Cancer genetic testing among a diverse sample of American Muslims

Cancer genetic testing among a diverse sample of American Muslims | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Cancer genetic testing among a diverse sample of American Muslims Maisha R. Huq, Shreya Kaushik, Saara Bidiwala, Chiranjeev Dash, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8903379/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background American Muslims face notable cancer disparities. Yet we know little about cancer genetic testing among this group. The current study aims to explore: 1) interest in cancer genetic testing, 2) predictors of interest, focusing on religion and discrimination factors, and 3) preferences for receiving cancer genetic education and testing among a diverse community sample of American Muslims. Methods. We surveyed a community-based convenience sample of 158 American Muslims from the DC-Maryland-Virginia area. Our primary outcome was interest in cancer genetic testing; secondary outcomes were preferred delivery channels and facilitators for receiving genetic education and testing. Predictors included sociodemographics, cancer history, knowledge, and religion and discrimination factors. We conducted descriptive statistics, student’s t-tests, Chi-square tests, and logistic regression. Results. Participants ranged 18 to 72 years (Mean = 34). The majority were foreign-born (62%). Seventy six percent strongly agreed or agreed with interest in testing. Only spirituality (OR = 2.72, 95% CI: 1.24, 5.96) and discrimination in healthcare due to looking Muslim (OR = 2.81, 95% CI: 1.23, 6.39) were independently associated with interest in testing. Participants most preferred cancer genetic education via: a document (83%), doctor (80%), genetic counselor (80%), or a website (79%). Participants least preferred a chatbot (30%). Participants most highly endorsed as facilitators of testing: informational materials (59%), insurance coverage (59%), at-home testing kits (52%), and integrating testing into routine care (44%). Discussion & Conclusions Addressing religion and discrimination factors may promote access to cancer genetic testing among the under-researched population of American Muslims, as well as aligning future interventions with their preferences. cancer genetic testing healthcare delivery religion discrimination Introduction Muslims are the fastest growing religious group in the United States (Mogahed et al., 2022 ; Mohamed, 2018 ). Over the next 25 years, the American Muslim population is expected to more than double from 3.45 million individuals in 2017 to 8.1 million by 2050 (Mogahed et al., 2022 ; Mohamed, 2018 ). While 20% of American Muslims are US-born, American Muslims are a predominantly immigrant population, originating largely from South Asia, Asia-Pacific, the Middle East, North Africa, sub-Saharan Africa, and Europe. Socioeconomically, American Muslims tend to be lower income— 40% of Muslim Americans have household incomes less than $ 30,000/year (Mogahed et al., 2022 ; Mohamed, 2018 ). Their religion acts as a unifying factor integrated in various aspects of their lifestyle, including healthcare (Padela & Zaidi, 2018 ). American Muslims report lower cancer screening rates relative to non-Muslims (Afsah & Kaneko, 20231130; Ahmed & Mushahid, 2023 ; Azhar et al., 2022 ; Hasnain et al., 2014 ; Islam et al., 2017 ). A survey of 240 mammogram-eligible Muslim women found that 37% had not had a mammogram in the past 2 years, 30% lower than the national average (Padela et al., 2015 ). Among 207 first-generation American Muslim women, only 52% of screening-age women reported a mammogram in the prior two years, which was substantially lower than the national rate of 67% at the time (Hasnain et al., 2014 ). Further, community-based studies report disproportionately lower colorectal cancer screening among Muslims relative to non-Muslims (Majeed et al., 2023 ). Multilevel factors have been linked with lower cancer screening rates among American Muslims. Individual-level factors include Islam-related beliefs and knowledge of cancer screening (Al Alawi et al., 20230228; Al-Amoudi et al., 2015 ; Alkhaifi et al., 2023 ; Choudhri et al., 2024 ). Predictors also span the interpersonal (Azhar et al., 2022 ; Samari et al., 2018 ) (e.g. perceived discrimination in healthcare) and system (Majeed et al., 2023 ) (e.g., lack of culturally or religiously-concordant providers) levels. Religion-related factors may be particularly salient (Choudhri et al., 2024 ; Majeed et al., 2023 ; Padela et al., 2012 , 2014 , 2015 ; Padela & Zaidi, 2018 ). Islam provides a unifying lens through which to make healthcare decisions among American Muslims (Choudhri et al., 2024 ; Majeed et al., 2023 ; Padela et al., 2012 , 2014 , 2015 ; Padela & Zaidi, 2018 ). Islam-based beliefs about stewarding the body to good health and predestination (Afsah & Kaneko, 20231130; Padela & Zaidi, 2018 ), as well as one’s spirituality, religiosity, and religious coping (i.e. the use of religious beliefs, practices, and community to manage stress) can influence cancer screening decisions (Al-Amoudi et al., 2015 ; Azhar et al., 2022 ; Choudhri et al., 2024 ; Islam et al., 2017 ; Moey et al., 2022 ). Perceived religion-based discrimination (i.e., Islamophobia) has also been associated with reduced healthcare utilization (Samari et al., 2018 ). Taken together, existing studies warrant further examination of the role of religion and discrimination-related factors on cancer control behaviors. Germline genetic testing for hereditary cancer risk is becoming increasingly important as a cancer prevention and control strategy for the general population. Cancer genetic testing is a blood or saliva-based test that identifies if an individual carries an inherited genetic mutation that increases their risk of developing cancer. Among individuals found to be at increased risk, follow-up risk management strategies can reduce breast, ovarian, colorectal, and endometrial cancer risk and mortality significantly (Bernstein et al., 2015 ; De Jong et al., 2006 ; Liu et al., 2023 ; Prince et al., 2017 ; Salhab et al., 2010 ; Valachis et al., 2014 ). Despite these benefits, cancer genetic testing remains severely underutilized overall, and particularly among minoritized groups (Chapman-Davis et al., 2021 ; Clarke & Van El, 2022 ; Dharwadkar et al., 2022 ; Mittendorf et al., 2021 ; Muller et al., 2018 ; Paiella et al., 2023 ; Parikh et al., 2020 ; Sayani, 2019 ; Suther & Kiros, 2009 ; Tawfik et al., 2023 ). To our knowledge, there have been no studies examining cancer genetic testing among American Muslims. It is likely that American Muslims may face barriers in accessing cancer genetic testing comparable to the disparities they face regarding cancer screening. However, little is known about awareness, interest, and attitudes toward cancer genetic testing, as well as factors that may influence genetic testing interest among American Muslims, including religion and discrimination-related factors. Given the lack of research on cancer genetic testing among the under-researched and growing group of American Muslims, the aims of our current work are to assess interest in cancer genetic testing, factors influencing interest in cancer genetic testing including religion and discrimination factors, and preferences for receiving cancer genetic education and testing within a diverse, community sample of American Muslims. Methods Sample and Recruitment We recruited a community-based convenience sample of American Muslims from the DC-Maryland-Virginia (DMV) area between August 2024 and September 2024. Eligible individuals were aged 18 years or older, currently residing in the DMV, and self-reported Muslims. The first author (MH) established communication with leadership at eight DMV-based Muslim-serving community organizations. Five were mosques (ADAMS mosque in Virginia, and the MCC, ICM, ICCP, and Maqaame Ibrahim mosques in Maryland), and three were predominantly Muslim-facing community organizations (DMV Jobs group, DMV Refugees Network, MFC AFSP Volunteers). We distributed the study flyer, eligibility screener and survey through in-person events, and text message (e.g., community organization WhatsApp groups) and online listservs. The study flyer clarified that no prior knowledge of cancer genetic testing was needed. Across four weeks of recruitment, we distributed the screener to approximately 2783 individuals. However, we could not determine the number of duplicates across the online/text listservs, nor the exact number of community members who received information about the survey during in-person recruitment. Thus, the number of unique individuals to whom the screener was distributed is likely less than 2783. Overall, 223 participants completed the screener for an estimated response rate of 8.0%. The true response rate was likely higher given the factors described