title: Social and familial context of prenatal genetic testing decisions: are there racial/ethnic differences?
abstract: The purpose of this cross-sectional study of 999 socioeconomically and racially/ethnically diverse pregnant women was to explore prenatal genetic testing attitudes and beliefs and the role of external influences. Surveys in English, Spanish, and Chinese included questions regarding the value of testing, pregnancy, and motherhood; the acceptability of Down syndrome in the subject's community; and the role of social and cultural influences in prenatal testing decisions. We analyzed racial/ethnic differences in all attitudinal and external influence variables, controlling for age, relationship status, and socioeconomic status. We found statistically significant racial/ethnic group differences in familiarity with an individual with Down syndrome and in 10 of 12 attitude, belief, and external influence variables, even after controlling for other sociodemographic characteristics. We also observed substantial variation within racial/ethnic groups for each of these measures. Despite the statistically significant group differences observed, R(2) values for all multivariate models were modest and response distributions overlapped substantially. Social and familial contexts for prenatal testing decisions differ among racial/ethnic groups even after accounting for age, marital status, and other socioeconomic factors. However, substantial variation within groups and overlap between groups suggest that racial/ethnic differences play a small role in the social and familial context of prenatal genetic testing decisions.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA. learmanl@obgyn.ucsf.edu
authors.forename: Lee A
authors.initials: LA
authors.lastname: Learman
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
authors.forename: Elena
authors.initials: E
authors.lastname: Gates
authors.forename: Robert F
authors.initials: RF
authors.lastname: Nease
authors.forename: Virginia
authors.initials: V
authors.lastname: Gildengorin
authors.forename: A Eugene
authors.initials: AE
authors.lastname: Washington
mesh_terms: D001294:Attitude to Health / Q000208:ethnology; D003430:Cross-Sectional Studies; D003625:Data Collection; D003657:Decision Making; D004314:Down Syndrome / Q000175:diagnosis / Q000523:psychology; D005190:Family / Q000208:ethnology / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D044382:Population Groups; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000523:psychology*; D012944:Social Support