在拉丁裔中重新思考基因测试意图的机构:确定携带者查和癌症倾向测试意图的预测因素
Daniel Chavez-Yenter1, Kimberly A Kaphingst2
1Division of Hematology-Oncology, University of Pennsylvania; Department of Medical Ethics and Health Policy, University of Pennsylvania.
概括
感知机构,而不仅仅是态度或规范,显著影响拉丁裔个人的遗传测试意图,包括载体查和癌症倾向性测试. 通过以机构为重点的干预措施赋予患者权力,可以改善获得这些关键遗传服务的机会.
科学领域:
- 健康行为理论健康行为理论
- 基因咨询 基因咨询
- 拉丁裔的健康差异
背景情况:
- 基因测试的采用受到行为意图的影响.
- 在基因测试研究中,理论框架未得到充分利用,特别是在拉丁裔人群中.
- 综合行为模型 (IBM) 为了解健康行为提供了一个强大的框架.
研究的目的:
- 模拟态度,规范和行为意图与行为意图之间的关系,用于仅拉丁裔队列的载体查 (CS) 和癌症倾向测试 (CPT).
- 应用IBM来了解特定种族群体内的基因测试意图.
- 为了确定基因测试在拉丁美洲人群中普及的关键预测因素.
主要方法:
- 使用结构方程建模 (SEM) 来分析数据.
- 确认因素分析 (CFA) 用于建立IBM构造的测量模型.
- 一个结构模型评估了态度,规范和代理对CS和CPT的意图的直接影响.
主要成果:
- 感知机构是CS (β=.381,p<.01) 和CPT (β=.559,p<.01) 两种最强的预测因素.
- 态度与CS意图有负面关联 (β=-.313,p<.05).
- 社会规范与CS意图有积极的关联 (β=.350,p<.01).
结论:
- 调查结果表明,感知机构是拉丁裔个人基因测试决策的关键因素.
- 干预措施应将重点从仅仅教育和改变态度转移到通过解决机构来赋予患者权力.
- 加强患者权力可以显著改善拉丁裔社区对遗传检测服务的访问和使用.
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