Acceptability, consideration, intention, and uptake of six common types of direct-to-consumer genetic tests in the Netherlands

While direct-to-consumer genetic testing (DTC-GT) has gained significant popularity, concerns persist that the public may lack adequate information and support to make well-informed decisions and understand test results. Several types of DTC-GT are on the market, each with distinct purposes and risks. The expected user population may differ per type of DTC-GT, suggesting a need for tailored information materials. Considering six different types of DTC-GT, this paper aims to identify how people's acceptability of DTC-GT and their interest in undergoing a DTC-GT within the next year (intention) and in the future (consideration) may differ depending on individuals' characteristics or the type of DTC-GT. An online cross-sectional survey was conducted in April 2022 among Dutch adults. Generalized linear models determined factors associated with DTC-GT acceptability, consideration, and intention. Open-ended responses were analyzed using inductive content analysis in MaxQDA. Of 907 respondents, 34 (3.7%) had purchased a DTC-GT, with the majority opting for ancestry tests. Health-related tests had the highest consideration and intention but were deemed the least acceptable to undergo without a healthcare professional. Open-ended responses supported quantitative findings on the differences in acceptability, consideration, and intention across test types. Overall, few respondents intended to undergo a test within the next year. Factors influencing DTC-GT acceptability, consideration, and intention overlapped by the test type. The most common factors, age and education level, were both inversely associated with the outcomes. This study suggests that the Dutch public is mostly interested in health-related DTC-GT but does not find them acceptable without professional support. Ensuring that DTC-GT information is comprehensible for younger and less educated individuals is crucial. Genetic counselors could provide valuable expertise in developing these materials.