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  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.