Academic journal article American Journal of Health Education

Entering the Public Health Genomics Era: Why Must Health Educators Develop Genomic Competencies?

Academic journal article American Journal of Health Education

Entering the Public Health Genomics Era: Why Must Health Educators Develop Genomic Competencies?

Article excerpt

ABSTRACT

Although the completion of the Human Genome Project will offer new insight into diseases and help develop efficient, personalized treatment or prevention programs, it will also raise new and non-trivial public health issues. Many of these issues fall under the professional purview of public health workers. As members of the public health workforce, health educators are being called upon to deal with genomic-related public health topics. Thus, we propose five arguments supporting the need for health educators to develop their genomic competencies and integrate public health genomics (PHG) into health promotion. These arguments highlight various dimensions of health educators' professional goals and range from professional responsibilities and competencies to the availability of funding for genomic-related research or interventions and opportunities for future employment. Alongside these arguments, we present key PHG terms to facilitate understanding and to establish a common set of meanings for readers. Moreover, we discuss the current efforts being made by the field of health education to integrate genomics into research and practice, as well as implications and next steps required to optimize this integration.

INTRODUCTION

In 2003, the National Institutes of Health (NIH) announced the completion of the Human Genome Project (HGP). The project represents a milestone in human history, as advanced genomic technologies/information can offer insight into specific diseases and may help develop highly efficient, personalized treatment and prevention programs. (1) According to Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC), "There are exciting things going on right now in public health. Certainly, genomics is going to have a profound impact on the public health practice of the future." (2)

Yet in the wake of its completion, the HGP also raised new and non-trivial public health issues. These include, but are not restricted to, the general public's level of genetic literacy, the nature and challenges of informed consent for genetic testing, the intricate decision-making process associated with genetic testing, public fears about genetic discrimination, lack of access to genetic services, challenges regarding maintenance of healthy lifestyles following genomic profiling, the potential increase in health disparities, and insufficient knowledge or awareness of genomic information and technologies among health care providers and public health workers. (3,4)

Many of these concerns fall under the professional purview of public health workers. Even before the completion of the HGP, scholars such as Muin Khoury (director, National Office of Public Health Genomics, CDC) recommended that public health professionals (1) understand genomic factors in population health, (2) examine the clinical validity and value of genomic tests, and (3) assess individuals' family history in order to recommend genetic evaluations, intensive screening, and/or lifestyle changes. (5) Once the HGP ended, Khoury and others called for a renewed commitment of the public health workforce to the incorporation of genomics into public health. Khoury and Mensah, (6) for instance, postulated three immediate priorities for public health action regarding genomics: (1) investigating the relationship between genetic variants and diseases through administration of population-based surveys; (2) establishing an evidence base for various genomic technology applications, and (3) developing the capacity of the public health workforce and systems.

As members of the public health workforce, health educators also have been called upon to deal with genomic-related public health topics. In 1993, Sorenson and Cheuvront (7) authored the first paper advocating for "health behavior and health education studies to contribute to effective programs and policies" ((p591)) due to the increasing demands for genetic services since the beginning of the HGP. …

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