Development and Validation of the Minnesota Assessment of Pharmacogenomic Literacy (MAPL)

Abstract

Ensuring that patients have an adequate understanding of pharmacogenomic (PGx) test results is a critical component of implementing precision medicine into clinical care. However, no PGx-specific validated literacy assessment has yet been developed. To address this need, we developed and validated the Minnesota Assessment of Pharmacogenomic Literacy (MAPLTM). Foundational work included a scoping review of patient and general public attitudes and experiences with pharmacogenomic testing, three focus groups, readability assessments, and review by experts and members of the general public. This resulted in a 15-item assessment designed to assess knowledge in four domains: underlying concepts, limitations, benefits, and privacy. For validation, 646 participants completed the MAPL as a part of a larger survey about pharmacogenomic research and statewide PGx implementation. Two items were deemed to be “too easy” and dropped. The remaining 13 items were retained in the final MAPL with good internal reliability (Cronbach’s alpha = 0.75). Confirmatory factor analysis validated the four-domain construct of MAPL and suggested good model performance and high internal validity. The estimated coefficient loadings across 13 questions on the corresponding domains are all positive and statistically significant (p < 0.05). The MAPL covers multiple knowledge domains of specific relevance to PGx and is a useful tool for clinical and research settings where quantitative assessment of PGx literacy is of value.

Public Attitudes toward Pharmacogenomic Testing and Establishing a Statewide Pharmacogenomics Database in the State of Minnesota

“…Yet, the role of health literacy in clinical PGx service and research has only been sparsely explored. The Minnesota Assessment of Pharmacogenomic Literacy (MAPL) was recently developed and validated by our team, aiming to quantify individuals’ PGx literacy to address the needs of both clinical and research settings [ 28 ]. Additional efforts are needed to examine and improve health literacy in both the clinical and research contexts of PGx in the near future.…”

“…The survey consisted of 44 to 53 questions, depending on the skip pattern, related to participant sociodemographic and health-related characteristics, health literacy, and personal beliefs regarding PGx testing and research. An additional set of 15 items included questions used to assess PGx literacy, which was used to validate the Minnesota Assessment of Pharmacogenomic Literacy (MAPL) [ 28 ].…”

“…The AAHLS total score was calculated by summing the score across 10 questions of functional, communicative, and critical health literacy, which were rated on a three-point Likert scale (0, 1, 2). The AAHLS total score ranges from 0 to 20, with a higher score indicating higher health literacy (see Allen et al, 2022 [ 28 ] for details on AAHLS scoring).…”

Assessing pharmacogenomic literacy in China through validation of the Chinese version of the Minnesota Assessment of Pharmacogenomic Literacy

“…25 Research assessing knowledge of PGx is emerging worldwide, including in countries like China, using diverse methodologies ranging from self-report assessments to customized instruments. 17,23,[26][27][28] However, these efforts have predominantly focused on evaluating the readiness of health professionals to offer PGx services, rather than assessing the understanding of PGx among patients or test recipients. Shared decision making and counseling about medical tests and treatments are essential components of clinical care and personalizing treatment.…”

“…29,30 Recognizing the need for a PGx-specific instrument to assess patients' knowledge of key PGx concepts, our group recently developed the Minnesota Assessment of Pharmacogenomic Literacy (MAPL). 26 This validated instrument is the first to quantitatively measure the knowledge that test recipients have about PGx in clinical and research settings. It is available for clinical, academic, and research use.…”