Impact of family history and behavioral risk on beliefs about disease causation

Providing genetic risk feedback to individuals may motivate behavior change, but this likely depends on their pre-existing disease attributions. We are examining the degree to which individuals' beliefs about disease causation incorporate genetic and behavioral factors, based on the Common Sense Model. We hypothesize that the relative weight given to these factors will reflect self-serving biases. For example, those with fewer behavioral risk factors and a family history will weight health behavior as more important, while those with a greater number of behavioral risk factors but no family history will weight genetic makeup as more important. We are also investigating how gender, education, health literacy, and socioeconomic status affect this balance.

This analysis is based on data from 1630 individuals who completed the telephone baseline assessment of the Multiplex Initiative, a study being conducted with Henry Ford Health System patients to examine uptake and reactions to genetic testing for 8 common health conditions. Among participants, 54% are female, 57% African American, and 21% have no more than a high school education.

We will present outcome data computed for each health condition to reflect the relative weight attributed to genetic versus behavioral causes. Possible outcome values range from 0 (attributes disease to behavior alone) to 1 (attributes disease to genetics alone). Multivariate regression models will be used to examine the associations between the outcome and family history and behavioral risk. These findings will expand our understanding of disease attributions for common health conditions, and aid the development of future communication efforts.