above, particularly the duplicates across DMV-area listservs. Of the 223 screener completers, 48 did not meet eligibility criteria. Specifically, two did not self-identify as Muslim; three were younger than 18 years; six lived outside the DMV; 37 did not meet a criterion for living in select DMV counties that we had implemented but later removed. Of the 175 eligible participants who completed the screener, five (3%) did not complete the survey, and six (3%) had high missing data or did not respond to the primary outcome, leaving 164 survey participants. Of the 164 survey participants, six (4%) reported prior cancer genetic testing. Since this group was too small for separate analyses, we excluded them from subsequent analyses – leaving a final sample of n = 158. Procedures We administered a three-item eligibility screener in person and electronically. As stated, inclusion criteria were to be: aged 18 years or older, currently residing in the DMV, and self-reported Muslim. Eligible individuals received the survey in person or electronically. The survey included 40-items and took 10–15 minutes to complete. Participants who completed the survey received a $ 25 e-gift card to compensate their participation. Measures Primary Outcome Interest in cancer genetic testing (GT). We assessed interest in GT with a single item adapted from prior research (Kaphingst et al., 2022 ): “I am interested to learn more about cancer genetic testing” on a 5-point Likert scale. For analyses, we dichotomized GT interest as strongly agree vs. all other categories (agree through strongly disagree). We chose this operationalization to examine strong interest in genetic testing, as strong interest is more closely linked to behavioral uptake. Further, this dichotomization is closest to a median splite, which maximizes our power in subsequent analyses. Secondary outcomes Preferences for genetic education. We evaluated participant preferences for receiving education about genetic testing with the following question: “If you were thinking about getting genetic testing, how would you prefer to receive information about genetic testing?” For each delivery channel option (a document, a video, a website, chatbot, speaking with a doctor, speaking with a genetic counselor, speaking with a community health worker or patient navigator), participants rated their preference on a scale of 1 to 3 (1 = I do not prefer this, 2 = I am ok with this, 3 = I highly prefer this). For analyses, we created a binary measure (0 = do not prefer, 1 = am ok or highly prefer) for each option. Facilitators of genetic testing. To assess facilitators of genetic testing, we provided a menu of 14 clinically validated options (e.g. transportation, more information) adapted from our prior research (Gómez-Trillos et al., 2020 ; Steffen et al., 2017 ) and asked, “Which of the following would make it easier for you get cancer genetic testing?” Participants selected all options that applied. Predictors Demographics. Participants self-reported age, sex at birth, race, highest education completed, employment status, annual household income, foreign-born status, years living in the USA, and health insurance type. Cancer history. Participants self-reported personal and family history of cancer. Knowledge. Participants self-rated their knowledge of hereditary cancer via the item, “How would you rate your knowledge of hereditary cancer?” and their knowledge on genetic testing via the item, “How would you rate your knowledge of genetic testing?” both rated from 0 = very little to 10 = a lot. We operationalized these as continuous measures as the data were roughly symmetric and distributed. Participants selected all settings where they regularly received healthcare in the last three years (hospital, community clinic, private clinic, do not regularly receive healthcare). We assessed value for ancestral culture through a single face-valid five-point Likert-scale item: “It is important to me to keep the culture(s) of my ancestors.” For analyses, we dichotomized value for ancestral culture as strongly agree/agree (n = 95) vs neither/disagree/strongly disagree (n = 57). We measured religion-related factors : spirituality, religiosity in daily life, role of religion in cancer screening, positive religious coping, and negative religious coping. For spirituality , we employed a single face-valid item: “How spiritual do you consider yourself?” where participants self-rated from 0 = not at all to 10 = very spiritual. For analyses we dichotomized spirituality at the median of 8 due to a skewed distribution. We assessed religiosity in daily life with a single face-valid item: “How important is religion to your daily life?” Although the existing literature rarely examines religiosity in daily life, we added this measure as daily practice is salient in the context of Islam (e.g., five daily prayers). Participants rated themselves from 0 = not at all to 10 = very important. Due to an extreme right skew at the value of 10, we analyzed the item as binary: 10 and < 10. We evaluated the role of religiosity in cancer screening with a single face-valid item: “How much does religion influence your desire to get cancer screenings?” Participants rated themselves from 0 = not at all to 10 = a lot. We analyzed the item as continuous as data were roughly symmetric and distributed. To measure positive and negative religious coping , we used the Positive Religious Coping subscale (summary score ranging 7 to 28; cronbach’s α = .90) and Negative Religious Coping subscale (summary score ranging 5 to 20; cronbach’s α = .85), from the 12-item Psychological Measure of Islamic Religiousness scale (Abu Raiya et al., 2008 ; Raiya et al., 2007 ). Higher summary scores indicate higher positive/negative religious coping. An example positive religious coping subscale item is, “When I face a problem in life, I look for a stronger connection with Allah” and an example negative religious coping subscale item is, “When I face a problem in life, I believe that I am being punished for bad actions I did.” For analyses, we treat the measures as continuous as they are validated sub-scales. We measured discrimination in healthcare using the 7-item Everyday Discrimination in Healthcare Scale (Peek et al., 2011 ; Williams et al., 1997 ) (Cronbach’s α = .89), where higher summary scores (ranging 7 to 35) indicate greater perceived discrimination. We also employed a single five-point Likert scale face-valid item: “I feel like I have experienced discrimination due to looking Muslim in a healthcare setting, in my life”. For analysis, we dichotomized this measure as strongly agree/agree (n = 45) vs neither/disagree/strongly disagree (n = 107) to conceptually capture having ever experienced Islamophobia in healthcare. Analyses We summarized sample characteristics and key study measures using descriptive statistics. To identify bivariate associations with our primary outcome, interest in genetic testing, we employed student’s t-tests and Chi-square tests. To evaluate multivariate associations with our primary outcome, we employed a logistic regression with backward elimination, inputting only those variables with p < 0.05 bivariate associations with interest in genetic testing. To analyze our secondary outcomes on intervention preferences and facilitators, we assessed the frequency with which participants endorsed delivery channel options and perceived facilitators. All analyses used two-tailed tests at a significance level of 0.05. Analyses were completed using SPSS 29 ( IBM SPSS Statistics for Macintosh , 2022). Results Sample Characteristics As displayed in Table 1 , our sample had a mean age of 34.3 years (SD = 10.9; range = 18 to 72). The majority of the participants were South Asian (64%), female (80%), and foreign-born (62%). Among those born outside the US, the mean years in the USA was 16.5 (SD = 11.4). The sample was socioeconomically diverse with 5% having incomes less than $ 20,000, 17% between $ 20,000 and $ 59,999, 17% between $ 60,000 and $ 99,999; and 34% $ 100,000 or more; 17% had Medicaid or no insurance; and 15% did not regularly receive any healthcare. Table 1 Sample Characteristics (n = 158) Characteristic n % Age (mean, SD) (34.3, SD = 10.9) Sex at birth Female 127 80.4% Male 31 19.6% Race/ethnicity African, African American, Black 11 7.0% Central/East Asian 9 5.7% Middle Eastern/North African 25 15.8% South Asian 101 63.9% White 5 3.2% Other 7 4.4% Foreign-born 98 62.0% Years in USA (mean, SD) (16.5, SD = 11.4) Highest educational level High school 11 7.0% Some college 26 16.5% College 46 29.1% Graduate school 63 39.9% Missing 12 7.6% Household income < $ 20,000 9 5.7% $ 20, 000 - $ 59,999 27 17.1% $ 60,000 - $ 99,999 27 17.1% $ 100,000 or more 54 34.2% Missing 41 25.9% Employment Full-time work 74 50.0% Part-time work 22 13.7% Full-time homemaker or caregiver 18 11.2% Unemployed, seeking 15 9.3% Student 12 7.5% Other 5 3.1% Missing 