Perception of genetic risk in sexual and reproductive decision-making (PGRID) by college students

Abstract

One psychosocial variable, human mate selection, has been studied extensively within the field of evolutionary psychology. A question of interest is how sexual/reproductive decision-making (i.e., dating, marrying, and childbearing) might be influenced by an individual’s perception of his/her genetic risk and other psychosocial variables. There is a paucity of empirical studies within the literature exploring this specific relationship. This partially mixed, sequential mixed methods study addresses how individual perception of genetic risk (PGR) influences or predicts sexual/reproductive intentions and decision-making. A systematic review of the literature was conducted by searching for English language, peer-reviewed, empirical studies in Cambridge Scientific Abstracts databases (N=26). Next, students from three Southwestern universities were recruited for focus groups and responded to 15 open-ended questions (N=86). Transcripts were audiotaped, transcribed verbatim and analyzed using holistic-content analysis. Based on the literature review and qualitative findings, a 138-item, web-based instrument was designed and tested at two Southwestern universities (N=2,576). Survey data were analyzed using non-parametric univariate analyses and multiple regression. Approximately 50 demographic, individual/familial psychosocial and genetic testing-related factors influenced the relationship between PGR and sexual/reproductive decision-making in reviewed studies. Individual psychosocial factors (e.g., intention, attitudes) represented 65.8% of all findings. Participants in the qualitative phase exhibited moderate health literacy when interpreting and discussing genetic risk information. A number of factors including age, gender, religion, individual/family values, and exposure to genetic concepts/technology appeared to influence sexual/reproductive decision-making. Demographic, Health Belief Model (HBM) and Theory of Planned Behavior (TPB) variables predicted the relationship between PGR and dating, marital, and childbearing intention in the quantitative phase. TPB variables were the strongest predictors of intention accounting for 33.1-38.7% of variance. Positive family norms were the single best predictor of dating and marital intention. Age was the best predictor of childbearing intention. Further research is needed to understand how young adults incorporate genetic risk perceptions into sexual/reproductive decision-making. Mixed methods and longitudinal study designs, and structural equation modeling are recommended for use in future studies. Study findings affirm a need for health educators to consider adopting genomic competencies; creating theory-based curricula/interventions; and forming partnerships with genetic specialists and local/regional health departments.