FAQ
FREQUENTLY ASKED QUESTIONS
About the Healthy Nevada Project
Q. What is the Healthy Nevada project?
A: The Healthy Nevada Project is one of the largest community-based population health programs in the world. Our goal is to understand factors that determine health outcomes—one of these factors is your genetics. We hope to learn how your genetics impact your personal health trajectory and use this information to help you and your healthcare providers make more informed decisions about your health.
Q. Does it cost anything to participate
A: No, you can enter the study at no cost. Participants receive clinical grade genetic sequencing and screening for three of the most common hereditary risks, as well as regional ancestry and wellness insights at no cost. If we find any genetic variants indicating an increased health risk in your DNA, you will be contacted directly regarding your results and be offered no-cost genetic counseling with a licensed genetic counselor to discuss your individual results. Any follow-up care or treatment required after the disclosure of your results, such as through your primary care provider, will be charged to you and/or your health insurance in the usual manner.
Q. When did this project start/how long has it been running?
A: The first phase of the Healthy Nevada Project (HNP) was launched in September 2016 with 10,000 Nevadans joining the study in partnership with 23andMe. In March 2018, the second phase of the project was introduced with our partners at Helix for a more clinically focused experience, inviting 40,000 more Nevadans to participate. In May 2019, the third phase of the HNP began to include Las Vegas and southern Nevada. The Healthy Nevada Project will continue indefinitely with an expectation of enrolling over 250,000 participants into the study.
In August 2024, we updated our consent workflow to provide a more efficient experience for our participants and to align with the Helix Research Network. The Helix Research Network is a group of like-minded health systems trying to improve clinical care with genomic medicine tools and make research breakthroughs across a larger sample size than any one health system can provide.
Q. Who is involved
A: The Healthy Nevada Project is powered by Renown Health and Renown’s Institute for Health Innovation (Renown IHI) in collaboration with the University of Nevada, School of Medicine. Renown Health is a locally governed and owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. UNR Med is the research home of the HNP team.
During phase two, the personal genomics company, Helix, and a telegenomics technology and services company, Genome Medical, joined the project. Helix handles DNA sequencing and secure data storage while Genome Medical provides medically licensed genetic counseling to participants with positive findings.
Q. Why Helix?
A: We learned from the pilot study that we needed to integrate the Healthy Nevada Project into clinical care. To do this, we needed a vendor that could provide clinically actionable results to enrolled patients and their physicians. Renown IHI research teams will have greater depth and quality of DNA data thanks to Helix’s Next Generation Sequencing (NGS) technology and one of the world’s largest CAP- and CLIA accredited exome sequencing labs.
Benefits to the Participants
Q. How do I benefit from the study
A: Our study offers screening and clinical results for 3 inherited genetic conditions: Hereditary Breast and Ovarian Cancer Syndrome, Lynch Syndrome, and Familial Hypercholesterolemia. There is no cost to you as a participant and the results from the genetic testing will be returned directly to you and may also be made a part of your medical record. These results may indicate you are at increased risk for certain conditions, such as heart disease
or certain cancers, that when detected early can have a positive impact on your health. You may also receive insights into your personal ancestry and other non-medical traits such caffeine sensitivity, earwax type and more, that may be of interest to you by signing up for an optional account with Helix.
Q. Will I be opting into being contacted about future research studies by participating in this project?
A: Yes, but you will be under no obligation to participate in future research studies and may opt-out of being contacted regarding additional research studies at any time by contacting the study team directly. Study participants are often the first to be offered new research opportunities that may benefit them.
For example, Renown IHI may open additional clinical trials in specific disease areas, such as our M/NASH Liver Disease Study, to participants interested in taking part.
Who Can Join the Study?
Q. Who can join the study?
A: Nevada residents over the age of 18 years with an active Renown MyChart account who do not have a history of a stem cell or bone marrow transplant from a donor. Renown patients who reside just outside of Nevada but seek care at Renown Health are also eligible to participate.
Need a MyChart visit: https://mychart.renown.org/mychart/signup
Q. Are children under the age of 18 allowed to enroll in the study?
A: Currently the Healthy Nevada Project is not enrolling children under the age of 18. Please check back in the future for updates on how children can participate.