12 7.6% Insurance Private 96 60.8% Public 27 17.1% No insurance 8 5.1% Prefer not to say 15 9.5% Missing 12 7.6% Key study measures Overall, 76% of the sample reported interest in cancer genetic testing (see Table 2 ) of whom 33% indicated strong interest. About half the sample (50.6%) had a family history of cancer. Participants reported relatively low self-rated knowledge of hereditary cancer (Mean = 4/10; SD = 3) and genetic testing (Mean = 3/10; SD = 3). Table 2 Key Study Variables (n = 158) Characteristic n % Interest in genetic testing Strongly agree 52 32.9% Agree 68 43.0% Neither agree nor disagree 32 20.3% Disagree 6 3.8% Strongly disagree 0 0.0% Cancer history Has personal history of cancer 7 4.4% Has family history of cancer 80 50.6% Knowledge Knowledge of hereditary cancer (4.0, SD = 3.0) Knowledge of GT (3.0, SD = 3.0) Regular healthcare a Hospital 46 29.1% Community clinic 26 16.5% Private clinic 77 48.7% No regular healthcare 24 15.2% Everyday Discrimination in Healthcare Scale (14.1, SD = 4.6) Discrimination in healthcare Agree 45 28.7% Disagree 107 67.7% Value ancestral Culture Agree 95 60.1% Disagree 57 36.1% Spirituality (mean, SD) Rating 8 65 41.1% Positive religious coping 24.1 (SD = 4.3) Negative religious coping 9.0 (SD = 3.8) Religiosity in daily life (mean, SD) Rating of 10 96 60.8% Rating <10 55 34.8% Religiosity in screening (mean, SD) (5.3, SD = 3.4) a Categories are not mutually exclusive; participants were able to select multiple responses for where they regularly received healthcare in the past 3 years. Bivariate associations As displayed in Table 3 , in bivariate analyses, interest cancer genetic testing was associated with: having family history of cancer (p=.024) and being South Asian (p=.028). In terms of religion and discrimination factors, interest in cancer genetic testing was associated with: greater self-reported role of religion in cancer screening (p=.015), greater experiences of discrimination in healthcare (p=.009), and higher spirituality (p=.016). No sociodemographics were significantly associated with interest in testing; but household income (p=.058) approached significance. Table 3 Bivariate Results of Differences Between Participants Who Are Strongly Interested and Not Strongly Interested in Cancer Genetic Testing Variable Strongly Interested Not Strongly Interested p-value Continuous variables M ± SD Age (years) 34.0 ± 11.0 35.0 ± 11.0 .628 Years lived in the USA 16.5 ± 11.8 16.5 ± 11.3 .994 Knowledge of hereditary cancer 4.4 ± 2.8 3.5 ± 2.7 .058 Knowledge of genetic testing 3.8 ± 3.0 2.8 ± 2.7 .056 Religiosity in cancer screening 6.3 ± 3.1 4.8 ± 3.4 .015* Positive religious coping 24.9 ± 4.7 23.7 ± 4.1 .104 Negative religious coping 8.6 ± 3.5 9.3 ± 4.0 .270 Everyday Discrimination in Healthcare Scale a 14.0 ± 4.1 14.2 ± 4.8 .824 Categorical variables n (%) Sex at birth Female 41 (78.8%) 86 (81.1%) .734 Male 11 (21.2%) 20 (18.9%) South Asian ethnicity b Yes 27 (51.9%) 74 (69.8%) .028* No 25 (48.1%) 32 (30.2%) Born in the USA Yes 26 (46.0%) 36 (33.0%) .138 No 28 (53.8%) 70 (66.0%) Highest education ≥ College 40 (78.4%) 69 (72.6%) .442 < College 11 (21.6%) 26 (27.4%) Household income c ≥ $ 100k 24 (46.2%) 30 (28.3%) .058 < $ 100k 19 (36.5%) 44 (41.5%) Missing 9 (17.3%) 32 (30.2%) Employment Full-time 31 (60.8%) 43 (45.3%) .074 Not full-time 20 (39.2%) 52 (54.7%) Insurance c Private 34 (70.8%) 62 (60.8%) .106 Public 10 (20.8%) 17 (16.7%) Missing 4 (8.3%) 23 (22.5%) Regular healthcare d Hospital 18 (34.6%) 28 (26.4%) .286 Private clinic 27 (51.9%) 50 (47.2%) .574 Cancer history Yes 3 (5.8%) 4 (3.8%) .567 No 49 (94.2%) 102 (96.2%) Family history of cancer Yes 33 (63.5%) 47 (44.3%) .024* No 19 (36.5%) 59 (55.7%) Value ancestral culture Agree 35 (68.6%) 60 (59.4%) .267 Disagree 16 (31.4%) 41 (40.6%) Spirituality ≤ 8 22 (43.1%) 63 (63.6%) .016* > 8 29 (56.9%) 36 (36.4%) Religiosity in daily life = 10 34 (66.7%) 62 (62.0%) .573 < 10 17 (33.3%) 38 (38.0%) Discrimination in healthcare Agree 22 (43.1%) 23 (22.8%) .009** Disagree 29 (56.9%) 78 (77.2%) Notes. Independent samples t-tests were used for continuous variables; chi-square tests were used for categorical variables. p < .05 = *, p < .01 = **. a The validated 7-item Everyday Discrimination in Healthcare Scale summary score (range = 7–35) measures perceived discrimination in healthcare. b We only present a South Asian measure (‘yes, South Asian’ vs. ‘no, not South Asian’) because no other race group was sufficiently large to analyze as an individual group. c We created three-level categorical measures for income ($100,000 or more, and missing) and insurance (private, public, missing), where one category captured missing responses as both had significant missing data. We included the eight individuals who had no insurance in the missing group. We compared a listwise deletion approach (i.e. restricted to complete cases) to our ‘missing indicator’ approach. Our results did not change substantively across the approaches. Thus, we concluded that the high missingness in our income and insurance measures did not significantly affect our conclusions. d We created binary measures for each setting. For instance, a binary measure was: ‘yes, regularly receive care at hospital, ‘no, did not receive care at hospital’. To ensure adequate cell sizes, only categories with at least 30 participants (i.e., hospital, private clinic) were retained as binary variables. Multivariate associations In the initial step of a multivariable logistic regression with backward elimination, we inputted the five measures with P<.05 associations with genetic testing interest: being South Asian, having family history of cancer, role of religion in cancer screening, perceived discrimination in healthcare, and spirituality. As displayed in Table 4 , the final model indicates that the only variables independently associated with interest in cancer genetic testing were: spirituality (OR = 2.72, 95% CI: 1.24, 5.96) and discrimination in healthcare due to looking Muslim (i.e., Islamophobia) (OR = 2.81, 95% CI: 1.23, 6.39). Table 4 Results from multivariate logistic regression p-value Odds Ratio 95% CI Discrimination in health .014 2.807 [1.234, 6.388] Spirituality .013 2.715 [1.237, 5.960] Note. We only inputted the variables that had a significant bivariate association at alpha=.05 with interest in cancer genetic testing: South Asian ethnicity, family history of cancer, religiosity in cancer screening, discrimination in healthcare (binary), and spiritualty. We outputted variables that were significant at alpha=.0549 value with interest in cancer genetic testing. Preferences for receiving cancer genetic services From a list of seven options, participants most frequently endorsed the following preferences for receipt of genetic education (Table 5 ): a document (82%), a website (77%), doctor (76%), genetic counselor (75%), a video (72%), and a patient navigator (63%). Participants were least interested in receiving genetic information via a chatbot (29%). Those who were not strongly interested in genetic testing selected fewer options than those who were strongly interested in testing (M = 0.81, SD = 1.2 vs. M = 1.94, SD = 1.78, p<.001). From a menu of 14 options, participants reported that the following would most facilitate receipt of testing: informational materials (59%), insurance coverage for most/all costs (59%), at-home testing kit (52%), offering testing as part of a routine medical appointment (44%), and if the genetic testing is near home (41%) (Table 6 ). Table 5 Participant preferences for delivery through which to receive genetic information/counseling (n = 158) N % Document Everything else 26 16.5% Prefer 130 82.3% Video Everything else 37 23.4% Prefer 114 72.2% Website Everything else 32 20.3% Prefer 122 77.2% Chatbot Everything else 106 67.1% Prefer 45 28.5% Doctor Everything else 30 19.0% Prefer 120 75.9% Genetic counselor Everything else 30 19.0% Prefer 119 75.3% Patient Everything else 50 31.6% Navigator Prefer 100 63.3% Table 6 Participant endorsement of facilitators of cancer genetic testing (n = 158) Characteristic n % If I receive more informational materials 95 59.0% If genetic counseling was over phone 64 39.8% If genetic counseling was optional 38 23.6% If I could receive at home testing kit 84 52.2% If testing was a part of another routine medical appt 71 44.1% If the clinic was close to home 66 41.0% If I had transportation 28 17.4% If I had childcare 14 8.7% If clinic had flexible hours 57 35.4% If insurance would pay most/all of the cost 95 59.0% If another organization would help pay 63 39.1% If my doctor recommended genetic testing 72 44.7% If I trusted my doctor’s recommendation 57 35.4% If my family encouraged me to get genetic testing 37 23.0% Discussion Our study aimed to explore: interest in cancer genetic testing, factors influencing interest in testing, particularly religion and discrimination factors, and cancer genetic