Student Interest in Genetic Testing for Type 2 Diabetes Mellitus Sajel Shah, Biological Sciences

Type 2 Diabetes Mellitus -- A person with T2DM can’t use energy that comes from eating food -- Increase in incidence of T2DM has paralleled increase in overweight/obesity epidemic in America -- There are ways to reduce one’s risk of T2DM (healthy lifestyle)

Genetic Susceptibility Test for T2DM -- Genetic susceptibility tests indicate a person’s risk for developing a p particular disease. It is a form of DNA testing. -- Genetic susceptibility tests can tell you if you carry a “high- risk” gene f for Type 2 Diabetes. 1) A positive test for the “high-risk” gene indicates that a person’s chance for developing Type 2 diabetes is higher than the average person in the population. 2) Carrying the “high-risk” gene does not mean a person will definitely become a diabetic. -- Several new genes correlated with Type 2 Diabetes have been identified ( (ex. TCF7L2 variant)

Why create this survey? -- This survey is an extension of Dr. Kyung Rhee’s work. She wrote a survey that explores parent interest/response to pediatric genetic testing for T2DM -- Survey aims to answer: What are the most important factors that will influence students to obtain a genetic susceptibility test for T2DM and how will they respond to the results? Will genetic susceptibility tests for T2DM be useful in motivating college students to live healthier? Do college students know how they can reduce their risk of T2DM? -- Why choose college students to survey? Prevention

Survey Development & Types of Questions -- Things to think about: 1) What do you really hope to answer with the questions? Analyze value of each question. 2) Hypothesize trends in data -- Types of Questions 1)Yes/No 2)Likert scale questions 3)Demographic Questions 4)Multiple choice (Ex. 5 levels of agreement)

Developing Valuable Survey Questions -- Sample question: “For adults, the CDC recommends at least 150 minutes per week (or 30 minutes per day for most days of the week) of moderate-intensity exercise (i.e. brisk walking) and muscle strengthening activities on 2 or more days a week that work all major muscle groups. Based on these CDC recommendations, at this time, do you think you exercise enough?” -- Better option: Form a 2 part question that 1) asks how many minutes/hours per week the student engages in moderate-intensity exercise and 2) asks how many minutes/hours per week the student engages in muscle strengthening activities -- Why is the second option better? 1) Still allows for analysis of whether or not student is exercising enough based on CDC recommendations 2) Could be useful in identifying trends based on amount of exercise time reported. Ex.: Data may show that the greater the amount of time exercised by a student, the more likely he/she was to agree that exercise would reduce his/her risk of T2DM

Analyzing the Value of a Question -- This question is designed to gauge the survey-taker’s perception of his/her weight. -- A person that is identified as overweight by their BMI might not think their weight is actually unhealthy. If a person does not think their weight is unhealthy, then they probably would not be motivated to change their eating/activity habits. Thus, it is important to ask how healthy a person thinks his/her weight and diet is. 11) At this time, how healthy do you think your weight is? Not healthy at all Very healthy

Example of Axed Question Question included in survey: --Genetic testing to indicate a person’s risk for developing Type Diabetes should be easily accessible for everyone. a. Strongly disagree b. Disagree c. Don’t agree or disagree d. Agree e. Strongly agree Question omitted from survey: -- Genetic testing to indicate a person’s risk for developing Type 2 Diabetes should be easily accessible only for those individuals who have a family history of Type 2 Diabetes and have a reason to think that they might carry the “high risk” gene. a. Strongly disagree b. Disagree c. Don’t agree or disagree d. Agree e. Strongly agree

Hypotheses -- Family history of T2D, perceived current risk, student’s academic interests/goals, & weight status will be the most important factors that influence whether or not a student would get tested -- Knowledge of having the high risk gene would motivate people that currently perceive their weight, diet, and exercising habits as unhealthy to take steps to maintain a healthier weight, eat healthier, and exercise more than if they did not have the high risk gene. How much more motivated they would be is unclear. People that already perceive their weight, diet, and exercising habits as healthy will probably not be motivated to change their behavior.

Hypotheses -- If a person knows he/she has a family history of T2DM but is not motivated to live healthier, perhaps a genetic test would not be an extra motivator for this person. On the other hand, maybe a formal genetic test early in life would confirm the risk for the individual and prompt him/her to take actions to live healthier. -- Overweight students that have been warned about the risks of being overweight by a health care professional might be more knowledgeable than non-overweight people on how to reduce their risk of T2DM -- A student’s major or family history of T2DM will also probably be correlated with his/her knowledge about reducing one’s risk for T2DM

IRB Approval & Survey Administration -- Institutional review board’s expedited review criteria: 1)Research on individual or group behavior, including research on cognition/motivation 2)Research employing survey methodologies -- This survey is pending IRB approval, so it has not been formally administered -- Participant recruitment: Fall 2009 survey will be administered to 100 college students in a gen-ed class (important to obtain a diverse sample)

L i v e H a l t h y s k questions. April 30, 2009 Thanks, Dr. Norris & Kay!