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Impact of Literacy and Numeracy on Motivation for Behavior Change After Diabetes Genetic Risk Testing

Author

Listed:
  • Jason L. Vassy
  • Kelsey E. O’Brien
  • Jessica L. Waxler
  • Elyse R. Park
  • Linda M. Delahanty
  • Jose C. Florez
  • James B. Meigs
  • Richard W. Grant

Abstract

Background Type 2 diabetes genetic risk testing might motivate at-risk patients to adopt diabetes prevention behaviors. However, the influence of literacy and numeracy on patient response to diabetes genetic risk is unknown. Objective The authors investigated the association of health literacy, genetic literacy, and health numeracy with patient responses to diabetes genetic risk. Design and Measurements Overweight patients at high phenotypic risk for type 2 diabetes were recruited for a clinical trial of diabetes genetic risk testing. At baseline, participants predicted how their motivation for lifestyle modification to prevent diabetes might change in response to hypothetical scenarios of receiving “high†and “low†genetic risk results. Responses were analyzed according to participants’ health literacy, genetic literacy, and health numeracy. Results Two-thirds (67%) of participants ( n = 175) reported very high motivation to prevent diabetes. Despite high health literacy (92% at high school level), many participants had limited health numeracy (30%) and genetic literacy (38%). Almost all (98%) reported that high-risk genetic results would increase their motivation for lifestyle modification. In contrast, response to low-risk genetic results varied. Higher levels of health literacy ( P = 0.04), genetic literacy ( P = 0.02), and health numeracy ( P = 0.02) were associated with an anticipated decrease in motivation for lifestyle modification in response to low-risk results. Conclusions While patients reported that high-risk genetic results would motivate them to adopt healthy lifestyle changes, response to low-risk results varied by patient numeracy and literacy. However, anticipated responses may not correlate with true behavior change. If future research justifies the clinical use of genetic testing to motivate behavior change, it may be important to assess how patient characteristics modify that motivational effect.

Suggested Citation

  • Jason L. Vassy & Kelsey E. O’Brien & Jessica L. Waxler & Elyse R. Park & Linda M. Delahanty & Jose C. Florez & James B. Meigs & Richard W. Grant, 2012. "Impact of Literacy and Numeracy on Motivation for Behavior Change After Diabetes Genetic Risk Testing," Medical Decision Making, , vol. 32(4), pages 606-615, July.
    • Handle: RePEc:sae:medema:v:32:y:2012:i:4:p:606-615
    DOI: 10.1177/0272989X11431608
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    Cited by:

    1. Karen Hovhannisyan & Michelle Günther & Rie Raffing & Maria Wikström & Johanna Adami & Hanne Tønnesen, 2019. "Compliance with the Very Integrated Program (VIP) for Smoking Cessation, Nutrition, Physical Activity and Comorbidity Education Among Patients in Treatment for Alcohol and Drug Addiction," IJERPH, MDPI, vol. 16(13), pages 1-14, June.

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