Background/Aims: It is widely accepted that type 2 diabetes is caused by an interaction of both lifestyle and genetic factors. However, the impact of explaining disease aetiology as primarily genetic or environmental is relatively unexplored for common chronic multi-factorial conditions. This study investigates whether perceiving the cause of type 2 diabetes as primarily genetic or environmental influences attitudes towards the controllability of the condition. Methods: Using a between-participants vignette-based experimental survey design, 200 participants aged 40 years and above from a primary care setting responded to a vignette which implied the cause of diabetes as being predominantly genetic or environmental. Attitudes towards personal responsibility, prevention and treatment were measured using an attitude questionnaire. Results: There was a significant interaction effect between perceived aetiology and family history on attitude to treatment; participants with a family history of type 2 diabetes perceived treatment as less effective if they read the genetic vignette, but those without a family history did not (p < 0.05). The findings also indicated that an individual was perceived as less responsible for the development of type 2 diabetes (p < 0.05) when participants (regardless of family history) read a vignette with an implied genetic causation. Conclusion: Awareness by health professionals of the impact of genetic attributions in disease aetiology is fundamental when encouraging positive attitudes to personal responsibility for lifestyle change and treatment for the condition. These findings may impact the way preventative health messages are tailored to people depending on their family history of diabetes.

1.
Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4-14.
2.
Department of Health and Diabetes UK: Structured patient education in diabetes: a report from the patient education working group. London, Department of Health, 2005.
3.
Nolan CJ, Damm P, Prentki M: Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet 2011;378:169-181.
4.
Diabetes UK: Diabetes in the UK 2010: Key statistics on diabetes. 2010. http://www.diabetes.org.uk/Documents/Reports/Diabetes_in_the_UK_2010.pdf (accessed February 8, 2010).
5.
Valdez R, Yoon PW, Qureshi N, Fisk Green R, Khoury MJ: Family history in public health practice: a genomic tool for disease prevention and health promotion. Ann Rev Public Health 2010;31:69-87.
6.
Scheumer MT, Sieverding P, Shekelle PG: Delivery of genomic medicine for common chronic adult diseases. A systematic review. JAMA 2008;299:1320-1334.
7.
O'Rahilly S, Barroso I, Wareham NJ: Genetic factors in type 2 diabetes: the end of the beginning. Science 2005;307:370-373.
8.
Smerecnik CMR: Lay responses to health messages about the genetic risk factors for salt sensitivity: do mass media genetic health messages result in genetic determinism? Psychol Health Med 2010;15:386-393.
9.
McBride CM, Koehly LM, Sanderson SC, Kaphingst KA: The behavioral response of personalized genetic information: will genetic risk profiles motivate individuals and families to choose more healthful behaviors? Ann Rev Public Health 2010;31:89-103.
10.
Schwarz PE, Greaves CJ, Lindström J, Yates T, Davies MJ: Nonpharmacological interventions for the prevention of type 2 diabetes mellitus. Nat Rev Endocrinol 2012;8:363-373.
11.
Lindström J, Neumann A, Sheppard KE, Gilis-Januszewska A, Greaves CJ, Handke U, et al: Take action to prevent diabetes-the IMAGE toolkit for the prevention of type 2 diabetes in Europe. Horm Metab Res 2010;42(suppl 1):S37-S55.
12.
National Health Service: Statistics on obesity, physical activity and diet. 2011. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/statistics-on-obesity (accessed January 24, 2012).
13.
Straughan PT, Seow A: Fatalism reconceptualised: a concept to predict health screening behaviour. J Gender Cult Health 1998;3:85-100.
14.
Senior V, Marteau T, Peters TJ: Will genetic testing for predisposition for disease result in fatalism? A qualitative study of parents' responses to neonatal screening for familial hypercholesterolaemia. Soc Sci Med 1999;48:1857-1860.
15.
Hunt K, Davison C, Emslie C, Ford G: Are perceptions of a family history of heart disease related to health-related attitudes and behaviour? Health Educ Res 2000;15:131-143.
16.
Frosch DL, Mello P, Lerman C: Behavioral consequences of testing for obesity risk. Cancer Epidemiol Biomarkers Prev 2005;14:1485-1489.
17.
Pijl M, Timmermans DRM, Claassen L, Janssens AC, Nijpels G, Dekker J, Marteau T, Henneman L: Impact of communicating familial risk of diabetes on illness perceptions and self-reported behavioral outcomes: a randomized control trial. Diabetes Care 2009;32:597-599.
18.
Claassen L, Henneman L, De Vet R, Knol D, Marteau T, Timmermans D: Fatalistic responses to different types of genetic risk information: exploring the role of self-malleability. Psychol Health 2010;25:183-196.
19.
Bandura A: Self-Efficacy: The Exercise of Control. New York, Worth Publishers, 1997.
20.
Leventhal H, Meyer D, Nerenz DR: The common sense representation of illness danger; in Rachman S (ed): Contributions to Medical Psychology. New York, Pergamon Press, 1980, pp 17-30.
21.
Bennett L, Thirlaway K, Murray A: The stigmatising implications of presenting Schizophrenia as a genetic disease. J Genet Couns 2008;17:550-559.
22.
Collins RE, Wright AJ, Marteau TM: Impact of communicating personalized genetic risk information on perceived control over the risk: a systematic review. Genet Med 2011;13:273-277.
23.
Möller-Leimkühler AM: Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord 2002;71:1-9.
24.
Cohen J: Statistical Power Analysis for the Behavioral Sciences, ed 2. New Jersey, Lawrence Erlbaum Associates, 1988.
25.
Hale ED, Treharne GJ, Kitas GD: The common-sense model of self-regulation and illness: how can we use it to understand and respond to our patients' needs? Rheumatology (Oxford) 2007;46:904-906.
26.
Davison C, Frankel S, Smith G: The limits of lifestyle: re-assessing ‘fatalism' in the popular culture of illness prevention. Soc Sci Med 1992;34:675-685.
27.
Halpern C, Bates C, Mulgan G, Aldridge S, Beales G, Heathfield A: Personal responsibility and changing behaviour: the state of knowledge and its implications for public policy. 2004. http://cdi.mecon.gov.ar/biblio/docelec/dp4105.pdf (accessed January 8, 2012).
28.
National Institute for Health and Clinical Excellence: Preventing type 2 diabetes: population and community-level interventions. NICE public health guidance PH35. 2011. http://publications.nice.org.uk/preventing-type-2-diabetes-population-and-community-level-interventions-ph35/recommendations#recommendation-4-interventions-for-communities-at-high-risk-of-type-2-diabetes.
29.
Alexander CS, Becker HJ: The use of vignettes in survey research. Public Opin Q 1978;42:93-104.
30.
Hughes R: Considering the vignette technique and its application to a study of drug injecting and HIV risk and safer behaviour. Sociol Health Ill 1998;20:381-400.
31.
Bates BR, Templeton A, Achter PJ, Harris TM, Condit CM: What does ‘a gene for heart disease' mean? A focus group study of public understandings of genetic risk factors. Am J Med Genet A 2003;119A:156-161.
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