Effects of health literacy skills, educational attainment, and level of melanoma risk on responses to personalized genomic testing Journal Article


Authors: Kaphingst, K. A.; Khan, E.; White, K. M.; Sussman, A.; Guest, D.; Schofield, E.; Dailey, Y. T.; Robers, E.; Schwartz, M. R.; Li, Y.; Buller, D.; Hunley, K.; Berwick, M.; Hay, J. L.
Article Title: Effects of health literacy skills, educational attainment, and level of melanoma risk on responses to personalized genomic testing
Abstract: Objective: Few studies have examined how health literacy impacts responses to genetic information. Methods: We examined this issue among 145 English or Spanish-speaking adult primary care patients enrolled in a trial that offered testing for MC1R gene variants that confer moderately increased melanoma risk. We investigated whether health literacy skills, educational attainment, or melanoma risk were related to short-term cognitive and affective responses to genetic test results. Results: On average, participants found the test results to be highly believable and clear, with low levels of negative emotional responses and moderate levels of positive responses. In adjusted models, health literacy skills were significantly inversely associated with confusion (OR = 0.75, 95 % CI = 0.58, 0.96); those with higher education thought significantly less about their test results (β = −0.66), were less hopeful (β = −0.89), and had lower distress (β = −1.15). We also observed a significant interaction (p <.001) between health literacy and melanoma risk in affecting the frequency of thoughts about test results. Conclusion: The findings indicate that health literacy skills may affect to what extent individuals elaborate cognitively on genetic information. Practice implications: Patients with lower health literacy skills or education may need support in understanding genetic test results. © 2020 Elsevier B.V.
Keywords: melanoma; communication; genetic testing; health literacy; return of results
Journal Title: Patient Education and Counseling
Volume: 104
Issue: 1
ISSN: 0738-3991
Publisher: Elsevier Ireland Ltd.  
Date Published: 2021-01-01
Start Page: 19
End Page: 26
Language: English
DOI: 10.1016/j.pec.2020.07.019
PUBMED: 32773237
PROVIDER: scopus
PMCID: PMC7749822
DOI/URL:
Notes: Article -- Export Date: 4 January 2021 -- Source: Scopus
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  1. Yuelin Li
    219 Li
  2. Jennifer L Hay
    265 Hay
  3. Elizabeth A Schofield
    161 Schofield
  4. Erva Khan
    3 Khan