors of behavior change, suggesting it could be leveraged to enhance risk counseling, particularly when lifestyle change is desirable. Genetic risk was able to alter perceptions about the seriousness of T2D risk in those with moderate and average FHH risk, suggesting that FHH could be used to selectively identify individuals who may benefit from genetic risk testing.
Published Version (Please cite this version)10.1007/s10897-016-9988-z
Publication InfoCho, Alex Han; Ginsburg, Geoffrey Steven; Hauser, Elizabeth Rebecca; Myers, Rachel A; Orlando, Lori Ann; Vorderstrasse, A; & Wu, Rebekah Ryanne (2017). Impact of Genetic Testing and Family Health History Based Risk Counseling on Behavior Change and Cognitive Precursors for Type 2 Diabetes. J Genet Couns, 26(1). pp. 133-140. 10.1007/s10897-016-9988-z. Retrieved from https://hdl.handle.net/10161/12509.
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Assistant Professor of Medicine
Population health; telehealth; primary care; implementation science; applied genomics; health behavior; patient self-management; health policy.
Professor of Medicine
Dr. Geoffrey S. Ginsburg's research interests are in the development of novel paradigms for developing and translating genomic information into medical practice and the integration of personalized medicine into health care.
Professor of Biostatistics and Bioinformatics
My research interests are focused on developing and applying statistical methods to search for genes causing common human diseases. Recent work has been in the development of statistical methods for genetic studies and in identifying optimal study designs for genetic studies of complex traits. As application of these methods to specific diseases has progressed it has become apparent that etiologic and genetic heterogeneity is a major stumbling block in the research for genes for common diseases.
Associate Professor of Medicine
Dr. Lori A. Orlando, MD MHS is an Associate Professor of Medicine and Director of the Precision Medicine Program in the Center for Applied Genomics and Precision Medicine at Duke University. She attended Tulane Medical Center for both medical school (1994-1998) and Internal Medicine residency (1998-2000). There she finished AOA and received a number of awards for teaching and clinical care from the medical school and the residency programs, including the Musser-Burch-Puschett award in 2000 fo
Dorothy L. Powell Term Chair of Nursing
Dr. Vorderstrasse is an Adult Nurse Practitioner whose clinical practice and scholarship focuses on chronic illness, particularly in ethnic minority populations. Dr. Vorderstrasse's doctoral dissertation research, recent publications, and national presentations illuminate the relationships of psychosocial factors with dietary intake in Black American women with Type 2 diabetes. She is a core team member of Durham Health Innovations: Partnership IMPACTS Diabetes. Dr. Vorderstrasse has also examin
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Assistant Professor of Medicine
Dr. Wu is an internal medicine physician and health services researcher. Her main research interest is the use of precision medicine applications to improve clinical care. She is involved in projects currently looking at a patient-facing family history risk assessment tool, MeTree, which provides individualized risk stratification and clinical decision support recommendations to clinicians and patients. In addition she is also involved in a large scale sequencing project in Singapore looking at
Alphabetical list of authors with Scholars@Duke profiles.