Elsevier

Social Science & Medicine

Volume 184, July 2017, Pages 153-160
Social Science & Medicine

“I don’t believe it.” Acceptance and skepticism of genetic health information among African-American and White smokers

https://doi.org/10.1016/j.socscimed.2017.04.053Get rights and content

Highlights

  • Lay conceptualizations of genetic risk include a complex constellation of beliefs.

  • Lay skepticism of genetic information can result from divergent lay/expert beliefs.

  • Genetic communications that incorporate lay beliefs may be more effective.

Abstract

Rationale

Effective translation of genomics research into practice depends on public acceptance of genomics-related health information.

Objective

To explore how smokers come to accept or reject information about the relationship between genetics and nicotine addiction.

Methods

Thirteen focus groups (N = 84) were stratified by education (seven < Bachelor's degree, six ≥ Bachelor's degree) and race (eight black, five white). Participants viewed a 1-min video describing the discovery of a genetic variant associated with increased risk of nicotine addiction and lung cancer. Next, they provided their opinions about the information. Two coders analyzed the data using grounded theory.

Results

Pre-video knowledge about why people smoke cigarettes and what genetic risk means informed beliefs about the relationship between genes and addiction. These beliefs were not always consistent with biomedical explanations, but formed the context through which participants processed the video's information. This, in turn, led to information acceptance or skepticism. Participants explained their reactions in terms of the scientific merits of the research and used their existing knowledge and beliefs to explain their acceptance of or skepticism about the information.

Conclusion

Laypeople hold complex understandings of genetics and addiction. However, when lay and biomedical explanations diverge, genetics-related health information may be rejected.

Section snippets

Study overview

Thirteen focus groups (N = 84) were conducted in the St. Louis metropolitan area from April to August 2012. Participants stratified by race (African American, White) and educational attainment (<Bachelor's degree, ≥Bachelor's degree). Four groups fell within the higher education/African American and lower education/African American strata, two groups within the higher education/White stratum, and three groups in the lower education/White stratum. Assuming six to eight participants per group, we

Preliminary analyses

Of 84 participants, 44 (52.4%) were men, 52 (61.9%) were African American, and 57 (67.9%) reported having less than a Bachelor's degree. Their mean age was 42.8 years (SD = 12.9 years). Participants were established smokers; 78 (95.9%) smoked daily and 25 (29.8%) smoked at least a pack of cigarettes daily.

Model summary

As described in detail below, participants' explanations for accepting, rejecting, or being skeptical of the news that nicotine addiction has a genetic component were based primarily on their

Discussion

Ineffective communication is a critical barrier to the successful translation of genomics research into public health and clinical practice. Overcoming this barrier would facilitate translation and might help prevent the exacerbation of health disparities due to unequal access to genomics technologies. The present research makes four key contributions. First, it fills a gap in scientific understanding of the way in which the general public—particularly those who may be medically underserved,

Conclusions

Smokers used their existing knowledge and beliefs as context through which to interpret a novel mass media report about the discovery of a genetic variant associated with increased severity of nicotine addiction. Many smokers responded with skepticism and mistrust, due in part to discrepancies between their understandings of the smoking-genetics relationship and expert understandings. Resolving these discrepancies in a way that respects smokers’ experiential knowledge and also helps them to

Conflict of interest

Erika Waters, Linda Ball, and Sarah Gehlert each declare that they have no financial or personal conflicts of interest. The study sponsors had no role in study design; collection, analysis and interpretation of data; writing of the report and in the decision to submit the report for publication.

Acknowledgements

This research was supported by a grant from the American Cancer Society (ACS) to Erika Waters (MRSG-11-214-01-CPPB) and by the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448 from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH or ACS.

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