The influence of genetic explanations of type 2 diabetes on patients' attitudes to prevention, treatment and personal responsibility for health

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.