(62) Genetic Health Literacy in an Urban Southeastern Population

Objective: As prenatal genetic screening and diagnostic testing is recommended for all pregnant persons, we sought to evaluate genetic literacy in an urban population in the Southeast.

Study Design: Prospective study of all individuals seeking prenatal care at the University of Alabama at Birmingham from 3/2020-8/2022. Consenting individuals were administered a computer-based survey which included an introduction to genetic screening/diagnostic testing and assessed patient attitudes towards genetic testing. Genetic literacy was assessed using two validated measures: the Genetic Literacy and Comprehension (GLAC), which assesses a patient’s self-reported familiarity with 8 genetics terms, and the Genetic Knowledge Survey (GKS) which assesses correctness on 16 genetics questions. Mean scores for both instruments as well as GKS score ranges (Table) were computed for the overall population. Scores were compared between private vs. public insured groups and low-risk vs. high-risk populations (referred for potential genetic abnormalities e.g., abnormal genetic screening, fetal anomalies) using appropriate tests.

Results: A total of 1596 people were approached for this study, of whom 895 enrolled. Of these, 776 were low-risk (53.6% publicly insured) and 119 high-risk (54.5% publicly insured). Our cohort was on average 27±6 yrs old, primarily Black (55%), with at least a high school education (92%). The overall mean GLAC score was 5.2±2.3 and was significantly higher in privately insured patients and those with high genetic risk (Table). GKS scores were overall low in our cohort (6.9 ± 4.7), with lower scores among publicly insured participants (Table). GKS scores were similar among low and high-risk groups (p=0.095). While rates of high knowledge were greatest in those with private insurance (13.9%), high GKS scores were infrequent (Table).

Conclusion: While pregnant individuals report familiarity with genetic terms, they do not have high genetic knowledge. Efforts to improve genetic knowledge are urgently needed, so that pregnant patients can make informed decisions about prenatal genetic screening and diagnosis.