Investigating Latinx populations’ attitudes, perceptions, and use of genomic testing

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PROJECT SUMMARY Genomic medicine has transformed prevention, care, and targeted medical regiments through the milestone achievements of Human Genome Project and the advent of genetic testing for health purposes. Germline genetic testing focused on hereditary risk, the focus of this proposal, can include various types and purposeful testing like carrier screening, newborn screening, and cancer predisposition testing, etc. This tests have already enabled genetic providers to improve health outcomes for many with increased screening recommendations, prevention efforts (chemoprevention), and behavioral change recommendations. However, the diffusion of genetic testing for underserved groups, specifically Latinx (gender neutral use of Latino/a/e) groups, remains a major challenge. Despite a strong interest in using genetic testing, there remains a dearth of research on facilitating and barrier factors for Latinx populations. Thus, the goal of this proposal is to empirically examine Latinx individuals' experiences with genetic testing, their attitudes, and identify perceived facilitators and barriers to testing. In particular, I will characterize salient attitudes, facilitators, and barriers of Latinx individuals towards genetic testing for health purposes using a sequential explanatory mixed-methods design (Aim 1). The first phase of the study (Aim 1A) will characterize salient attitudes, facilitators, and barriers of 20 Latinx individuals towards genetic testing for health purposes using semistructured elicitation interviews. The sample will be stratified by previous experience with genetic testing, and those who have not tested as was to better characterize attitudes, facilitators and barriers that differ between these groups. Interviews will center on questions of attitudes, perceived norms, and personal agency inclusive of facilitators and barriers. Results will then guide the next phase of the research (Aim 1B). In this phase, I will examine the associations of attitudes, facilitators, and barriers with intentions related to carrier screening and cancer predisposition testing for a Latinx population. Specifically, using wording from interviews, I will design a survey focused on attitudes, facilitators, and barriers and administer the survey on a Qualtrics Panels with 500 Latinx individuals. Using Structural Equation Modeling, I will then test the associations between attitude, facilitators, and barrier factors with behavioral intention to both carrier screening and cancer predisposition testing to determine which may be the best factors for intervention. Building upon the F99 results, in the postdoctoral phase I will utilize findings about attitudes, facilitators, and barriers to develop translational intervention research to engage Latinx populations in genetic testing (Aim 2). The goal of my postdoctoral research training developing culturally appropriate communication strategies to improve genetics engagement for Latinx populations. Through a more robust understanding of attitudes, facilitators, and barriers can genomic researchers better engage with Latinx populations and therein reduce health inequities within genomics.