142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Angelina Jolie's Choice: Influences of genetic literacy and gender on public attitudes about prophylactic mastectomies

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 10:30 AM - 10:50 AM

Leah Abrams, BA , Social and Behavioral Research Branch, National Human Genome Research Institute, NIH, Bethesda, MD
Colleen McBride, PhD , Department of Behavioral Science and Health Education, Emory Rollins School of Public Health, Atlanta, GA
Joseph N. Cappella, PhD , Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
Gillian Hooker, PhD , NextGxDx, Franklin, TN
Laura Koehly, PhD , Social and Behavioral Research Branch, National Human Genome Research Institute, NIH, Bethesda, MD
The scientific community has voiced concerns about the public’s likelihood of misunderstanding genomics and resulting negative consequences for health-related decision-making.  Angelina Jolie’s highly publicized choice to have a bilateral prophylactic mastectomy due to a rare BRCA genetic mutation offers a context for considering whether levels of genetic literacy influence attitudes towards prophylactic mastectomies. Data were collected from a relatively representative online panel of 1,028 adults using a one-time survey in the fall of 2013. In addition to testing genomic knowledge, we measured familiarity with genetic terms and ability to interpret information about BRCA mutations. These measures of genetic literacy were positively associated with confidence to evaluate whether Jolie’s choice was justified (R=0.396, P<0.001), with gender modifying this association (females R=0.438, males R=0.359; P=0.047). Women and those with higher genetic literacy were more likely to hold strong opinions regarding prophylactic mastectomies (OR=1.729, P<0.001 and OR=1.613, P<0.001). Increased genetic literacy was associated with favoring mastectomies; confidence to evaluate Jolie’s choice mediated this association. Respondents with above average confidence to evaluate Jolie’s choice were almost twice as likely to support prophylactic mastectomies, which objectively reduce cancer risk (OR=1.882, P<0.001). These results demonstrate how the ability to confidently apply genomic information in everyday situations may be important in facilitating informed health decisions.  Additionally, these findings suggest that rather than emphasizing genetic facts and terminology, genomics education programs might be more effective if they focused on improving understanding of risk information, while considering how other contextual factors may shape interpretations of genomic-based health risks.

Learning Areas:

Advocacy for health and health education
Communication and informatics
Planning of health education strategies, interventions, and programs

Learning Objectives:
Compare different aspects of genetic literacy and how they are measured. Describe how gender and other demographic factors shape individuals’ understandings of genomics. Explain how genetic literacy influences confidence to use genomic knowledge and ability to make informed health decisions.

Keyword(s): Genetics, Health Literacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified as an Intramural Research Training Award fellow in the Social and Behavioral Research Branch of the National Human Genome Research Institute, where I have been conducting research on public health implications of genomics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.