Consumers report lower confidence in their genetics knowledge following direct-to-consumer personal genomic testing

Purpose: The aim of this study was to measure changes to genetics knowledge and self-efficacy following personal genomic testing (PGT). Methods: New customers of 23andMe and Pathway Genomics completed a series of online surveys. We measured genetics knowledge (nine true/false items) and genetics self-efficacy (five Likertscale items) before receipt of results and 6 months after results and used paired methods to evaluate change over time. Correlates of change (e.g., decision regret) were identified using linear regression. Results: 998 PGT customers (59.9% female; 85.8% White; mean age 46.9 +/- 15.5 years) were included in our analyses. Mean genetics knowledge score was 8.15 +/- 0.95 (out of 9) at baseline and 8.25 +/- 0.92 at 6 months (P = 0.0024). Mean self-efficacy score was 29.06 +/- 5.59 (out of 35) at baseline and 27.7 +/- 5.46 at 6 months (P < 0.0001); on each item, 30-45% of participants reported lower self-efficacy following PGT. Change in self-efficacy was positively associated with health-care provider consultation (P = 0.0042), impact of PGT on perceived control over one's health (P < 0.0001), and perceived value of PGT (P < 0.0001) and was negatively associated with decision regret (P < 0.0001). Conclusion: Lowered genetics self-efficacy following PGT may reflect an appropriate reevaluation by consumers in response to receiving complex genetic information.