What people really change after genetic testing (GT) performed in private labs: results from an Italian study

Abstract

Despite the widespread diffusion of direct-to-consumer genetic testing (GT), it is still unclear whether people who learn about their genetic susceptibility to a clinical condition change their behaviors, and the psychological factors involved. The aim of the present study is to investigate long-term changes in health-related choices, individual tendencies and risk attitudes in an Italian sample of GT users. In the context of the Mind the Risk study, which investigated a sample of Italian adults who underwent GT in a private laboratory, 99 clients participated in the follow up assessment. They completed a self-administered questionnaire investigating: (a) clinical history and motivation for testing, (b) lifestyle and risk behaviors, (c) individual tendencies toward health, and (d) risk-taking attitude and risk tolerance. Such variables were measured at three different time-points: T0—before GT, T1—at 6 months after genetic results, and T2—at 1 year from results. Results showed that, at baseline, participants who stated they intended to modify their behavior after GT results, effectively did so over time. This result held both for participants who received a positive or negative test result. In general, a healthier diet was the most frequently observed long-term behavioral change. As regards psychological variables, a risk-taking attitude and risk tolerance did not seem to affect the decision to change the lifestyle. Finally, we found an overall reduction in anxiety and worry over health over time, but also a reduction in the motivation for health promotion and prevention, health esteem, and positive expectations for their health in the future.

Genetic testing users in Italy and Germany: Health orientation, health‐related habits, and psychological profile

“…In the present study, and in line with previous studies (McGrath et al, 2019 ; Oliveri et al, 2021 ; Oliveri, Marton, et al, 2020 ; Roberts et al, 2017 ), the sample of Italian GT users was predominantly female, young adult, married, well‐educated and without children. German GT users were divided fairly between men and women, with and without children, generally well‐educated and predominantly married or in a stable relationship.…”

“…A recent systematic review and meta‐analysis of 19 studies, conducted mainly in the United States, showed that GT users are more likely to improve their lifestyle, follow a healthier diet, increase exercise and medical preventive checks, and quit smoking (Stewart et al, 2018 ). Similar results were found in a very recent Italian study (Oliveri et al, 2021 ), where GT users reported high motivation to change health‐related habits reducing risky conditions, following a healthier diet, practicing more exercise, and improving medical preventive checks specifically (Oliveri et al, 2021 ; Oliveri, Marton, et al, 2020 ).…”

“…As already showed in previous studies, Italian respondents tended not to consider the genetic risk as a "certainty" (deterministic) about their future health conditions, as seems to be the tendency of the Germans, but rather as a possibility to know and be able to actively manage their own risk (Wöhlke et al, 2020). In order to avoid that people pay and gather information that won't use (Gorini & Pravettoni, 2016), it is also important to early identify the intention that people have to make specific health-related choices after GT, in order to support preventive decision-making and concrete implication of genetic risk information (Horne et al, 2018;Oliveri et al, 2021;Wolff et al, 2011). The present study also showed that Italian GT users were referred to undergo regular medical checks more frequently than the Germans, who instead have a higher percentage of people who underwent medical visits sporadically.…”

“…People with higher levels of Health Esteem and Confidence are more likely to engage in protective behavior oriented to maximize health status (Geçkil & Dündar, 2011;Lowery et al, 2005). The Germans declared to be more motivated than the Italians to avoid being unhealthy, but other research suggest that this motivation does not directly translate into actual personal actions after GT (e.g., avoid unhealthy dietary behaviors; Oliveri et al, 2021;Oliveri, Masiero, et al, 2016).…”

“…Besides these different habits, there were also differences in the intention to change lifestyle after receiving GT results. In past studies that have investigated genetic testing users profiles, the decision to undergo genetic testing (e.g., nutrigenetics or predisposition to certain diseases such as cancer, where diet is important for prevention; Oliveri et al, 2019 ) was found to be closely linked to the intention to change certain behaviors such as dietary in particular, physical activity and frequency of medical check‐ups (Horne et al, 2018 ; Oliveri et al, 2018 , 2021 ; Stewart et al, 2018 ; Wolff et al, 2011 ). In the current study, the majority of Italian participants declared their intention to modify mainly dietary and exercise habits to tackle their risk or health condition after testing, while Germans participants seem to approach genetic testing without linking it to preventative behavior, confirming that they do not consider genetic testing strictly linked to decisions of such nature, for example, abandoning improper eating habits (Wöhlke et al, 2020 ).…”