testing intervention preferences among a community sample of American Muslims. We found notable interest in cancer genetic testing—76% were interested; 33% were strongly interested in cancer genetic testing. Although multiple variables were associated with testing interest in bivariate analyses, only spirituality and perceived discrimination in healthcare due to looking Muslim (i.e. Islamophobia) were independently associated with greater interest in cancer genetic testing. In terms of preferences for the receipt of genetic information, participants most frequently endorsed the use of documents and a websites, followed by preference for doctors and genetic counselors. Future research is needed on which combinations of specialists vs non-specialists, as well as digital vs non-digital channels optimize cancer genetic service delivery. In our sample interest in cancer genetic testing was comparable to prior samples. In previous community-based convenience samples, approximately 50–90% of participants reported interest in cancer genetic testing (Botoseneanu et al., 2011 ; Guo et al., 2022 ; Hay et al., 2018 ; Kaphingst et al., 2022 ; Roberts et al., 2022 ; Rubinsak et al., 2019 ), compared to 76% of our sample. Further, 30–90% (Alvord et al., 2020 ; Roberts et al., 2022 ; Rubinsak et al., 2019 ) of these samples report strong interest in testing, compared to 32% of our sample. These data suggest that nearly 70% of certain samples remain less than strongly interested, with about 30% not at all interested in testing. By understanding the predictors of interest, we can close gaps in cancer genetic testing interest and, potentially, uptake among American Muslims. Intriguingly, factors that typically drive interest in cancer genetic testing were not predictive in our sample of American Muslims. Demographic factors such as younger age and being female, and social determinants of health such as education and income have consistently been found to strongly predict interest in cancer genetic testing (Botoseneanu et al., 2011 ; Guo et al., 2022 ; Hay et al., 2018 ; Kaphingst et al., 2022 ; Nordin et al., 2004 ; Roberts et al., 2022 ; Rubinsak et al., 2019 ). Family history of cancer, cognitive factors (e.g., greater knowledge of hereditary cancer or cancer genetic testing) and psychosocial characteristics have also generally been associated with testing interest (Botoseneanu et al., 2011 ; Guo et al., 2022 ; Hay et al., 2018 ; Kaphingst et al., 2022 ; Nordin et al., 2004 ; Roberts et al., 2022 ; Rubinsak et al., 2019 ). Although some of these factors were associated at the bivariate level in this study (i.e., family history of cancer), none were independently associated with test interest. It is possible that these factors were non-significant in our sample because our participants’ spirituality and experiences of perceived Islamophobia in healthcare are more salient. Our findings reveal that leveraging American Muslims’ spirituality is perhaps more salient for influencing interest in cancer genetic testing than other factors. This is noteworthy as spirituality is rarely examined in the context of cancer genetic testing, and when it has been findings were mixed (Austin et al., 2025 ; Botoseneanu et al., 2011 ; Schwartz et al., 2000 ). One explanation for the positive link between spirituality and testing interest is that Muslims who consider themselves more spiritual may place greater value on the Islamic call to steward the body to good health (Afsah & Kaneko, 20231130; Padela & Zaidi, 2018 ). Consequently, Muslims who consider themselves more spiritual may view cancer genetic testing as a proactive approach for stewarding the body to good health. One of our most striking and surprising findings was that greater experiences of perceived Islamophobia in healthcare was associated with interest in cancer genetic testing. This contrasts with prior research that suggests the experience religious discrimination in healthcare deters service utilization (Samari et al., 2018 ). For example, a study of 240 Muslim women found that perceived Islamophobia in healthcare was linked with not having had a mammogram in the prior two years (Padela et al., 2015 ). One explanation for our paradoxical finding draws on Minority Stress Theory (Meyer, 2003 ) and resilience frameworks (Lewis et al., 2015 ). These frameworks suggest that discrimination can motivate health protective behaviors via fostering hypervigilance (Lewis et al., 2015 ). Another explanation could reflect our highly educated sample. Individuals with higher education are more likely to report concerns of discrimination (Das, 2020 ); further, individuals with higher education are more likely to report greater interest in genetic testing (Giri et al., 2020 ; Roberts et al., 2022 ). Future research with a more diverse sample in terms of education is needed to fully address this possibility. The results of this study could have clinical implications. Notably, prior religiously -tailored interventions have preliminarily shown promise for improving cancer early detection behaviors among American Muslims (Abu Khait & Lazenby, 2021 ; Padela et al., 2018 ; Pratt et al., 2020 ). Examining the mechanisms for health behavior change among such religiously tailored interventions is needed, however, including given spirituality was the only significant religion-related factor in our sample. In Padela and colleagues’ (Padela et al., 2018 ) religiously-tailored program, for example, the program increased mammography screening intention and behavior. However, the mechanisms for change were not causally examined. Similarly, Pratt and colleagues (Pratt et al., 2020 ) religiously tailored workshops were found to improve attitudes toward cervical cancer screening, but without examination of mechanisms of change. Nakajima and colleagues (Nakajima et al., 2022 ) administered a two-series workshop, that included a 25-minute video. The video improved intentions for colorectal screening. However, this study was observational and did not causally examine which spiritual and/or religious beliefs, barriers, and facilitators influenced health behavior outcomes. Future research is needed to identify which spiritual and/or religious factors influence health behavior outcomes. Beyond designing cancer genetic promotion interventions to leverage American Muslims’ experiences of spirituality and discrimination, there may be benefits to delivering interventions via non-specialist and specialist channels. Participants preferred receiving cancer genetic testing information from: a document, website, doctor, genetic counselor, video, and patient navigator, in that order. They also reported that mailed testing kits and incorporating testing into routine medical appointments would facilitate testing. These findings highlight potentially actionable strategies to increase access to genetic testing in this population. With traditional models of genetic service delivery reliant on the scarce workforce of genetic counselors, these findings suggest that novel models that utilize non-genetics providers (e.g., primary care doctors) and asynchronous options (e.g., document, website, video) are potentially acceptable strategies for expanding access among American Muslims. Future research is needed, however, to evaluate which delivery channels are appropriate for each aspect of service delivery. Limitations . Our study had several limitations. The generalizability of our findings is limited as we relied on a community-based convenience sample recruited from the DC–Maryland–Virginia area. Additionally, our low response rate limits the conclusions that can be drawn from the study. It is important to note, that we closed the survey after approximately one-month with little repeat outreach. Further, we took measures to mitigate potential nonresponse bias, such as clarifying in the recruitment flyer that there is compensation for completing the survey and that no prior knowledge of cancer genetic testing is required. Still, the low response rate and highly select sample require that these results be interpreted with caution – particularly if considering American Muslims residing outside of the Maryland-Virginia-DC area. Finally, our study assessed stated interest in GT rather than GT uptake. To inform interventions that promote cancer genetic testing in this population, future research should examine predictors of testing uptake. Conclusion The study provides important exploratory insights into an under-researched population. The associations between increased spirituality, perceived religion-based discrimination in healthcare, and interest in cancer genetic testing, demonstrates potential benefits of tailoring cancer genetic testing promotion interventions among American Muslims. Future research with larger, more representative samples can build on this work to better understand the mechanisms underlying these associations and to inform