Public Health Recommendations for Healthcare Providers on Direct-to-Consumer Genetic Testing

Direct-to-consumer genetic testing (DTC-GT) provides individuals with access to their personal genetic information without healthcare intervention. DTC-GT has the potential to enhance population-level utilization of genetic tests, but the field needs to make adjustments to ensure equitable usage and understanding in the general population. Concerns related to clinical utility and consumer misinterpretation are seen across all use levels. This capstone looked to develop public health recommendations based on the social-ecological model to offer healthcare providers actionable steps to improve population utilization of DTC-GT. A snapshot of current DTC-GT literature was organized by the individual, interpersonal, community, and policy and cross-cutting levels. Gaps in the model helped develop the actionable recommendations. Individual-level findings observed mixed knowledge, attitudes, and behavioral change, but belief in utility. Inconsistent knowledge and protocol among providers were seen at the interpersonal level. Community-level findings indicate low involvement in research, understanding, and utilization from diverse communities. Despite some increased regulation, policy level findings identified that regulation of DTC-GT is often confusing. Themes seen across all levels of the model identified a lack of privacy and protection for consumers. Based on this model, the public health recommendations developed looked to expand patient education materials, increase provider education, identify community health resources, advocate for increased regulatory oversight, and expand safeguards for consumers. Overall, DTC-GT is limited. These public health recommendations look to address gaps across the field by helping ensure more equitable usage and contributing to the developing exchange on DTC-GT as the field continues to expand