A Qualitative Study of Anticipated Decision Making around Type 2 Diabetes Genetic Testing: the Role of Scientifically Concordant and Discordant Expectations.

Type 2 diabetes mellitus (T2DM) genetic testing is undergoing clinical trials to measure the efficacy of genetic counseling for behavior-based risk reduction. The expectations patients bring to the testing process may play an important role in individual outcomes. We conducted a qualitative exploration of anticipated decision-making and expectations around T2DM genetic testing. Semi-structured interviews were completed with Mexican Americans (n = 34), non-Hispanic Black Americans (n = 39), and non-Hispanic White Americans (n = 39) at risk for T2DM. Transcripts were analyzed for themes. Most participants would accept T2DM genetic testing in order to motivate risk-reducing behaviors or apprise family members of their risk. Participants who would decline testing wished to avoid emotional distress or believed the test would not reveal new risk information. Non-Hispanic Whites and those with college education declined genetic testing more often than other groups. Those without college education were more likely to have testing expectations that were discordant with current science, such as conflating genetic testing with common 'blood tests.' Understanding expectations and decision-making factors around T2DM genetic testing will better prepare healthcare professionals to counsel their patients. This may lead to a higher efficacy of T2DM genetic testing and counseling.

Searching for the Kinkeepers: Historian Gender, Age, and Type 2 Diabetes Family History.

Kinkeepers facilitate family communication and may be key to family medical history collection and dissemination. Middle-aged women are frequently kinkeepers. Using type 2 diabetes (T2DM) as a model, we explored whether the predicted gender and age effects of kinkeeping can be extended to family medical historians. Through a U.S. telephone survey, nondiabetic Mexican Americans (n = 385), Blacks (n = 387), and Whites (n = 396) reported family histories of T2DM. Negative binomial regressions used age and gender to predict the number of affected relatives reported. Models were examined for the gender gap, parabolic age effect, and gender-by-age interaction predicted by kinkeeping. Results demonstrated support for gender and parabolic age effects but only among Whites. Kinkeeping may have application to the study of White family medical historians, but not Black or Mexican American historians, perhaps because of differences in family structure, salience of T2DM, and/or gender roles.

Does Biology Justify Ideology? The Politics of Genetic Attribution.

Conventional wisdom suggests that political conservatives are more likely than liberals to endorse genetic explanations for many human characteristics and behaviors. Whether and to what extent this is true has received surprisingly limited systematic attention. We examine evidence from a large U.S. public opinion survey that measured the extent to which respondents believed genetic explanations account for a variety of differences among individuals as well as groups in society. We find that conservatives were indeed more likely than liberals to endorse genetic explanations for perceived race and class differences in characteristics often associated with socioeconomic inequality (intelligence, math skills, drive, and violence). Different ideological divisions emerged, however, with respect to respondents' explanations for sexual orientation. Here, liberals were more likely than conservatives to say that sexual orientation is due to genes and less likely to say that it is due to choice or the environment. These patterns suggest that conservative and liberal ideologues will tend to endorse genetic explanations where their policy positions are bolstered by "naturalizing" human differences. That said, debates over genetic influence may be more politicized with respect to race, class, and sexual orientation than population differences generally: We find that left/right political ideology was not significantly associated with genetic (or other) attributions for individual differences in intelligence, math skills, drive, or violence. We conclude that conceptions of the proper role of government are closely intertwined with assumptions about the causes of human difference, but that this relationship is a complex one.

Differentiating Contemporary Racial Prejudice from Old-Fashioned Racial Prejudice.

The present study addresses the distinction between contemporary and old-fashioned prejudice using survey data from a national sample (n=600) of self-identified whites living in the United States and interviewed by telephone in 2001. First, we examine associations among indicators of contemporary and old-fashioned prejudice. Consistent with the literature, contemporary and old-fashioned prejudice indicators represent two distinct but correlated common factors. Second, we examine whether belief in genetic race differences uniformly predicts both types of prejudice. As might be expected, belief in genetic race differences predicts old-fashioned prejudice but contrary to recent theorizing, it also predicts contemporary prejudice.

