Racial and Ethnic Differences in Direct-to-Consumer Genetic Tests Awareness in HINTS 2007: Sociodemographic and Numeracy Correlates
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To examine the association of 1) race/ethnicity and 2) numeracy with awareness of DTC genetic tests. Secondary analysis of 6,754 Hispanic, black, and white adult respondents to the National Cancer Institute’s 2007 Health Information National Trends Survey (HINTS). Logistic regression was used to examine sociodemographic predictors of DTC genetic tests awareness including race/ethnicity, income, education, and gender. Next, two numeracy variables were added to the model. After controlling for sociodemographic variables, black respondents were significantly less likely to have heard of DTC genetic tests compared to white respondents (OR = 0.79; CI: 0.65–0.97). When numeracy variables were added to the model, the effect of black race was no longer significant (OR = 0.84; CI: 0.69–1.04). Hispanic respondents did not significantly differ from white respondents in awareness of DTC genetic tests. Other significant correlates of DTC genetic tests awareness in the full model included education, income, age, and numeracy variables including degree to which people use medical statistics and numbers to make health decisions, and preference for words or numbers when discussing “the chance of something happening.” Although black respondents were generally less aware of DTC genetic tests than white respondents, this relationship appears to be partially mediated by numeracy.
KeywordsDirect-to-consumer genetic tests Genetic testing Health disparities Numeracy African American Hispanic
- 110th Congress (2008). H.R.493. http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h.r.00493. Accessed 5 June 2011.
- 23andMe (2011). Core values. https://www.23andme.com/about/values/. Accessed 18 Sept 2011.
- Akl, E. A., Oxman, A. D., Herrin, J., Vist, G. E., Terrenato, I., Sperati, F., et al. (2011). Using alternative statistical formats for presenting risks and risk reductions. Cochrane Database of Systematic Review (3), CD006776. doi: 10.1002/14651858.CD006776.pub2.
- American College of Medical Genetics (2008). ACMG statement on direct-to-consumer genetic testing. http://www.acmg.net/AM/Template.cfm?Section=Policy_Statements&Template=/CM/ContentDisplay.cfm&ContentID=2975. Accessed 18 Sept 2011.
- American Society of Human Genetics (2007). ASHG statement on direct-to-consumer genetic testing in the United States. http://ashg.org/pdf/dtc_statement.pdf. Accessed Sept 2011.
- Armstrong, K., Micco, E., Carney, A., Stopfer, J., & Putt, M. (2005). Racial differences in the use of BRCA1/2 testing among women with a family history of breast or ovarian cancer. Journal of the American Medical Association, 293(14), 1729–1736. doi: 10.1001/jama.293.14.1729.PubMedCrossRefGoogle Scholar
- CDC (2008). Adding power to our voices: A framing guide for communicating about injury. http://wwwn.cdc.gov/NCIPC-SuccessStory/files/Adding%20Power%20to%20Our%20Voices%20Injury%20Framing%20Guide.pdf. Accessed 22 Sept 2011.
- Center for Health Improvement (2004). Using data strategically: Social math. http://www.chipolicy.org/pdf/TA5.pdf. Accessed 23 Sept 2011.
- Fischhoff, B., Brewer, N., & Downs, J. (2011). Communicating risks and benefits: An evidence-based user’s guide http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Reports/UCM268069.pdf. Accessed 22 Sept 2011.
- Genetic Alliance (2011). Genetic alliance resources and services. http://www.geneticalliance.org/resources#engage. Accessed 20 Sept 2011.
- Genetics Home Reference (2011). What is direct-to-consumer genetic testing? http://ghr.nlm.nih.gov/handbook/testing/directtoconsumer. Accessed 5 Feb 2011.
- GenoCommunity Think Tank (2011). Knowledge modules. http://genocommunity.org/index.php?note=Events. Accessed 5 June 2011.
- Goddard, K. A., Duquette, D., Zlot, A., Johnson, J., Annis-Emeott, A., Lee, P. W., et al. (2009). Public awareness and use of direct-to-consumer genetic tests: Results from 3 state population-based surveys, 2006. American Journal of Public Health, 99(3), 442–445. doi: 10.2105/AJPH.2007.131631.PubMedCrossRefGoogle Scholar
- Hamilton, A. (2008). Best inventions of 2008. http://www.time.com/time/specials/packages/article/0,28804,1852747_1854493,00.html. Accessed 5 June 2011.
- Kutz, G. (2010). Direct-to-consumer genetic tests: Misleading test results are further complicated by deceptive marketing and other questionable practices (p. 33). Washington: U.S. Government Accountability Office.Google Scholar
- Leighton, J. W., Valverde, K., & Bernhardt, B. A. (2011). The general public’s understanding and perception of direct-to-consumer genetic test results. Public Health Genomics. doi: 10.1159/000327159.
- National Cancer Institute (2009a). Health Information National Trends Survey (HINTS) 2007: Final report. http://hints.cancer.gov/docs/HINTS2007FinalReport.pdf. Accessed 7 May 2011.
- National Cancer Institute (2009b). HINTS survey instruments. http://hints.cancer.gov/instrument.aspx. Accessed 7 May 2011.
- National Human Genome Research Institute (2010a). Direct to consumer marketing of genetic tests. http://www.genome.gov/12010659. Accessed 5 Feb 2011.
- National Human Genome Research Institute (2010b). Frequently asked questions about genetic testing. http://www.genome.gov/19516567#al-5. Accessed 7 Feb 2011.
- National Society of Genetic Counselors (2007). Position statements: Direct to consumer genetic testing. http://www.nsgc.org/Media/PositionStatements/tabid/330/Default.aspx#DTC. Accessed 18 Sept 2011.
- Genetics and Public Policy Center (2006). Public health at risk: Failures in oversight of genetic testing laboratories. http://www.dnapolicy.org/images/reportpdfs/PublicHealthAtRiskFinalWithCover.pdf. Accessed 5 May 2011.
- Ramirez, A. G., Aparicio-Ting, F. E., de Majors, S. S., & Miller, A. R. (2006). Interest, awareness, and perceptions of genetic testing among Hispanic family members of breast cancer survivors. Ethnicity & Disease, 16(2), 398–403.Google Scholar