strategies to tailor interventions promoting cancer genetic testing among American Muslims. Declarations Competing Interests: The authors declare that they have no conflicts of interest. Ethics Approval: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Approval was granted by the Georgetown-MedStar joint oncology Institutional Review Board (STUDY00007505). Consent to participate: Informed consent was obtained from all patients for being included in the study. Consent to publish: Informed consent to participate in the study was obtained from all individual participants. Funding: This research did not receive funding. Author Contribution MRH: conceptualization, study design, project management, data curation, analysis, writing, review; SK: data management, writing; SB: data management; CD: conceptualization, review, editing; MDS: conceptualization, study design, review, editing; AHDM: conceptualization, study design, review, editing. Acknowledgements: We are immensely thankful to our participants for their time and responses. Data Availability The authors welcome inquiries from investigators interested in possible collaboration and use of de-identified data from this study. The data has not been placed into a public repository. References Abu Khait A, Lazenby M (2021) Psychosocial-spiritual interventions among Muslims undergoing treatment for cancer: An integrative review. BMC Palliat CARE 20(1). https://doi.org/10.1186/s12904-021-00746-x Abu Raiya H, Pargament KI, Mahoney A, Stein C (2008) A Psychological Measure of Islamic Religiousness: Development and Evidence for Reliability and Validity. Int J Psychol Relig 18(4):291–315. https://doi.org/10.1080/10508610802229270 Afsah YR, Kaneko N (20231130). Barriers to cervical cancer screening faced by immigrant Muslim women: A systematic scoping review. BMC Public Health , 23 (1), 2375. https://doi.org/10.1186/s12889-023-17309-9 Ahmed H, Mushahid H (2023) Overcoming challenges to breast cancer screening among Muslim women: Addressing barriers to early detection and treatment: A correspondence. Cancer Causes Control: CCC 34(6):505–507. https://doi.org/10.1007/s10552-023-01693-z Al Alawi S, Al Zaabi O, Heffernan ME, Arulappan J, Al Hasani N, Baluchi A, Mamari MA, A., Saadi A A. (20230228). Knowledge, attitudes and acceptance toward Human papillomavirus (HPV) vaccination: Perspectives of Muslim women and men. Vaccine , 41 (13), 2224–2233. https://doi.org/10.1016/j.vaccine.2023.02.063 Al-Amoudi S, Cañas J, Hohl SD, Distelhorst SR, Thompson B (2015) Breaking the silence: Breast cancer knowledge and beliefs among Somali Muslim women in Seattle, Washington. Health Care Women Int 36(5):608–616 Alkhaifi S, Padela AI, Hodge F, Brecht M-L (2023) Breast cancer screening among immigrant Muslim arab women in the United States: Analyzing relationships between beliefs, knowledge, spousal support and mammogram utilization. J Natl Med Assoc 115(3):302–313 Alvord TW, Marriott LK, Nguyen PT, Shafer A, Brown K, Stoller W, Volpi JL, Vandehey-Guerrero J, Ferrara LK, Blakesley S, Solomon E, Kuehl H, Palma AJ, Farris PE, Hamman KJ, Cotter M, Shannon J (2020) Public perception of predictive cancer genetic testing and research in Oregon. J Genet Couns 29(2):259–281. https://doi.org/10.1002/jgc4.1262 Austin S, Hanson EN, Delacroix E, Bacon E, Rice J, Gerido LH, Rizzo E, Pleasant V, Stoffel EM, Griggs JJ, Resnicow K (2025) Impact of barriers and motivators on intention and confidence to undergo hereditary cancer genetic testing. Journal of Genetic Counseling , 34 (1), e1926. https://doi.org/10.1002/jgc4.1926 Azhar S, Wyatt LC, Jokhakar V, Patel S, Raveis VH, Kwon SC, Islam NS (2022) Associations between spiritual health locus of control, perceived discrimination and breast and cervical cancer screening for muslim american women in New York city. Clin Breast Cancer 22(4):e586–e596 Bernstein I, Holinski-Feder E, Sala P, Evans DG, Lindblom A, Macrae F, Blanco I, Sijmons R, Jeffries J, Vasen H (2015) Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: First report from the prospective Lynch syndrome database. 1468–3288 Botoseneanu A, Alexander JA, Banaszak-Holl J (2011) To Test or Not to Test? The Role of Attitudes, Knowledge, and Religious Involvement Among U.S. Adults on Intent-to-Obtain Adult Genetic Testing. Health Educ Behav 38(6):617–628. https://doi.org/10.1177/1090198110389711 Chapman-Davis E, Zhou ZN, Fields JC, Frey MK, Jordan B, Sapra KJ, Chatterjee-Paer S, Carlson AD, Holcomb KM (2021) Racial and Ethnic Disparities in Genetic Testing at a Hereditary Breast and Ovarian Cancer Center. J Gen Intern Med 36(1):35–42. https://doi.org/10.1007/s11606-020-06064-x Choudhri A, Adams-Campbell L, Bright M, Zhu J, Dash C (2024) Cancer-Related Health and Educational Needs and Faith-Based Health Beliefs in an Urban Muslim Population. J Cancer Educ. https://doi.org/10.1007/s13187-024-02439-4 Clarke AJ, Van El CG (2022) Genomics and justice: Mitigating the potential harms and inequities that arise from the implementation of genomics in medicine. Hum Genet 141(5):1099–1107. https://doi.org/10.1007/s00439-022-02453-w Das A (2020) Major Discrimination Experiences, Education, and Genes. J Aging Health 32(7–8):753–763. https://doi.org/10.1177/0898264319851661 De Jong AE, Hendriks YMC, Kleibeuker JH, De Boer SY, Cats A, Griffioen G, Nagengast FM, Nelis FG, Rookus MA, Vasen HFA (2006) Decrease in Mortality in Lynch Syndrome Families Because of Surveillance. Gastroenterology 130(3):665–671. https://doi.org/10.1053/j.gastro.2005.11.032 Dharwadkar P, Greenan G, Stoffel EM, Burstein E, Pirzadeh-Miller S, Lahiri S, Mauer C, Singal AG, Murphy CC (2022) Racial and Ethnic Disparities in Germline Genetic Testing of Patients With Young-Onset Colorectal Cancer. Clin Gastroenterol Hepatol 20(2):353–361e3. https://doi.org/10.1016/j.cgh.2020.12.025 Giri VN, Knudsen KE, Kelly WK, Cheng HH, Cooney KA, Cookson MS, Dahut W, Weissman S, Soule HR, Petrylak DP, Dicker AP, AlDubayan SH, Toland AE, Pritchard CC, Pettaway CA, Daly MB, Mohler JL, Parsons JK, Carroll PR, Gomella LG (2020) Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology , 38 (24), 2798–2811. https://doi.org/10.1200/JCO.20.00046 Gómez-Trillos S, Sheppard VB, Graves KD, Song M, Anderson L, Ostrove N, Lopez K, Campos C, Gonzalez N, Hurtado‐de‐Mendoza A (2020) Latinas’ knowledge of and experiences with genetic cancer risk assessment: Barriers and facilitators. J Genet Couns 29(4):505–517. https://doi.org/10.1002/jgc4.1201 Guo F, Hirth JM, Fuchs EL, Cofie LE, Brown V, Kuo Y-F, Fernandez ME, Berenson AB (2022) Knowledge, Attitudes, Willingness to Pay, and Patient Preferences About Genetic Testing and Subsequent Risk Management for Cancer Prevention. J Cancer Educ 37(2):362–369. https://doi.org/10.1007/s13187-020-01823-0 Hasnain M, Menon U, Ferrans CE, Szalacha L (2014) Breast cancer screening practices among first-generation immigrant muslim women. J Women’s Health 23(7):602–612 Hay JL, Zielaskowski K, Meyer White K, Kaphingst K, Robers E, Guest D, Sussman A, Talamantes Y, Schwartz M, Rodríguez VM, Li Y, Schofield E, Bigney J, Hunley K, Buller D, Berwick M (2018) Interest and Uptake of MC1R Testing for Melanoma Risk in a Diverse Primary Care Population: A Randomized Clinical Trial. JAMA Dermatology 154(6):684. https://doi.org/10.1001/jamadermatol.2018.0592 IBM SPSS Statistics for Macintosh (Version Version 29.0). (2022) [Computer software] Islam N, Patel S, Brooks-Griffin Q, Kemp P, Raveis V, Riley L, Gummi S, Nur PQ, Ravenell J, Cole H (2017) Understanding barriers and facilitators to breast and cervical cancer screening among Muslim women in New York City: Perspectives from key informants. SM J Community Med, 3 (1) Kaphingst KA, Bather JR, Daly BM, Chavez-Yenter D, Vega A, Kohlmann WK (2022) Interest in Cancer Predisposition Testing and Carrier Screening Offered as Part of Routine Healthcare Among an Ethnically Diverse Sample of Young Women. Front Genet 13:866062. https://doi.org/10.3389/fgene.2022.866062 Lewis TT, Cogburn CD, Williams DR (2015) Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues. Ann Rev Clin Psychol 11(1):407–440. https://doi.org/10.1146/annurev-clinpsy-032814-112728 Liu T, Yu J, Gao Y, Ma X, Jiang S, Gu Y, Ming W (2023) Prophylactic Interventions for Hereditary Breast and Ovarian Cancer Risks and Mortality in BRCA1/2 Carriers. Cancers 16(1):103. https://doi.org/10.3390/cancers16010103 Majeed AM, Khan ZA, Aschebrook-Kilfoy B, Kibriya MG, Ahsan H, Padela AI (2023) Cancer Screening Differences Among Muslims and Non-Muslims: Insights from the Chicago Multiethnic Prevention and Surveillance Study. J Racial Ethnic Health Disparities 10(1):176–182. https://doi.org/10.1007/s40615-021-01208-z Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull 129(5):674 Mittendorf KF, Knerr S, Kauffman TL, Lindberg NM, Anderson KP, Feigelson HS, Gilmore MJ, Hunter JE, Joseph G, Kraft SA, Zepp JM, Syngal S, Wilfond BS, Goddard KAB (2021) Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities. JCO Precision Oncol 5:1709–1718. https://doi.org/10.1200/PO.21.00233 Moey SF, Sowtali SN, Ismail MFM, Hashi AA, Azharuddin NSM, Mohamed NC (2022) Cultural, Religious and socio-ethical misconceptions among Muslim women towards Breast Cancer Screening: A systematic review. Asian Pac J Cancer Prevention: APJCP 23(12):3971 Mogahed D, Ikramullah E, Chouhoud Y (2022) American Muslim poll 2022: A politics and pandemic status report. Inst Social Policy Underst, 25 Mohamed B (2018) New estimates show US Muslim population continues to grow. Pew Res Cent, 3 Muller C, Lee SM, Barge W, Siddique SM, Berera S, Wideroff G, Tondon R, Chang J, Peterson M, Stoll J, Katona BW, Sussman DA, Melson J, Kupfer SS (2018) Low Referral Rate for Genetic Testing in Racially and Ethnically Diverse Patients Despite Universal Colorectal Cancer Screening. Clin Gastroenterol Hepatol 16(12):1911–1918e2. https://doi.org/10.1016/j.cgh.2018.08.038 Nakajima M, Haji A, Mohamud S, Ahmed O, Hodges JS, Pratt R (2022) A Culturally Adapted Colorectal Cancer Education Video for the Somali Community in Minnesota: A Pilot Investigation. Am J Health Promotion 36(3):514–517. https://doi.org/10.1177/08901171211057690 Nordin K, Björk J, Berglund G (2004) Factors influencing intention to obtain a genetic test for a hereditary disease in an affected group and in the general public. Prev Med 39(6):1107–1114. https://doi.org/10.1016/j.ypmed.2004.04.021 Padela AI, Gunter K, Killawi A, Heisler M (2012) Religious values and healthcare accommodations: Voices from the American Muslim community. J Gen Intern Med 27(6):708–715. https://doi.org/10.1007/s11606-011-1965-5 . psyh Padela AI, Malik S, Ally SA, Quinn M, Hall S, Peek M (2018) Reducing Muslim mammography disparities: Outcomes from a religiously tailored mosque-based intervention. Health Educ Behav 45(6):1025–1035 Padela AI, Murrar S, Adviento B, Liao C, Hosseinian Z, Peek M, Curlin F (2015) Associations between religion-related factors and breast cancer screening among American Muslims. J Immigr Minor Health 17(3):660–669. https://doi.org/10.1007/s10903-014-0014-y . psyh Padela AI, Peek M, Johnson-Agbakwu CE, Hosseinian Z, Curlin F (2014) Associations between religion-related factors and cervical cancer screening among Muslims in greater chicago. J Lower Genit Tract Dis 18(4):326–332. https://doi.org/10.1097/LGT.0000000000000026 . cmedm Padela AI, Zaidi D (2018) The Islamic tradition and health inequities: A preliminary conceptual model based on a systematic literature review of Muslim health-care disparities. Avicenna J Med 8(1):1 Paiella S, Azzolina D, Gregori D, Malleo G, Golan T, Simeone DM, Davis MB, Vacca PG, Crovetto A, Bassi C, Salvia R, Biankin AV, Casolino R (2023) A systematic review and meta-analysis of germline BRCA mutations in pancreatic cancer patients identifies global and racial disparities in access to genetic testing. ESMO Open 8(2):100881. https://doi.org/10.1016/j.esmoop.2023.100881 Parikh DA, Dickerson JC, Kurian AW (2020) Health Disparities in Germline Genetic Testing for Cancer Susceptibility. Curr Breast Cancer Rep 12(2):51–58. https://doi.org/10.1007/s12609-020-00354-3 Peek ME, Nunez-Smith M, Drum M, Lewis TT (2011) Adapting the everyday discrimination scale to medical settings: Reliability and validity testing in a sample of African American patients. Ethn Dis 21(4):502 Pratt R, Mohamed S, Dirie W, Ahmed N, Lee S, VanKeulen M, Carlson S (2020) Testing a religiously tailored intervention with Somali American Muslim women and Somali American imams to increase participation in breast and cervical Cancer screening. J Immigr Minor Health 22(1):87–95 Prince A, Cadigan J, Henderson G, Evans J, Adams M, Coker-Schwimmer E, Penn D, Van Riper M, Corbie-Smith G, Jonas D (2017) Is there evidence that we should screen the general population for Lynch syndrome with genetic testing? A systematic review. Pharmacogenomics Personalized Med 10:49–60. https://doi.org/10.2147/PGPM.S123808 Raiya HA, Pargament KI, Stein C, Mahoney A (2007) Lessons Learned and Challenges Faced in Developing the Psychological Measure of Islamic Religiousness. J Muslim Mental Health 2(2):133–154. https://doi.org/10.1080/15564900701613058 Roberts MC, Foss KS, Henderson GE, Powell SN, Saylor KW, Weck KE, Milko LV (2022) Public Interest in Population Genetic Screening for Cancer Risk. Front Genet 13:886640. https://doi.org/10.3389/fgene.2022.886640 Rubinsak LA, Kleinman A, Quillin J, Gordon SW, Sullivan SA, Sutton AL, Sheppard VB, Temkin SM (2019) Awareness and acceptability of population-based screening for pathogenic BRCA variants: Do race and ethnicity matter? Gynecol Oncol 154(2):383–387. https://doi.org/10.1016/j.ygyno.2019.06.009 Salhab M, Bismohun S, Mokbel K (2010) Risk-reducing strategies for women carrying BRCA1/2 mutations with a focus on prophylactic surgery. BMC Women’s Health 10(1):28 Samari G, Alcalá HE, Sharif MZ (2018) Islamophobia, health, and public health: A systematic literature review. Am J Public Health 108(6):e1–e9 Sayani A (2019) Inequities in genetic testing for hereditary breast cancer: Implications for public health practice. J Community Genet 10(1):35–39. https://doi.org/10.1007/s12687-018-0370-8 Schwartz MD, Hughes C, Roth J, Main D, Peshkin BN, Isaacs C, Kavanagh C, Lerman C (2000) Spiritual faith and genetic testing decisions among high-risk breast cancer probands. Cancer Epidemiol Biomarkers Prev 9(4):381–385 Steffen LE, Du R, Gammon A, Mandelblatt JS, Kohlmann WK, Lee J-H, Buys SS, Stroup AM, Campo RA, Flores KG, Vicuña B, Schwartz MD, Kinney AY (2017) Genetic Testing in a Population-Based Sample of Breast and Ovarian Cancer Survivors from the REACH Randomized Trial: Cost Barriers and Moderators of Counseling Mode. Cancer Epidemiol Biomarkers Prev 26(12):1772–1780. https://doi.org/10.1158/1055-9965.EPI-17-0389 Suther S, Kiros G-E (2009) Barriers to the use of genetic testing: A study of racial and ethnic disparities. Genet Sci 11(9):655–662. https://doi.org/10.1097/GIM.0b013e3181ab22aa Tawfik SM, Elhosseiny AA, Galal AA, William MB, Qansuwa E, Elbaz RM, Salama M (2023) Health inequity in genomic personalized medicine in underrepresented populations: A look at the current evidence. Funct Integr Genom 23(1):54. https://doi.org/10.1007/s10142-023-00979-4 Valachis A, Nearchou AD, Lind P (2014) Surgical management of breast cancer in BRCA-mutation carriers: A systematic review and meta-analysis. Breast Cancer Res Treat 144(3):443–455. https://doi.org/10.1007/s10549-014-2890-1 Williams DR, Yu Y, Jackson JS, Anderson NB (1997) Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination. J Health Psychol 2(3):335–351. https://doi.org/10.1177/135910539700200305 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 25 Feb, 2026 Editor assigned by journal 25 Feb, 2026 Submission checks completed at journal 25 Feb, 2026 First submitted to journal 17 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8903379","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596877258,"identity":"371cdd71-93bf-4939-ae6f-33b4a824b177","order_by":0,"name":"Maisha R. Huq","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYDACCeaDj3/+sUETxK+FLdmYsSENyksgSguPmTRjw2EStOjObjCQLtxx3q6fvffxi48/bBK3MzAfvM2DR4vZnQMJxjPP3E6e2XPczHJGQlrizga2ZGu8Wm4kHEjgYbudbHAjjc2YJ+Fw7oYDQKfi15LYcICH7VyyPUjLH7AW/m8EtCQzNvO2HbAzkEhjfswAsYWNgJY0ZsYZZ5ITJM4cY2PsSUur33CYzdhyDl4t+d9/fKiws+dvb2P+8MPGxtjgePPDG2/waIGBxAYGBjZIdDAToRwE7EFqPxCpeBSMglEwCkYYAACX3VQS6bESzwAAAABJRU5ErkJggg==","orcid":"","institution":"Georgetown University Medical Center","correspondingAuthor":true,"prefix":"","firstName":"Maisha","middleName":"R.","lastName":"Huq","suffix":""},{"id":596877259,"identity":"65824ec5-109d-4618-b034-64edd525008a","order_by":1,"name":"Shreya Kaushik","email":"","orcid":"","institution":"Georgetown University Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Shreya","middleName":"","lastName":"Kaushik","suffix":""},{"id":596877260,"identity":"f4528470-db01-486f-94a2-1174730faa93","order_by":2,"name":"Saara Bidiwala","email":"","orcid":"","institution":"Georgetown University Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Saara","middleName":"","lastName":"Bidiwala","suffix":""},{"id":596877261,"identity":"17ec0a97-39f4-4721-a772-b2ead7dc64c4","order_by":3,"name":"Chiranjeev Dash","email":"","orcid":"","institution":"Georgetown University Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Chiranjeev","middleName":"","lastName":"Dash","suffix":""},{"id":596877262,"identity":"a7bc210e-7e5d-454a-bc81-8a90ee7bbf33","order_by":4,"name":"Marc D. Schwartz","email":"","orcid":"","institution":"Georgetown University Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Marc","middleName":"D.","lastName":"Schwartz","suffix":""},{"id":596877263,"identity":"d5869969-c281-4643-af8d-7e69f60fa19f","order_by":5,"name":"Alejandra Hurtado-de-Mendoza","email":"","orcid":"","institution":"Georgetown University Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Alejandra","middleName":"","lastName":"Hurtado-de-Mendoza","suffix":""}],"badges":[],"createdAt":"2026-02-17 17:38:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8903379/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8903379/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104399326,"identity":"7a43e715-e9ac-4e2b-93a0-e9f140321bb1","added_by":"auto","created_at":"2026-03-11 12:05:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1158882,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8903379/v1/26108fbb-be7b-47d3-aa21-0441c66f75a1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Cancer genetic testing among a diverse sample of American Muslims","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMuslims are the fastest growing religious group in the United States (Mogahed et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Mohamed, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Over the next 25 years, the American Muslim population is expected to more than double from 3.45\u0026nbsp;million individuals in 2017 to 8.1\u0026nbsp;million by 2050 (Mogahed et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Mohamed, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). While 20% of American Muslims are US-born, American Muslims are a predominantly immigrant population, originating largely from South Asia, Asia-Pacific, the Middle East, North Africa, sub-Saharan Africa, and Europe. Socioeconomically, American Muslims tend to be lower income\u0026mdash; 40% of Muslim Americans have household incomes less than \u003cspan\u003e$\u003c/span\u003e30,000/year (Mogahed et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Mohamed, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Their religion acts as a unifying factor integrated in various aspects of their lifestyle, including healthcare (Padela \u0026amp; Zaidi, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmerican Muslims report lower cancer screening rates relative to non-Muslims (Afsah \u0026amp; Kaneko, 20231130; Ahmed \u0026amp; Mushahid, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Azhar et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hasnain et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Islam et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). A survey of 240 mammogram-eligible Muslim women found that 37% had not had a mammogram in the past 2 years, 30% lower than the national average (Padela et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Among 207 first-generation American Muslim women, only 52% of screening-age women reported a mammogram in the prior two years, which was substantially lower than the national rate of 67% at the time (Hasnain et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Further, community-based studies report disproportionately lower colorectal cancer screening among Muslims relative to non-Muslims (Majeed et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMultilevel factors have been linked with lower cancer screening rates among American Muslims. Individual-level factors include Islam-related beliefs and knowledge of cancer screening (Al Alawi et al., 20230228; Al-Amoudi et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Alkhaifi et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Choudhri et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Predictors also span the interpersonal (Azhar et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Samari et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) (e.g. perceived discrimination in healthcare) and system (Majeed et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) (e.g., lack of culturally or religiously-concordant providers) levels. Religion-related factors may be particularly salient (Choudhri et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Majeed et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Padela et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2012\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2014\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Padela \u0026amp; Zaidi, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Islam provides a unifying lens through which to make healthcare decisions among American Muslims (Choudhri et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Majeed et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Padela et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2012\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2014\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Padela \u0026amp; Zaidi, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Islam-based beliefs about stewarding the body to good health and predestination (Afsah \u0026amp; Kaneko, 20231130; Padela \u0026amp; Zaidi, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), as well as one\u0026rsquo;s spirituality, religiosity, and religious coping (i.e. the use of religious beliefs, practices, and community to manage stress) can influence cancer screening decisions (Al-Amoudi et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Azhar et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Choudhri et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Islam et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Moey et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Perceived religion-based discrimination (i.e., Islamophobia) has also been associated with reduced healthcare utilization (Samari et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Taken together, existing studies warrant further examination of the role of religion and discrimination-related factors on cancer control behaviors.\u003c/p\u003e \u003cp\u003eGermline genetic testing for hereditary cancer risk is becoming increasingly important as a cancer prevention and control strategy for the general population. Cancer genetic testing is a blood or saliva-based test that identifies if an individual carries an inherited genetic mutation that increases their risk of developing cancer. Among individuals found to be at increased risk, follow-up risk management strategies can reduce breast, ovarian, colorectal, and endometrial cancer risk and mortality significantly (Bernstein et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; De Jong et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Liu et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Prince et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Salhab et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Valachis et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Despite these benefits, cancer genetic testing remains severely underutilized overall, and particularly among minoritized groups (Chapman-Davis et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Clarke \u0026amp; Van El, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Dharwadkar et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Mittendorf et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Muller et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Paiella et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Parikh et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Sayani, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Suther \u0026amp; Kiros, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Tawfik et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTo our knowledge, there have been no studies examining cancer genetic testing among American Muslims. It is likely that American Muslims may face barriers in accessing cancer genetic testing comparable to the disparities they face regarding cancer screening. However, little is known about awareness, interest, and attitudes toward cancer genetic testing, as well as factors that may influence genetic testing interest among American Muslims, including religion and discrimination-related factors. Given the lack of research on cancer genetic testing among the under-researched and growing group of American Muslims, the aims of our current work are to assess interest in cancer genetic testing, factors influencing interest in cancer genetic testing including religion and discrimination factors, and preferences for receiving cancer genetic education and testing within a diverse, community sample of American Muslims.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSample and Recruitment\u003c/h2\u003e \u003cp\u003eWe recruited a community-based convenience sample of American Muslims from the DC-Maryland-Virginia (DMV) area between August 2024 and September 2024. Eligible individuals were aged 18 years or older, currently residing in the DMV, and self-reported Muslims. The first author (MH) established communication with leadership at eight DMV-based Muslim-serving community organizations. Five were mosques (ADAMS mosque in Virginia, and the MCC, ICM, ICCP, and Maqaame Ibrahim mosques in Maryland), and three were predominantly Muslim-facing community organizations (DMV Jobs group, DMV Refugees Network, MFC AFSP Volunteers). We distributed the study flyer, eligibility screener and survey through in-person events, and text message (e.g., community organization WhatsApp groups) and online listservs. The study flyer clarified that no prior knowledge of cancer genetic testing was needed.