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Abstract accepted for poster presentation at the Society of Behavioral Medicine Annual Meeting!

Illness Risk Perceptions and Health Protective Behaviors Prior to Genetic Sequencing


Courtney L Scherr, Kerstin Kalke, Hannah Getachew-Smith, Christin Hoell, Sharon Aufox & Maureen Smith Northwestern University

Background: Health protective behaviors (HPB) are believed to be driven by risk perceptions. However, personal experience with disease (affected vs. unaffected) and beliefs about genetic etiology may impact HPB in negative or positive ways. We explored the impact of risk perception, personal experience, and beliefs about genetic etiology on HPB among a sample of participants enrolled in the Electronic Medical Records and Genomics study at Northwestern.

Methods: Eligible participants (1) saw a Northwestern Medicine physician; (2) were ≥ 18 years; (3) could speak and read English or Spanish; and 4) agreed to have genetic sequencing with results placed in their electronic health record. Participants completed a baseline survey that asked about demographics, risk perception based on the Brief Illness Perception Questionnaire (BIPQ), personal experience with disease, and perceived causes of disease. A hierarchical multiple regression was conducted in SPSS to determine if the addition of personal experience and beliefs about genetic etiology improved the prediction of HPB beyond risk perception alone.

Results: A total of 604 participants completed the survey. The average age was 56, the majority were female (n=381;63.1%), white (n=506;83.8%), and non-Hispanic (n=575;95.2%), and unaffected (n=402;66.5%). The hierarchical regression model of gender, age, race/ethnicity, education, BIPQ score, personal experience, and belief in a genetic etiology was statistically significant, R2=.152, F(7, 413) = 10.587, p < .0005, adj. R2 = .138. The addition of BIPQ score led to a significant increase in the prediction of HPB R2 of .018, F(1, 415) = 8.626, p = .003 (Model 2), as did personal experience, R2= .012, F(1, 414) = 5.938, p = .015 (Model 3). Belief in a genetic etiology did not significantly increase the prediction of HPB.

Conclusions: Risk perception predicted HPB, but not as expected; those who viewed a disease as more threatening were less likely to engage in HPB. We found support to consider personal experience when examining the relationship between risk perception and HPB. Those affected were less likely to engage in HPB, perhaps due to reduce efficacy beliefs, however, additional investigation is needed. Results suggest those who are most concerned and affected by disease may need additional support to promote informed decision making about HPB. These findings will be examined longitudinally, after the return of genetic test results.

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