Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Healthcare Genetics

Committee Member

Dr. Rosanne H. Pruitt, Committee Chair

Committee Member

Dr. Bonnie Holaday, Committee Co-Chair

Committee Member

Dr. Kenneth Hepburn

Committee Member

Dr. Rachel Mayo

Committee Member

Dr. Julia Sharp

Committee Member

Dr. Holley Ulbrich


This dissertation addresses the interface of genetics, genomics, and older adults through a collection of three manuscripts that examine genetic and genomic testing and decision-making across age groups. The dissertation offers evaluations of a new lens for decision-making in genetics and genomics, a contextualization of the differences and similarities of perceptions and beliefs that exist among age groups engaging in direct-to-consumer personal genetic testing (DTC PGT), an identification of two factors that influence the decision to engage in DTC PGT, and an expansion of the current applications of Protection Motivation Theory to include disclosure, finance, and advance directive-management behaviors related to DTC PGT results.

Together these three manuscripts support and expand on previous understandings about older adults and decision-making in genetics and genomics. The dissertation findings identify many unique qualities of the 60+year old age group while also finding similarities that span age groups. These findings support the need for further examination of both age-group differences and the phenomenon of genetic or genomic decision-making. The differences and similarities among age groups will provide initial findings on which future work in decision-making and decision-support can be built. The dissertation’s focus on context as a key component of decision-making is both timely and forward looking. The need to create unique and informed decision-support interventions is growing as the personalized medicine movement begins to bring in more genetic information. Consumer-driven healthcare demands consumer-sensitive approaches. The use of behavioral economics and the Protection Motivation Theory as guides will help healthcare professionals to address the age-group differences and the individual contexts that shape the genetic decision-making process.



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