1. Lei-Shih Chen, Ph.D., P.T., CHES
Advocating for the incorporation of genomic competencies into public health education: Nation-wide evidence
Lei-Shih Chen, Ph.D., P.T., CHES
Department of Public Health
University of North Florida
Jacksonville, Florida
Patricia Goodson, Ph.D.
Department of Health and Kinesiology
Texas A&M University
College Station, Texas

2. Introduction The completion of the Human Genome Project
New public health issues
The Institute of Medicine’s 2002 report, "Who Will Keep the Public Healthy?"
include the lack of genetic literacy, the lack of informed consent for genomic testing, the intricate decision-making process of genomic testing, public fears about genetic discrimination, the lack of access to genetic intervention services, the maintenance of healthy lifestyles after genomic profiling, and insufficient knowledge and awareness of genomic information and technologies among health care providers

3. Definitions Genetics Genomics Public Health Genomics
The research of single genes and their structures, functions and effects
Genomics
The study of the entire human genome. It encompasses the research of a single gene’s structure and function, the exploration of multiple genes’ interactions and functions, and the investigations of environment-genes’ interaction.
Public Health Genomics
The study and application of knowledge about the elements of the human genome and its functions, including interactions with the environment, in relation to health and disease in populations.
single genes and their structures, functions and effects
Genomics, as an expansion of Genetics, is the study of the entire human genome. It encompasses the research of a single gene’s structure and function, the exploration of multiple genes’ interactions and functions, and the investigation of environment-genes’ interactions

4. Genomic Competencies for Health Educators (CDC’s)
Translate health-related information to lay communities, given cultural and social considerations
Identify factors influencing the lay public’s learning of genomics
Distinguish genomic education from genetic counseling
Facilitate genomic education for stakeholders, including administrators, communities, and volunteers
CDC. Genomic competencies for the public health workforce, 2001 (

5. Genomic Competencies for Health Educators (CDC’s)
Utilize social marketing strategies to develop genomics-related health education services with the commitment of communities, experts, and other resource people
Analyze current and future community genomic education needs
Advocate for genomic education and/or add genomic components into existing programs
Using commercial marketing principles to influence consumer ideas, attitudes, and lifestyles relating to the issues of social concern.
The social marketing "product" is not necessarily a physical offering. A continuum of products exists, ranging from tangible, physical products (e.g., condoms), to services (e.g., medical exams), practices (e.g., breastfeeding, ORT or eating a heart-healthy diet) and finally, more intangible ideas (e.g., environmental protection).
CDC. Genomic competencies for the public health workforce, 2001 (

6. Purpose of study To answer the question:
What is health educators’ likelihood of adopting genomic competencies into health promotion research and practice?

7. Methods: Study Sample E-mails (n= 9,391) of members from:
The National Commission for Health Education Credentialing Inc. (NCHEC)
The Society for Public Health Education (SOPHE)
The School Health Education and Services (SHES) Section of the American Public Health Association (APHA)
Health Education Directory (HEDIR)

8. Methods: Instrument
A web-based survey, entitled “Health Promotion and Genetics/Genomics (HPG)” was created with the assistance of ZoomerangTM
Estimated time to complete the survey: minutes
Validity and reliability of the web-based survey data were tested
convergent validity when you showed that measures that are theoretically supposed to be highly interrelated are, in practice, highly interrelated. And, you showed discriminant validity when you demonstrated that measures that shouldn't be related to each other in fact were not.
Internal consistency (Cronbach's Alpha) split half

9. Methods: Survey Distribution Phase
Three personalized s, containing the link to the HPG web-based survey were sent (n= 9,391)
Incentives
A drawing for one of four $50 money order certificates
Five educational resources
After deleting the invalid and duplicated s,
8,058 s were valid.
A total of 1,862 health educators completed the survey (adjusted response rate = 23.1%)
1,607 responses were utilized in the final report.

10. Results

11. Sample Characteristics (n= 1,607)
Gender: Female (83.9%)
Ethnicity: White (76.8%)
Age: 40.1 years (SD=12.0)
Religious preference: Christian (70.5%)
CHES certification (81.1%)
Work setting:
Community setting (51.7%)
College/University setting (44.4%)
Government setting (37.3%)
Health care setting (35.8%)
No training in genetics/genomics or public health genomics (71.4%)

12. How likely are you to translate complex genomic information for use in community-based health education programs?
N=1,607

13. How likely are you to facilitate genomic education for agency staff, administrators, volunteers, community groups, and other interested personnel?
N=1,607

14. How likely are you to develop a plan for incorporating genomics into health education services by working with community organizations, genomic experts, and other stakeholders?
N=1,607

15. How likely are you to conduct a needs assessment for community-based genomic education programs?

16. How likely are you to advocate for community-based genomic education programs?

17. How likely are you to integrate genomic components into community-based genomic education programs?

18. How likely are you to evaluate the effectiveness of community-based genomic education programs?

19. Limitations
Lack of generalization (sample bias)

20. Conclusions and Discussion
Overall, health educators in our sample had low likelihood of adopting genomic competencies into health promotion
The lowest likelihood was found for the competency: “To translate complex genomic information for use in community-based health education programs.” (23.1% somewhat likely and extremely likely)
Conversely, integrating genomic components into community-based genomic education programs had the highest likelihood (34.8% somewhat likely and extremely likely).

21. Conclusions and Discussion
As public health educators seem reluctant to incorporate the CDC genomic competencies into practice, increasing health educators’ awareness of their roles in public health genomics becomes a critical and urgent issue.
Researchers and the government should advocate for health educators’ understanding of their responsibilities in the intersection of genomics and public health.
Chen, L.S., Goodson, P. Entering the Public Health Genomics Era: Why Must Health Educators Develop Genomic Competencies? American Journal of Health Education, 38(3), , (feature article)

22. Acknowledgments Funding source All participants in this study
The 2007AAHE/Will Rogers Institute Fellowship to Dr. Lei-Shih Chen
The 2007 Society of Behavior Medicine’s Distinguished Student Award (Excellent in Research) to Dr. Lei-Shih Chen
Graduate Student Research Grant, Department of Health and Kinesiology, Texas A&M University to Dr. Lei-Shih Chen
Program to Enhance Scholarly and Creative Activities Grant, Texas A&M University to Dr. Patricia Goodson
All participants in this study
HPG survey reviewers
The HEDIR, NCHEC, SOPHE, and SHES Section of the APHA
Ms. M. Elaine Auld, Dr. Stephen Gambescia, Ms. Carmen J. Head, Dr. Mark D. Kittleson, Ms. Linda Lysoby, Dr. Larry Olson, and Dr. Susan F. Wooley

23. Likelihood (29.3% Somewhat & Extremely)
Each Genomic Competency
Not likely
at all
(%)
Not
Likely (%)
Somewhat likely
Extremely likely
Translating complex genomic information for use in community-based health education programs
40.3
36.6
20.7
2.4
Facilitating genomic education for agency staff, administrators, volunteers, community groups, and other interested personnel
36.7
39.4
21.2
2.6
Developing a plan for incorporating genomics into health education services by working with community organizations, genomic experts, and other stakeholders
32.2
23.1
5.2
Conducting a needs assessment for community-based genomic education programs
29.0
37.0
26.6
7.4
Advocating for community-based genomic education programs
28.0
41.0
4.5
Integrating genomic components into community-based genomic education programs
27.0
38.1
30.3
Evaluating the effectiveness of community-based genomic education programs
29.5
40.6
24.5
5.4