Dr. McBride's research focuses on developing innovative public health interventions to promote risk-reducing behaviors. Building on her behavioral epidemiology and genetics experience, she is investigating how genetic information can best be used to motivate people to behave in more healthful ways. A central assumption regarding genetic discovery is that it will eventually allow lifestyle interventions to be personalized in ways that make compliance easier which, in turn, would make them more effective in lowering disease risk. Currently, new genetic information is primarily being used to personalize risk communications under the assumption that individuals given this individualized information will then be motivated to adopt healthier lifestyles.
Private companies have recently started marketing genetic tests called "multiplex" genetic profiles. These profiles test simultaneously for multiple gene variants, suggesting that these variants increase one's risk for a variety of common diseases. A number of laboratories are advertising and/or offering multiplex tests direct-to-consumer with little regulatory or clinical oversight. Little is known about the populations that are seeking testing or the effects on behavioral and health outcomes. In 2005, Dr. McBride and colleagues launched the Multiplex Initiative, a large pilot study to explore healthy young adults' interest in "multiplex testing". The prototype multiplex test assessed an individual's genetic susceptibility to eight common health conditions (e.g., heart disease and several cancers) based on 15 genetic variants. Individuals who are insured by the Henry Ford Health System in Detroit, Michigan were offered the testing as part of a research study. Those who opted to undergo testing were followed up to determine whether receipt of genetic risk information prompted them to seek other risk information, such as that based on family history and any behavioral risk factors. This is the first study to inform the public debate about the effects of genetic susceptibility testing among healthy populations.
In two other studies, Dr. McBride is evaluating the potential of genetic risk information to motivate parents to positively influence their children's health behaviors. In the first study, parents who enrolled in the Multiplex Initiative were asked to complete additional surveys that asked them to hypothetically consider multiplex testing for one of their children, selected randomly. In a second study, overweight parents are provided with information about their child's genetic risk of becoming overweight as adults. Following receipt of this information, the parent is observed in a virtual cafeteria making food choices for that child. The objective of both studies is to evaluate whether, and under what circumstances, genetic risk information could be used to prompt parenting practices that facilitate family-based health promotion.
Lastly, Dr. McBride is evaluating public health models for using genetic information to categorize populations according to risk level. Dr. McBride is working with Dr. Gail Davey, a colleague at Addis Ababa University in Ethiopia and the Mossy Foot Foundation to address podoconiosis, a debilitating rare tropical disease seen in genetically susceptible farmers who work barefoot in clay soil. An effective intervention for reducing the occurrence of podoconiosis is to encourage those deemed to be "at risk" to wear protective footwear. However, Ethiopia's high poverty rate means that access to footwear is limited and, under these circumstances, wearing shoes would publicly identify those "at risk", leading to social stigma. Dr. McBride, and her colleagues are comparing approaches to distributing footwear based on genetic risk profiles that increase the likelihood of compliance and make best use of these limited resources.
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Last Reviewed: April 18, 2012