Bringing the Social into Genetics: The Psychosocial Genetics Risk Assessment and Management Framework (PG-RAM)

Abstract

As increasing numbers of people are identified at risk for multi-factorial diseases, questions of how to assess, communicate and manage genetic risk will be critical from health services and policy perspectives. However, there is currently no evidence-based genetic risk assessment and management framework to assist policy makers, clinicians and other stakeholders. A comprehensive psychosocial framework for risk assessment and management has been developed in the context of security hazards or threats. In an adaptation of that model, we present the Psychosocial Genetics Risk Assessment and Management framework (PG-RAM). It offers principles to enhance the integration of evidence-based best practices into genetics health services, as well as to identify issues, knowledge and gaps. The framework identifies the core elements of the situation, effects, population and interventions, all spanning several phases of genetic disorders. The framework provides an excellent starting point for knowledge syntheses in the context of genetic risk and could serve as the conceptual basis for practical tool development to guide healthcare professionals and decision makers in preparing for and responding to the psychosocial aspects of genetic risk.