To Test or Not to Test: A Real-World Study of Employee Views and Decision-Making for Genetic Testing in the Workplace

This study explored employees' decision-making processes and perspectives on workplace genetic testing (wGT), comparing those who had not participated (Non-Testers) with those who had participated (Testers) in wGT.

Employees at a large US healthcare system offering wGT were recruited via email and onsite advertising and surveyed. The web survey assessed respondent demographics, information-seeking activities, and perceived benefits and risks of wGT. Descriptive statistics, Chi-square analyses, and multivariable logistic regression compared the similarities and differences between Non-Testers and Testers on key study outcomes.

Survey respondents included 358 Non-Testers (80.7% female; 69.8% White, non-Hispanic) and 418 Testers (88.3% female; 80.6% White, non-Hispanic). Demographics associated with lower odds of being a Tester included self-reporting as Black, non-Hispanic (p = 0.001), male (p = 0.004), and less than one year of employment (p < 0.001). Non-Testers endorsed more perceived risks regarding wGT (e.g., privacy, discrimination) than Testers, while Testers more commonly endorsed perceived benefits, including lack of cost and potential healthcare benefits. Non-Testers engaged in fewer information-seeking activities than Testers. Non-Testers' most common decision-making activity was talking with family (28.9%), and Testers' most common activity was engaging with the testing company's information (50.0%).

This is the first study to examine wGT decision-making in a real-world setting. To address the perceived risks of Non-Testers and ensure equitable access, it may be necessary to develop educational materials that review current legal protections and limitations, as well as potential health benefits of genetic testing. Outreach strategies providing such education must address different types of information seeking to ensure perceived risks are addressed.