Exploratory Analysis of Health Literacy and Genetic Testing Awareness, Uptake, and Desire for Genetic Risk Information: Findings From a Cross-Sectional Community Survey

Abstract

Introduction Limited research has examined whether genetic testing awareness and uptake differ for individuals with varying levels of health literacy. We examined the association between health literacy and genetic testing and 1) awareness, 2) uptake, and 3) desire for genetic risk information, while controlling for socio-demographic factors. Methods We conducted secondary analyses using cross-sectional data from a Community Health Needs Assessment (CHNA) survey conducted between January and March 2022. Multivariable binary logistic regression models were used to examine the relationship between health literacy and genetic testing awareness and uptake, and an ordinal logistic regression model examined the association between health literacy and desire for genetic risk information. All models were adjusted for demographic characteristics. Results The sample was predominantly female (67.8%), White (75.7%), non-Hispanic (77.1%), employed (52%), had a high school education or vocational training (44.8%), had health insurance coverage (85.6%), and preferred to speak English at home (79.4%). After controlling for socio-demographic characteristics, higher health literacy was associated with greater odds of genetic testing awareness (aOR = 1.27, 95% CI: 1.10 – 1.47), and inversely associated with genetic testing uptake (aOR = 0.78, 95% CI: 0.69 – 0.88). The association between health literacy and desire for genetic risk information was not statistically significant after controlling for demographics. Conclusions Our findings suggest that health literacy is associated with genetic testing awareness, but more research is needed to fully understand the relationship between health literacy and genetic testing engagement. Our findings could help inform future community-based, health literacy-sensitive interventions.