Q: If I participated when the project used 23andMe test, can I participate again and take the Helix DNA test?
A: Yes, of course! Visit our website at healthynv.org to learn how to join.
Q: Can I participate in the Healthy Nevada Project if my DNA has been previously sequenced by Helix?
A: Yes! If you have previously been sequenced by Helix and would like to participate in the Healthy Nevada Project, please contact our team at 775-982-6914. Depending on your specific circumstances, you may need to sign a consent form and/or provide a new sample.
Q: WHY CAN’T I PARTICIPATE IF I HAVE HAD A BONE MARROW TRANSPLANT OR STEM CELL TRANSPLANT FROM A DONOR?
A: If you have received a bone marrow or stem cell transplant as a treatment for blood cancer or another type of blood disease, it is recommended that you do not participate in this research study.
This study tests DNA from cells that are collected from your saliva or blood sample. These cells are often created by your bone marrow or by your stem cells. If you have received a bone marrow or stem cell transplant from a donor, your DNA and the DNA of your donor may be included in your specimen. Genetic test results may reflect the DNA of your donor or they may be inconclusive.
If you have been a bone marrow or stem cell donor, this would not impact your genetic test results.
What You Need to Know Before You Test
Q: How long does the appointments take?
A: On average, visiting the enrollment website and reviewing the consent form takes about 15 to 20 minutes. You may visit the enrollment website on your own and review and sign the consent form. If you prefer you may schedule a virtual appointment with a Genomic Representative who will answer any questions you might have.
Once you visit a laboratory for your blood draw, the visit will take about 15 to 20 minutes.
If you are providing a blood sample, fasting is not required, but please do not schedule your visit within 30 days of receiving a blood transfusion or blood products. In addition, if you are scheduling your blood sample with other labs please follow whatever guidelines they provide for those tests.
If you are eligible for the M/NASH sub study and you are providing a blood sample at the same time for the Enhanced Liver Fibrosis (ELF) test please remember to discontinue from taking anything with B7, normally found in multivitamins/biotin, 3 days prior to your blood draw. If you are eligible for the Liver Hepatoscopy test you will be contacted by a research coordinator at Renown Health.
If you are providing a saliva sample you cannot eat, drink (even water), chew gum or use tobacco products for 30 minutes prior to providing your sample.
Q: How is the screening done?
A: If you are providing a blood sample, the draw is just like a normal lab draw.
If you are providing a saliva sample we will provide you a collection tube at your appointment that you will spit into.
Once collected, your sample will be packaged and shipped to Helix where your DNA will be extracted and sequenced.
Q: How should I prepare for the appointments?
A: Prior to your virtual appointment we recommend participants review the consent form prior.
Blood sample: no fasting required unless you are having this done with other labs and these require you to do so. Please follow guidelines provided with those labs.
If you are providing a blood sample at the same time for the Enhanced Liver Fibrosis (ELF) test please remember to discontinue from taking anything with B7, normally found in multivitamins/biotin, 3 days prior to your blood draw.
Saliva sample: We ask that you not eat or drink anything for at least 30 minutes prior to testing. This includes water, chewing gum, smoking, using tobacco products or even taking a cough drop!
Q: How do I sign up for the Healthy Nevada Project?
A: We have several options for you:
- Visit the enrollment website hosted by hour partner Helix where you can review and sign the research consent form (link). By visiting the enrollment site, your information will be shared with our research partner, Helix, to assist with the enrollment process.
- If you prefer to review the consent form with a study team member or if you have questions you may schedule an an appointment through MyChart, with a Genomics Coordinator.
- To do so please:
- Select Visits(always visible from main screen)
- Select Schedule an Appointment
- Select Genetic Research Virtual Visit
- Select the date and time that works best for you
- Need a MyChart? Go to renown.orgto sign up.
- You can also call us at 775 982 6914.
Q: How do I create a Helix account?
A: You will receive an email from Helix within days of your screening to access your optional account. Participants can use their MyChart login for ease of access.
After You Test
Q: I finished my test. What’s next?
