ELSIcon2022 • Flash • May 27, 2022
Natalie Grafft, Maria Pineros Leano, Andrew Dwyer
Background: The American College of Obstetricians and Gynecologists recommends prenatal genetic testing (PGT) be offered to all pregnant women regardless of known risk factors. Significant racial/ethnic differences exist regarding acceptance of PGT with Latina women having low PGT acceptance rates. This systematic scoping review aimed to provide a landscape of existing literature on Latina women’s understanding of PGT to inform the development of culturally tailored interventions that support high-quality decisions.
Methods: We conducted a structured, systematic literature search of published articles and gray literature in eight electronic databases. Articles in English published prior to March 2021 were retrieved relating to genetics, pregnancy, and Latina women. Articles underwent title, abstract and full-text review by independent investigators to assess inclusion criteria. Iterative thematic analysis was employed to group study findings into themes to identify possible targets for interventions.
Results: Thirty-five studies meeting inclusion criteria were identified. Three overarching themes emerged: genetic knowledge/literacy (26/35, 74%), provider (mis)communication/patient satisfaction (21/35, 60%), and cross-cultural beliefs (12/35, 34%). Studies indicate discordant patient-provider language (n=5), miscommunication (n=4), and lack of concordant decision-making (n=4) pose barriers to high-quality PGT decisions. Immigration status (n=1) and religious beliefs (n=5) are additional factors influencing PGT decisions.
Conclusions: Identified studies suggest that cultural and linguistic factors affect Latina PGT decision-making. Latina’s comprehension and recall of PGT information is enhanced by culturally and linguistically concordant providers - suggesting that culturally-informed interventions (i.e., inclusion of community health workers or cultural brokers) may enhance PGT acceptability and empower Latina women to make informed decisions.