The Perennial Debate: Nature, Nurture, or Choice? Black and White Americans' Explanations for Individual Differences.

This paper examines three common explanations for human characteristics: genes, the environment, and choice. Based on data from a representative sample of White and Black Americans, respondents indicated how much they believed each factor influenced individual differences in athleticism, nurturance, drive, math ability, violence, intelligence, and sexual orientation. Results show that across traits: 1) Black respondents generally favor choice and reject genetic explanations, whereas White respondents indicate less causal consistency; 2) although a sizeable subset of respondents endorse just one factor, most report multiple factors as at least partly influential; and 3) among White respondents greater endorsement of genetic explanations is associated with less acceptance of choice and the environment, although among Black respondents a negative relationship holds only between genes and choice. The social relevance of these findings is discussed within the context of the attribution, essentialism and lay theory literature. The results underscore the need to consider more complex and nuanced issues than are implied by the simplistic, unidimensional character of the nature/nurture and determinism/free will debates - perennial controversies that have significance in the current genomic era.

Beliefs about the etiology of homosexuality and about the ramifications of discovering its possible genetic origin.

Homosexuality is viewed by many as a social problem. As such, there is a keen interest in elucidating the origins of homosexuality among many scholars, from anthropologists to zoologists, from psychologists to theologians. Research has shown that those who believe sexual orientation is inborn are more likely to have tolerant attitudes toward gay men and lesbians, whereas those who believe it is a choice have less tolerant attitudes. The current qualitative study used in-depth, open-ended telephone interviews with 42 White and 44 Black Americans to gain insight into the public's beliefs about the possible genetic origins of homosexuality. Along with etiological beliefs (and the sources of information used to develop these beliefs), we asked respondents to describe the benefits and dangers of scientists discovering the possible genetic basis for homosexuality. We found that although limited understanding and biased perspectives likely led to simplistic reasoning concerning the origins and genetic basis of homosexuality, many individuals appreciated the complex and interactive etiological perspectives. These interactive perspectives often included recognition of some type of inherent aspect, such as a genetic factor(s), that served as an underlying predisposition that would be manifested after being influenced by other factors such as choice or environmental exposures. We also found that beliefs in a genetic basis for homosexuality could be used to support very diverse opinions including those in accordance with negative eugenic agendas.

White Americans' Genetic Lay Theories of Race Differences and Sexual Orientation: Their Relationship with Prejudice toward Blacks, and Gay Men and Lesbians.

This study examined the relationship between White Americans' genetic explanations, conceptualized as genetic lay theories, for perceived racial differences and for sexual orientation, and attitudes toward Blacks, and gay men and lesbians, respectively. Considering contrasting public discourse surrounding race and sexual orientation, we predicted that genetic lay theories would be associated with greater prejudice toward Blacks, but less prejudice toward gay men and lesbians. The findings, based on a representative sample of 600 White Americans, were consistent with expectations. Results are discussed in relation to the literature on essentialism and implicit theories of the malleability of traits. The present research broadens our view of lay theories by showing how they support either prejudice or tolerance, depending on the target group.

Exploring the public understanding of basic genetic concepts.

It is predicted that the rapid acquisition of new genetic knowledge and related applications during the next decade will have significant implications for virtually all members of society. Currently, most people get exposed to information about genes and genetics only through stories publicized in the media. We sought to understand how individuals in the general population used and understood the concepts of "genetics" and "genes." During in-depth one-on-one telephone interviews with adults in the United States, we asked questions exploring their basic understanding of these terms, as well as their belief as to the location of genes in the human body. A wide range of responses was received. Despite conversational familiarity with genetic terminology, many noted frustration or were hesitant when trying to answer these questions. In addition, some responses reflected a lack of understanding about basic genetic science that may have significant implications for broader public education measures in genetic literacy, genetic counseling, public health practices, and even routine health care.