title: Genetic literacy and patient perceptions of IBD testing utility and disease control: a randomized vignette study of genetic testing.
abstract: BACKGROUND
  Findings from inflammatory bowel disease (IBD) genome-wide association studies are being translated clinically into prognostic and diagnostic indicators of disease. Yet, patient perception and understanding of these tests and their applicability to providing risk information is unclear. The goal of this study was to determine, using hypothetical scenarios, whether patients with IBD perceive genetic testing to be useful for risk assessment, whether genetic test results impact perceived control, and whether low genetic literacy may be a barrier to patient understanding of these tests.
  
  
  METHODS
  Two hundred fifty seven patients with IBD from the Johns Hopkins gastroenterology clinics were randomized to receive a vignette depicting either a genetic testing scenario or a standard blood testing scenario. Participants were asked questions about the vignette and responses were compared between groups.
  
  
  RESULTS
  Perceptions of test utility for risk assessment were higher among participants responding to the genetic vignette (P < 0.001). There were no significant differences in perceptions of control over IBD after hypothetical testing between vignettes (P = 0.24). Participant responses were modified by genetic literacy, measured using a scale developed for this study. Participants randomized to the genetic vignette who scored higher on the genetic literacy scale perceived greater utility of testing for risk assessment (P = 0.008) and more control after testing (P = 0.02).
  
  
  CONCLUSIONS
  Patients with IBD perceive utility in genetic testing for providing information relevant to family members, and this appreciation is promoted by genetic literacy. Low genetic literacy among patients poses a potential threat to effective translation of genetic and genomic tests.
authors.affiliation: *Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD; †Department of Health, Behavior and Society and the Center for Genomic Literacy and Communication, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and ‡Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Gillian W
authors.initials: GW
authors.lastname: Hooker
authors.forename: Holly
authors.initials: H
authors.lastname: Peay
authors.forename: Lori
authors.initials: L
authors.lastname: Erby
authors.forename: Theodore
authors.initials: T
authors.lastname: Bayless
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Biesecker
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D032882:Comprehension; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000706:statistics & numerical data*; D057220:Health Literacy; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000235:genetics* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult