Awareness, perceived barriers, and facilitators related to premarital screening and genetic counseling among Palestinian adults

Genetic diseases are hereditary conditions caused by DNA abnormalities, and they are an important public health issue worldwide, contributing considerably to morbidity and mortality. Palestine has a high incidence of genetic diseases, attributed to the high percentage of consanguineous marriages. Limited studies have been conducted to determine the level of awareness and knowledge among the Palestinian people about genetic disorders.

This study assessed awareness, perceived barriers, and facilitators related to premarital screening tests (PMST), genetic testing, and genetic counseling among Palestinian adults recruited through a web-based survey.

A cross-sectional, web-based survey was conducted in Palestine between August 2025 and January 2026 using an online, structured, self-administered questionnaire. Eligible participants were Palestinian residents aged ≥18 years who were able to complete the questionnaire online. Three submissions selecting "Under 18" were excluded before analysis, leaving 419 adult respondents. Descriptive statistics, bivariate tests, reliability analysis, and multivariable linear and logistic regression models were performed. Because the survey link was distributed through convenience and snowball sampling, a conventional response rate could not be calculated.

Among 419 adult respondents, 98.8% had heard of genetic diseases, 63.7% had heard of genetic counseling, and only 8.8% had visited a genetic diseases clinic. The mean BarrierScore was 4.65 ± 1.60, the mean MotivationScore was 6.77 ± 1.40, and the mean TotalScore was 11.42 ± 2.14. Using descriptive thresholds, 218 respondents (52.0%) had a high TotalScore, 185 (44.2%) had a moderate TotalScore, and 16 (3.8%) had a low TotalScore. In multivariable linear regression, higher TotalScore was independently associated with family history of genetic disease, correct knowledge that genetic diseases can appear at any stage of life, having heard of genetic counseling, knowing that PMST does not cover all genetic diseases, and stronger agreement that PMST is important.

In this convenience sample of Palestinian adults, general awareness of genetic diseases was high, but awareness and use of genetic counseling remained incomplete. The findings should not be interpreted as nationally representative. They support the need for culturally sensitive education about PMST limitations, wider availability of genetic counseling, and future representative research.