A: Your sample will be sent to Helix’s lab for processing. You will receive an emai from Helix within days of your screening to access your account. Participants can use their MyChart login for ease of access. Helix will sequence and store your genetic information from your sample and return genetic results on your Helix account, populated to your medical record and viewable through MyChart. You will be provided with two results products on your Helix account under the results tab. Participants typically receive ancestry and wellness insights through the“Helix Ancestry” and “Helix Traits” product first and then clinical results for Familial Hypercholesterolemia, Hereditary Breast and Ovarian Cancer Syndrome, and Lynch Syndrome in the “Helix Health” product shortly thereafter. Results can take up to 12 weeks to be returned and Helix will notify you by email when your results are available to review on your Helix account.
Although rare, if a genetic mutation is discovered for any of the conditions tested, you will be contacted by phone to discuss your results and be provided with additional resources about your findings, such as no cost genetic counseling with a licensed genetic counselor. You will not be contacted if there are no actionable findings.
Throughout the duration of the study, you may be periodically contacted by email to complete voluntary surveys to help improve our research. Some surveys may include additional incentives for completion that will be disclosed at the time of distribution.
Q: What kind of results will I receive?
A:. You will receive two kinds of results if you decide to participate. Participants receive non-clinical genetic results through the “Helix Ancestry” and “Helix Traits” results product. Through these results products, you will be able to learn and explore your genetic insights related to your regional ancestry and how your DNA can influence your body’s response to the foods you eat. Please note: this results product does not contain health results.
Clinical genetic results for Familial Hypercholesterolemia, Hereditary Breast and Ovarian Cancer Syndrome, and Lynch Syndrome are provided through the “Helix Health” results product. Participants will be notified by email when their results are available to be viewed directly on their Helix account. Results will be accessible for as long as the Helix account is active, and participants can download a clinical report for the genetic conditions being tested. Results will also be populated to a patient’s Renown medical record when testing is complete and viewable on MyChart.
Q: What is Familial Hypercholesterolemia (FH), Breast and Ovarian Cancer and Lynch Syndrome?
Familial Hypercholesterolemia (FH): Increased risk for early heart disease and high cholesterol
Breast & Ovarian Cancer Syndrome (BRCA 1&2 genes): Increased risk for Breast, Ovarian, Prostate, and Pancreatic cancers
Lynch Syndrome: Increased risk for colon and endometrial cancers
Q: Why only these three conditions?
A: These three conditions are CDC (Centers for Disease Control) Tier 1 clinically actionable conditions. This means that actions can be taken to treat, prevent, delay or reduce symptoms of these health conditions. Therefore, if you learn that you or your family member have an increased risk of developing any of these conditions, you and your primary care provider can follow an action plan that may help improve health outcomes.
The Healthy Nevada Project may expand to report on additional hereditary risks in the future. You will not receive additional results without your consent. We will let you know if other results may be offered in the future.
Q: When will I find out about my results?
A: Sequencing and return of results may take up to 12 weeks once your sample has been received at the Helix lab. Helix will notify you by email with updates regarding the status of your sample and when your results are ready to be viewed on your Helix account. Your genetic results will also be populated to your medical record and viewable through MyChart.
Q: What if I do not have a genetic variant for these conditions?
A: Only about 1% of the population will have the genetic variants that are understood to cause an increased risk for the conditions we are currently screening for. That means about 99% of the study participants will not have a pathogenic/likely pathogenic variant for the 3 conditions we are currently screening for. If no DNA variants are found for the conditions being tested, this is reassuring, but there are other causes of cancer and heart disease that were not evaluated as part of this test. Lifestyle, family history, environment, personal medical history and other genetic conditions all contribute to your overall health and personal risk for disease. Therefore, continued routine screening for cancer and coronary artery disease is important. Please talk with your doctor about ongoing recommended screening for cancer and heart disease. You may still be contacted by your provider for additional follow-up.
Q: Are these results final? Do I no longer need to worry about the conditions you are screening for?
