"I make my own decisions": Views on precision medicine research participation decisions from adults with intellectual...

Autonomy is a leading indicator of well-being and a cornerstone principal of research ethics. Yet adults with intellectual disability are routinely denied autonomy in research settings, affecting participation and generalizability. To inform health research policy and practice, we conducted a national survey of 150 adults with intellectual disability to explore their views on autonomy and decision-making in precision medicine research (PMR), a leading area of health research. Participants expressed strong interest in participating in PMR and controlling their participation decisions, sometimes with support. Findings highlight the need for policies and practices that honor these interests and facilitate autonomy. Over time, such efforts can improve health outcomes for this underserved population.