title: Consumers' use of web-based information and their decisions about multiplex genetic susceptibility testing.
abstract: BACKGROUND
  Few data exist to inform concerns raised by online direct-to-consumer marketing of genetic susceptibility tests, such as those offered by commercial entities like 23andme, Navigenics, and DNA Direct. The Multiplex Initiative, a population-based study of healthy adults, provides the first opportunity to evaluate how use of a Web-based decision tool that conveyed information about a genetic susceptibility test influenced individuals' test decisions.
  
  
  OBJECTIVE
  To inform the ongoing debate over whether individuals offered genetic susceptibility testing without the involvement of a health care provider (eg, through direct-to-consumer testing) can make informed decisions about testing when guided by online decision aids.
  
  
  METHODS
  Participants were 526 members of a large health maintenance organization aged 25 to 40 years old who visited a study website. Multivariate logistic regression models were tested to examine the association of website usage with downstream test decisions.
  
  
  RESULTS
  Participants viewed an average of 2.9 of the 4 pages introducing the multiplex test, 2.2 of the 8 pages describing the health conditions, and 3.2 of the 15 pages describing the genes. For each page viewed, participants were more likely to describe their decision-making as easy (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01-1.07) and to decide to be tested (OR 1.08, 95% CI 1.05-1.11).
  
  
  CONCLUSIONS
  Healthy adults in this study perceived Web-based genomic information presented using evidence-based communications approaches to be helpful in supporting both decisions to test and not to test. Continued research is needed to ensure that these results generalize to target groups with lower literacy and less Internet savvy.
authors.affiliation: Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA. kkaphingst@gwbmail.wustl.edu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kaphingst
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McBride
authors.forename: Christopher
authors.initials: C
authors.lastname: Wade
authors.forename: Sharon Hensley
authors.initials: SH
authors.lastname: Alford
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Brody
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Baxevanis
mesh_terms: D000328:Adult; D003657:Decision Making; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D006279:Health Maintenance Organizations; D006801:Humans; D020407:Internet; D012044:Regression Analysis; D013663:Teaching / Q000379:methods / Q000592:standards