A: Not completely – Your negative result is reassuring, but there are other causes of cancer and heart disease that were not evaluated as part of this test. Lifestyle, family history, environment, personal medical history and other genetic conditions all contribute to your overall health and personal risk for disease. Therefore, continued routine screening for cancer and coronary artery disease is important. Even without an identifiable genetic risk factor, one in eight biological women will develop breast cancer in their lifetime, and one in twenty-five people will develop colorectal cancer in their lifetime. Additionally, nearly one in four people will develop coronary artery disease in their lifetime. Please talk with your doctor about ongoing recommended screening for cancer and heart disease. If you have previously been diagnosed with Hereditary Breast and Ovarian Cancer syndrome, Lynch Syndrome, or Familial Hypercholesterolemia, do not disregard those test results. The negative screening test results from this study do NOT mean your previous results were incorrect. Science is constantly evolving, and we know researchers have not identified all possible genetic variants that could be associated with these conditions. There are other genes known to increase the risk for cancer or cardiovascular disease development that we are not screening for yet. Therefore, if you have a personal or family history of cancer, cardiovascular disease, or a cardiovascular event, be sure to share this information with your medical provider. Your doctor can help you determine if further genetic testing is appropriate.
The American College of Medical Genetics provides a list of other genetic conditions that can be diagnosed and managed through genetic screening, Healthy Nevada Project is currently reporting on the top 3 conditions: Hereditary Breast and Ovarian Cancer Syndrome, Lynch Syndrome, and Familial Hypercholesterolemia. The Healthy Nevada Project will continue to report on more hereditary risks in the near future. With the advancement of genomic medicine, It is possible we may offer the return of additional results in the future.
Q: Will I get any more results in the future?
A: The American College of Medical Genetics provides a list of other genetic conditions that can be diagnosed and managed through genetic screening. Healthy Nevada Project is currently reporting on the top 3 conditions: Hereditary Breast and Ovarian Cancer Syndrome, Lynch Syndrome, and Familial Hypercholesterolemia. It is possible we may offer the return of additional results in the future. Continue to check your emails regularly and if you have any concerns about your health, consult with your physician.
Q: MY RESULTS SAY THAT THE TEST WAS NOT PERFORMED (TNP), WHY IS THAT?
A: A result of “test not performed” means the sample that was provided did not meet the quality standards needed to complete the DNA sequencing at the Helix lab. Some examples of why this might happen include, but are not limited to, issues with processing the sample and extracting the DNA, issues with the sample being read in the sequencing machine, or issues with the sequencing data not being a high enough quality for interpretation. Every sample and its associated data is checked at multiple stages for quality, and a typical sample is given a “Test Not Performed” result only after it has failed multiple attempts.
Most of these issues may be resolved by collecting another sample and therefore we encourage any participant who receives a TNP result to provide another sample. If this issue occurs again, additional review of the issue will be completed in order to provide the best next steps about additional sample collection.
Q: MY ANCESTRY AND/OR TRAIT RESULTS DIFFER FROM WHAT I EXPECTED. DOES THIS MEAN MY HELIX HEALTH RESULTS ARE WRONG?
A: No. The results of your ancestry and traits may be different from what you understand to be true about yourself. This does not mean the information provided to you about these results or your health results is inaccurate.
It is important to understand that trait and ancestry results are estimates based on DNA patterns rather than definitive information. These results give insights into a person’s genetic origins or predispositions. They do not guarantee the occurrence of specific ancestry or traits. While some traits are easy to predict based on genetic information, other traits are more complex and therefore more challenging to predict based on genetic data alone. Trait and ancestry results are different from Helix Health results. Helix Health screening looks for the presence or absence of specific genetic variants. Such variants have extensive evidence from the medical community linking them to risk for disease.
Why doesn’t my ancestry and/or trait result match my actual ancestry or trait?
Genetic variations linked to ancestry and traits occur throughout the genome. They are responsible for the natural genetic diversity among people. These genetic variants estimate the most likely ancestry or traits that a person will have. They are not definitive and do not guarantee the occurrence of specific ancestry or traits.
Sometimes, the ancestry and traits we express do not match what is expected based on DNA screening. There are a few reasons for this. First, Helix screening may not include all of the genetic variants linked to a specific trait or ancestry. Also, there may be interactions between genes that are not yet fully understood. Genetic traits are often influenced by multiple genes making it difficult to predict precise outcomes. Finally, genetic traits can be influenced by the environment or other factors. These factors can interact with your genetic makeup and contribute to differences between the traits you express and the traits expected based on your DNA screening.
Q: WHAT IF I HAVE A PERSONAL OR FAMILY HISTORY OF HEART DISEASE OR CANCER?
