Decisional Conflict Among Adolescents and Young Adults Before and After Facilitated Decision-Making About Learning...

To determine if decisional conflict differed between adolescent (ages 13-17) and young adult (ages 18-21) research participants making decisions about learning actual genomic testing results, and whether decisional conflict changed after a facilitated decision-making (FDM) session.

Participants between the ages of 13-21 (n = 483) completed decisional conflict scale (DCS) surveys after using an electronic decision tool to make independent choices about learning genomic testing results (T1) and again following FDM with a study team member and parent if one was involved (T2). Participants had the option to change their choices at T2. We compared DCS scores of adolescents and young adults at T1 and T2.

Median total DCS scores were significantly higher for adolescents than young adults at T1 (20.3 vs. 7.8; p < .0001) and T2 (11.7 vs. 1.6; p < .0001). There were significant decreases in median DCS scores from T1 to T2 among adolescents (20.3-11.7; p < .0001) and young adults (7.8-1.6; p < .0001).

Although DCS scores were low overall, adolescents experienced higher decisional conflict than young adults. Decisional conflict levels decreased among both cohorts after FDM. Researchers and clinicians should facilitate discussions to engage adolescents and young adults in values-centric informed decisions about genomic testing.