The Adoption of Genomic-Related Innovations by Family Physicians

Abstract

The speed of genomic discovery has left little time for health professionals to acquire an understanding of the implications for practice. We examine the factors influencing receptivity to genomic education and adoption of the genetics-informed optimal family history (OFH) among US family physicians (FPs). We test a model based on Rogers’ theory of innovation diffusion using data from a sample of 1035 FPs who completed a web-based survey. The pathways of influence are analyzed using structural equation modeling. As opposed to Rogers’ theory of innovation diffusion, we find that multiple pathways influence FPs’ receptivity to the adoption of genomic-related innovations. Their inclination to be innovative, and to resist a structured practice approach, is a significant initial indicator of receptivity for both paths. In Pathway 1, this inclination is associated with FPs’ increased comfort using genetic information, and in turn increased response to family history and subsequent use of the OFH and intent to undertake genomic education. In Pathway 2, this inclination increases the belief in the relevance of family history and genetics to common diseases. This in turn is associated with increased use of the OFH and intent to undertake genomic education. The path to adoption of genomic-related innovations in family practice may not follow the sequential process described by Rogers. Moreover, the data suggest that interventions aimed at increasing FPs’ belief in the relevance of family history and genetics to common diseases will have a greater positive impact on FPs’ adoption of the OFH and willingness to undertake genetic education than interventions that increase FPs’ level of comfort using genetic information by an equivalent amount. The paper is accessible to readers with an intermediate level of statistics. Prior exposure to structural equations models is useful but not strictly necessary.