A: If you have a personal or family history of a condition covered by this test, it is important to know the results of this test do not change a previous diagnosis or any family history risk you might have. This is because there are other causes of cancer and heart disease that were not evaluated as part of this test. For example, lifestyle, family history, environment, personal medical history, and other genetic conditions all contribute to your overall health and personal risk for disease. In addition, the screening test provided as part of the Healthy Nevada Project does not evaluate all genes associated with cancer and heart disease. Also, this test may not identify all DNA variants in the genes that were tested.
You may want to speak with a genetic counselor or your healthcare provider about the results of this test and whether additional or different genetic screening and general screening may be appropriate for you. In particular, participants with a negative genetic test and a clinical diagnosis of one of the conditions screened for by this test are recommended to consider a diagnostic genetics consultation to identify whether additional genetic screening or screening recommendations are indicated. A genetic counselor is a medical professional specifically trained to help you understand how your genetic information may impact your health and the health of your family members, discuss medical recommendations, and discuss how you can approach sharing any important information with others. Those communications would be separate from the Healthy Nevada Project.
Q: CAN MY GENETIC SEQUENCING COMPLETED THROUGH THIS RESEARCH PROGRAM BE USED FOR OTHER TESTS IN THE FUTURE?
A: Our partner, Helix, performs Exome+ sequencing on participant samples. This screening reads the DNA sequence of most genes (plus many other regions of the DNA). An individual’s DNA sequence is also called their genetic information. Through involvement in this study, participants will receive DNA test results for three medical conditions. These conditions include a genetic form of breast cancer, colon cancer and high cholesterol. There are no additional genetic test results planned for return through this research program at this time. This may change in the future if additional medical conditions become appropriate for general population screening. Participants will be notified of any updates before receiving new results.
Helix will store participants’ DNA sequence results for an unlimited time. Since participants’ genetic information has been sequenced and stored, it will be possible to use that information for future clinical genetic testing. Helix is actively working with Renown Health and other partnering healthcare institutions to offer opportunities for patients to learn more about their genetic information in the future. Such future clinical testing would only be performed at the request of an ordering healthcare provider and with the additional consent and payment by the patient.
Privacy Protection
Q: What is your privacy policy? How is my data used?
A: Unless explicitly stated differently in the Informed Consent for the Healthy Nevada Project, we follow the privacy policies of Renown Health. Any data obtained from your participation in this study is used for research purposes as outlined in our Informed Consent Form.
The information you contribute to the Healthy Nevada Project will be used by researchers to study a wide range of questions around how DNA can impact health. The databases created in this research program will be used for future research by our genomics partner Helix, by us, and by other members of the Helix Research Network. The Helix Research Network is a network of health systems that work with Helix to create and offer community health research programs to their patients and members of their community. The Healthy Nevada Project is a Helix Research Network study. That means; by agreeing to participate in the study, you are agreeing to have your information included in future research projects that are approved by us and by Helix.
Researchers outside of the Helix Research Network may also study your coded information and samples but will not have access to information that directly identifies you. These researchers may work for health systems, universities, government agencies, companies like drug companies and other foundations or groups interested in research. Any sharing of information outside of the network will be carefully reviewed and approved to make sure it is ethical, secure and protects your privacy.
We may share discoveries that are made by Renown Health researchers through our website and newsletters.
Q: What steps have you taken to ensure my information is kept private?
A: To help us protect your privacy, we have obtained a Certificate of Confidentiality (CoC) from the National Institutes of Health. The researchers can use this Certificate to legally refuse to disclose information that may identify you in any federal, state, or local civil, criminal, administrative, legislative, or other proceedings, for example, if there is a court subpoena. The researchers will use the Certificate to resist any demands for information that would identify you.
It is also important to note that all information is de-identified for research purposes. Your accounts with Helix and the products you may receive or purchase in the Helix Store are not accessible to any researcher at Renown or DRI. Helix will only share the parts of your genome that are relevant to this study with the Healthy Nevada Project. If researchers make findings that are deemed important to communicate back to individuals and you consented for us to do so, the Principal Investigator will be able to re-identify you for the purposes of communicating this vital information back through trained medical staff. Examples of this information are increased risk of developing serious diseases such as cardiovascular disease or cancer.
