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NIH Sep 30, 2009 | R01
Increasing confidence and changing behaviors in primary care providers
Institution: University of California, Davis
FOA Number: PA-08-012
Abstract
Primary care physicians have almost no training in genetics, nor in the ethical, legal and social implications (ELSI) of genetic testing, diagnosis and therapy. Further, mere provision of curricular content fails to impact physician behavior. However, programs with elements that are based on established educational and adult learning principles have been shown to effective in affecting behavioral change. We propose to evaluate whether participation in a web-based curriculum focusing on the ethical legal and social issues in primary care genetics will improve primary care physicians' approach to genetic issues. Specifically, we will assess whether participation will improve physician knowledge, attitudes, and practice-behaviors. We will recruit 120 PCPs across five health systems in California (UC Davis, Rural Health Network, UC Los Angeles, Kaiser Permanente, Sutter Medical Group Sacramento). PCPs will be randomized by practice site to control (paper curriculum) or active intervention with an interactive web-based curriculum previously developed with funding from the NHRGI. This curriculum utilizes visual tools, video clip vignettes, and other interactive content to illustrate key points about risk assessment, genetic screening, and SDM. PCPs encounters with Announced Standardized Patients Learning objectives will be used to assess PCP's ELSI related behavioral change. Evaluation will also include the effectiveness of the curriculum for genetic knowledge (testing of knowledge), skills (self-report, follow-through with learning plan), and attitudes (survey and self-efficacy assessments). If proven effective, these web-based tools can be easily disseminated around the country, and internationally, to improve knowledge and attitudes about genetic screening among physicians and patients. PUBLIC HEALTH RELEVANCE: Most primary care physicians have almost no training in genetics, nor in the ethical, legal and social implications (ELSI) of genetic testing, diagnosis and therapy. This project evaluates a novel web-based curriculum focusing on the ethical legal and social issues in primary care genetics in order to improve primary care physicians' understanding of the implications of genetic disorders in patients' lives. If proven effective, these web-based tools can be easily disseminated to improve physician's knowledge of the social context of genetics and improve their ability to engage in shared decision-making with patients about genetic screening.
FUNDING AGENCY:
Funder:
NIHInstitute:
NATIONAL HUMAN GENOME RESEARCH INSTITUTEFunding Type:
R01Project Number:
R01HG005117Start Date:
Sep 30, 2009End Date:
Aug 31, 2013PROJECT TERMS:
Advertisements, Affect, arm, Attitude, base, Behavior, behavior change, Behavioral, Beryllium, Breast, California, Camping, Childhood, Clinical, Clip, Colon, Communities, community setting, Control Groups, Counseling, Country, Cystic Fibrosis, Decision Making, Development, Diagnosis, Disease, Down Syndrome, Educational Curriculum, Effectiveness, Electronics, ethical legal social implication, Ethics, Evaluation, Exercise, Faculty, Family Practice, FAP gene, follow-up, Funding, Genetic, Genetic Screening, Genetic screening method, Grant, group intervention, Health Knowledge, Attitudes, Practice, Health system, Healthcare Systems, Hereditary Disease, Hour, improved, Individual, Internal Medicine, Internet, Intervention, Knowledge, Learning, legal implication, Life, Los Angeles, Measures, Medical, meetings, Modality, National Human Genome Research Institute, novel, Online Systems, Paper, Participant, Patient Self-Report, Patients, Pediatrics, Pennsylvania, Physicians, Predisposition, preference, Primary Care Physician, Primary Health Care, programs, Provider, public health relevance, Randomized, Recruitment Activity, Reporting, reproductive, Research Design, response, Risk, Risk Assessment, Rural, rural health network, satisfaction, Self Efficacy, shared decision making, Site, skills, social communication, Social Environment, social implication, Stress, suburb, Surveys, Testing, three-arm study, tool, Training, Universities, Visual, Washington, Writing
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