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IT CAN MAKE YOU OVERWEIGHT
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| There are certain foods that trigger weight gain. And not just weight gain like fat... But weight gain as in "poop that won't come out." Yes, for real... They act as ENABLERS for constipation and bloating. Even the healthiest of foods can sometimes be such triggers if things are wild in your tummy. Many people carry an extra 10-15 lbs... WITHOUT even suspecting it. See if that's the case in your tummy: How to know if you have stuck poop (and how to lose up 10 lbs of it within 7 days) | | | | | If you'd rather not receive these emails, you can unsubscribe here. | |
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A Digital Tool and Phone Coaching Nudged More People Toward Cancer Genetic Testing In a Michigan randomized trial of 793 adults eligible for hereditary cancer testing, both interventions raised testing, though fewer than 1 in 10 were tested within a year. | | | The Capital Brief | October 15 | | | Cancer Prevention Edition | | A Digital Tool and Phone Coaching Nudged More People Toward Cancer Genetic Testing | | | | Genetic testing can reveal inherited risks for cancers such as breast, ovarian and colorectal cancer, allowing earlier screening and prevention. Yet most people who qualify never get tested. Researchers led by the University of Michigan published the MiGHT randomized trial in JAMA Network Open on October 13. They enrolled 793 adults in Michigan who met national criteria for genetic evaluation but had never been tested, recruited from clinics, research registries and the community. Participants were randomly assigned to a self-directed digital program, telephone health coaching or usual care. Both active approaches used genetics education and motivational interviewing, a counseling style that helps people explore their own reasons for change. Overall, testing rates were low: fewer than 5% had been tested at six months and 9.6% at 12 months. Compared with usual care, the digital program was associated with higher odds of testing by six months, and coaching with higher odds by 12 months. Both raised intention to test. This was a randomized trial, the strongest design for testing an intervention, but testing was self-reported, absolute rates were low and the study took place in one state. The useful idea is that information and encouragement can help, but access barriers remain. This edition explores the evidence, not a recommendation for any individual test. Genetic testing decisions are best made with a clinician or genetic counselor. | | 01 | Why genetic testing matters | | | Some people inherit gene changes, such as in BRCA1, BRCA2 or genes linked to Lynch syndrome, that raise cancer risk. Knowing about these changes can lead to earlier or more frequent screening. Some people choose preventive surgery or medications based on results. Results can also inform relatives who may share the same gene change. National guidelines recommend evaluation for people with certain personal or family histories. Many eligible people are never referred or never complete testing. Barriers include cost concerns, worry about results and lack of information. | | 02 | How the trial was designed | | | The MiGHT trial enrolled adults who met criteria for genetic evaluation and had never had germline genetic testing. Participants were recruited from oncology, primary care and gastroenterology practices, research registries and the public. The median age was 64, and about 58% were women. 261 were assigned to telephone coaching, 265 to a digital program and 267 to usual care. The digital program let people learn at their own pace online. Coaching provided conversations with a trained health coach. The main outcome was self-reported completion of genetic testing by six months. | | | | Fewer than 5% of participants had completed testing by six months. By 12 months, 76 participants, or 9.6%, had been tested. The digital program was associated with about 3.9 times the odds of testing by six months compared with usual care, though the range of uncertainty was wide. Telephone coaching was associated with about 2.3 times the odds of testing by 12 months. Both interventions increased intention to undergo testing. The authors said overall testing rates were low. They called for attention to how content is delivered and to alternative models of genetic testing care. | | | | Even motivated people may face practical hurdles, such as finding a provider or arranging a test. Concerns about insurance coverage and cost can deter testing. Some people worry about what results could mean for them or their families. Genetic counseling appointments may involve waits. Interventions focused on motivation do not remove these structural barriers. Home testing kits and direct referral pathways are among the alternatives being studied. Combining education with easier access may be needed. | | 05 | Odds versus absolute rates | | | Odds ratios can make effects sound large when baseline rates are low. Because so few people in usual care got tested, even modest increases produce high odds ratios. Absolute testing rates remained under 10% after a year. That means most eligible participants were still untested. Both relative and absolute numbers matter for understanding impact. Per-group testing rates are reported in the full paper. Low-cost digital tools could still reach many people at scale. | | | | Testing completion was self-reported, not confirmed in all medical records. The trial took place in Michigan and may not generalize to other settings. Absolute testing rates were low in all groups. The confidence interval for the digital program's effect was wide. Participants who enrolled may have been more interested in testing than the general eligible population. Funding and conflict-of-interest details should be reviewed in the full paper. Longer follow-up and studies of cancer outcomes would be valuable. | | | | If you have a personal or family history of breast, ovarian, colorectal, pancreatic or prostate cancer, ask your clinician whether genetic evaluation is right for you. Collect family health history, including relatives' cancers and ages at diagnosis. Ask whether genetic counseling is available before and after testing. Check insurance coverage; many plans cover testing when guidelines are met. Understand that results can affect relatives and plan how to share them. Federal law provides some protections against genetic discrimination in health insurance and employment. Testing is a personal decision; counseling can help weigh benefits and concerns. | | 08 | The long view on prevention | | | Genetic testing can turn hidden risk into actionable information. This trial suggests digital tools and coaching can modestly increase testing among eligible adults. For individuals, practical questions include: Do I qualify? What would I do with results? Who in my family should know? For health systems, combining outreach with easier access to testing may help close the gap. For researchers, finding ways to reach the majority who remain untested is the challenge. The long-view idea is that knowing your risk early creates more options. Information helps most when the next step is easy. | | | | The Takeaway | | 1 | In a randomized trial of 793 adults eligible for hereditary cancer testing, both a digital program and phone coaching increased testing compared with usual care. | | 2 | Overall testing rates were low: under 5% at six months and 9.6% at 12 months. | | 3 | Both interventions also increased intention to test. | | 4 | Testing was self-reported, and the trial took place in one state. | | 5 | The findings support better outreach and easier access, not a test for everyone. | | | Stay patient, stay curious,
T.C. Brown
Editor, True Capital Talk | | | | Sources & Further Reading | | | | For educational and informational purposes only. Nothing here is a diagnosis, testing recommendation, or individualized medical advice. Talk to a qualified clinician or genetic counselor about genetic testing. | | |
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