Federal and state laws are in place to protect your protected health information (PHI).
Q: Will my insurance company use my genetic results against me (i.e. will they deny future claims because of my results?)
A: The Genetic Information Nondiscrimination Act of 2008 (GINA) is a federal law that protects individuals from genetic discrimination in health insurance and employment. With GINA’s protections, you can feel comfortable talking about family health history with your family and healthcare providers.
GINA legally forbids health insurers to request, require, or use genetic information to make decisions about your eligibility for health insurance and your health insurance premium, contribution amounts, or coverage terms. This means that it is against the law for your health insurer to use a genetic test result, or family health history, as a reason to deny you health insurance or decide how much you pay for your health insurance. However, GINA does not cover life insurance, disability insurance, or long-term care insurance.
To learn more about how you are and are not protected, check out ginahelp.org.
Q: Can the police ask Renown Health for my DNA sequence?
A: Signing the research consent form does not mean that Renown Health or Helix will share your research information with law enforcement. Renown Health and Helix take genetic privacy very seriously and would only share your research information with law enforcement in connection with a valid legal process requiring disclosure of such data or where disclosure is required by law (like a valid warrant or court order). All such requests would be reviewed on a case-by-case basis and you would be notified of such a request before sharing any data occurs unless Renown Health or Helix is legally barred from doing so. Helix will object to any request that does not meet legal standards.
Q: Has law enforcement ever contacted a private genetic sequencing company before to obtain personal information?
A: Helix has never been contacted by law enforcement to request personal information of a research participant. Most companies like Ancestry and 23andMe publish transparency reports with information about requests from law enforcement. For more information, please review these reports.
Q: WHAT IF I HAVE A PERSONAL OR FAMILY HISTORY OF HEART DISEASE OR CANCER?
A: If you have a personal or family history of a condition covered by this test, it is important to know the results of this test do not change a previous diagnosis or any family history risk you might have. This is because there are other causes of cancer and heart disease that were not evaluated as part of this test. For example, lifestyle, family history, environment, personal medical history, and other genetic conditions all contribute to your overall health and personal risk for disease. In addition, the screening test provided as part of the Healthy Nevada Project does not evaluate all genes associated with cancer and heart disease. Also, this test may not identify all DNA variants in the genes that were tested.
You may want to speak with a genetic counselor or your healthcare provider about the results of this test and whether additional or different genetic screening and general screening may be appropriate for you. In particular, participants with a negative genetic test and a clinical diagnosis of one of the conditions screened for by this test are recommended to consider a diagnostic genetics consultation to identify whether additional genetic screening or screening recommendations are indicated. A genetic counselor is a medical professional specifically trained to help you understand how your genetic information may impact your health and the health of your family members, discuss medical recommendations, and discuss how you can approach sharing any important information with others. Those communications would be separate from the Healthy Nevada Project.
Q: WHAT STEPS HAVE YOU TAKEN TO ENSURE MY INFORMATION IS KEPT PRIVATE?
Your privacy is very important to us, and we take many steps to ensure it is protected, such as:
- Your information (your genetic information and health records) will be stored in secure databases.
- We limit and closely monitor who can access your data.
- We limit who is allowed to see information that could identify you, like your name or contact information.
- Researchers who have access to your data must be trained and certified to work with this type of research data.
- You can choose to withdraw and stop sharing your information at any time.
Informed Consent
Q: What is in your informed consent?
A: Our Informed Consent Form is a form that will tell you all of the information about your involvement in this study. You can review the consent form on healthynv.org. We will ask you to sign a copy prior to or during your appointment.
Q: WHAT IF I PARTICIPATE NOW AND CHANGE MY MIND LATER?
A: You may withdraw from the study at any time. Your decision to withdraw will not result in any penalty or loss of benefits and will not affect the medical care or benefits to which you are otherwise entitled.
To withdraw, please send an email to the [Site Program Name] study team at [email].
If you withdraw from the study, you will no longer receive any emails or other communication as part of the study. Any information that has already been added to your medical record will remain in your medical record. However, no new information from the research study will go into your medical record. Your withdrawal from the project will be appropriately noted in your medical record.