\u003c/p\u003e \u003cp\u003eAcross four weeks of recruitment, we distributed the screener to approximately 2783 individuals. However, we could not determine the number of duplicates across the online/text listservs, nor the exact number of community members who received information about the survey during in-person recruitment. Thus, the number of unique individuals to whom the screener was distributed is likely less than 2783. Overall, 223 participants completed the screener for an estimated response rate of 8.0%. The true response rate was likely higher given the factors described above, particularly the duplicates across DMV-area listservs.\u003c/p\u003e \u003cp\u003eOf the 223 screener completers, 48 did not meet eligibility criteria. Specifically, two did not self-identify as Muslim; three were younger than 18 years; six lived outside the DMV; 37 did not meet a criterion for living in select DMV counties that we had implemented but later removed. Of the 175 eligible participants who completed the screener, five (3%) did not complete the survey, and six (3%) had high missing data or did not respond to the primary outcome, leaving 164 survey participants. Of the 164 survey participants, six (4%) reported prior cancer genetic testing. Since this group was too small for separate analyses, we excluded them from subsequent analyses \u0026ndash; leaving a final sample of n\u0026thinsp;=\u0026thinsp;158.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedures\u003c/h3\u003e\n\u003cp\u003eWe administered a three-item eligibility screener in person and electronically. As stated, inclusion criteria were to be: aged 18 years or older, currently residing in the DMV, and self-reported Muslim. Eligible individuals received the survey in person or electronically. The survey included 40-items and took 10\u0026ndash;15 minutes to complete. Participants who completed the survey received a \u003cspan\u003e$\u003c/span\u003e25 e-gift card to compensate their participation.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003ePrimary Outcome\u003c/h2\u003e \u003cp\u003eInterest in cancer genetic testing (GT). We assessed interest in GT with a single item adapted from prior research (Kaphingst et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e): \u0026ldquo;I am interested to learn more about cancer genetic testing\u0026rdquo; on a 5-point Likert scale. For analyses, we dichotomized GT interest as strongly agree vs. all other categories (agree through strongly disagree). We chose this operationalization to examine strong interest in genetic testing, as strong interest is more closely linked to behavioral uptake. Further, this dichotomization is closest to a median splite, which maximizes our power in subsequent analyses.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSecondary outcomes\u003c/h3\u003e\n\u003cp\u003ePreferences for genetic education. We evaluated participant preferences for receiving education about genetic testing with the following question: \u0026ldquo;If you were thinking about getting genetic testing, how would you prefer to receive information about genetic testing?\u0026rdquo; For each delivery channel option (a document, a video, a website, chatbot, speaking with a doctor, speaking with a genetic counselor, speaking with a community health worker or patient navigator), participants rated their preference on a scale of 1 to 3 (1\u0026thinsp;=\u0026thinsp;I do not prefer this, 2\u0026thinsp;=\u0026thinsp;I am ok with this, 3\u0026thinsp;=\u0026thinsp;I highly prefer this). For analyses, we created a binary measure (0\u0026thinsp;=\u0026thinsp;do not prefer, 1\u0026thinsp;=\u0026thinsp;am ok or highly prefer) for each option.\u003c/p\u003e \u003cp\u003eFacilitators of genetic testing. To assess facilitators of genetic testing, we provided a menu of 14 clinically validated options (e.g. transportation, more information) adapted from our prior research (G\u0026oacute;mez-Trillos et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Steffen et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and asked, \u0026ldquo;Which of the following would make it easier for you get cancer genetic testing?\u0026rdquo; Participants selected all options that applied.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003ePredictors\u003c/h2\u003e \u003cp\u003eDemographics. Participants self-reported age, sex at birth, race, highest education completed, employment status, annual household income, foreign-born status, years living in the USA, and health insurance type.\u003c/p\u003e \u003cp\u003eCancer history. Participants self-reported personal and family history of cancer.\u003c/p\u003e \u003cp\u003eKnowledge. Participants self-rated their knowledge of hereditary cancer via the item, \u0026ldquo;How would you rate your knowledge of hereditary cancer?\u0026rdquo; and their knowledge on genetic testing via the item, \u0026ldquo;How would you rate your knowledge of genetic testing?\u0026rdquo; both rated from 0\u0026thinsp;=\u0026thinsp;very little to 10\u0026thinsp;=\u0026thinsp;a lot. We operationalized these as continuous measures as the data were roughly symmetric and distributed.\u003c/p\u003e \u003cp\u003eParticipants selected all settings where they \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eregularly received healthcare\u003c/span\u003e in the last three years (hospital, community clinic, private clinic, do not regularly receive healthcare).\u003c/p\u003e \u003cp\u003eWe assessed \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003evalue for ancestral culture\u003c/span\u003e through a single face-valid five-point Likert-scale item: \u0026ldquo;It is important to me to keep the culture(s) of my ancestors.\u0026rdquo; For analyses, we dichotomized value for ancestral culture as strongly agree/agree (n\u0026thinsp;=\u0026thinsp;95) vs neither/disagree/strongly disagree (n\u0026thinsp;=\u0026thinsp;57).\u003c/p\u003e \u003cp\u003eWe measured \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003ereligion-related factors\u003c/span\u003e: spirituality, religiosity in daily life, role of religion in cancer screening, positive religious coping, and negative religious coping. For \u003cem\u003espirituality\u003c/em\u003e, we employed a single face-valid item: \u0026ldquo;How spiritual do you consider yourself?\u0026rdquo; where participants self-rated from 0\u0026thinsp;=\u0026thinsp;not at all to 10\u0026thinsp;=\u0026thinsp;very spiritual. For analyses we dichotomized spirituality at the median of 8 due to a skewed distribution. We assessed \u003cem\u003ereligiosity in daily life\u003c/em\u003e with a single face-valid item: \u0026ldquo;How important is religion to your daily life?\u0026rdquo; Although the existing literature rarely examines religiosity in daily life, we added this measure as daily practice is salient in the context of Islam (e.g., five daily prayers). Participants rated themselves from 0\u0026thinsp;=\u0026thinsp;not at all to 10\u0026thinsp;=\u0026thinsp;very important. Due to an extreme right skew at the value of 10, we analyzed the item as binary: 10 and \u0026lt;\u0026thinsp;10. We evaluated the role of \u003cem\u003ereligiosity in cancer screening\u003c/em\u003e with a single face-valid item: \u0026ldquo;How much does religion influence your desire to get cancer screenings?\u0026rdquo; Participants rated themselves from 0\u0026thinsp;=\u0026thinsp;not at all to 10\u0026thinsp;=\u0026thinsp;a lot. We analyzed the item as continuous as data were roughly symmetric and distributed. To measure \u003cem\u003epositive\u003c/em\u003e and negative \u003cem\u003ereligious coping\u003c/em\u003e, we used the Positive Religious Coping subscale (summary score ranging 7 to 28; cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;.90) and \u003cem\u003eNegative Religious Coping subscale\u003c/em\u003e (summary score ranging 5 to 20; cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;.85), from the 12-item Psychological Measure of Islamic Religiousness scale (Abu Raiya et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; Raiya et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Higher summary scores indicate higher positive/negative religious coping. An example positive religious coping subscale item is, \u0026ldquo;When I face a problem in life, I look for a stronger connection with Allah\u0026rdquo; and an example negative religious coping subscale item is, \u0026ldquo;When I face a problem in life, I believe that I am being punished for bad actions I did.\u0026rdquo; For analyses, we treat the measures as continuous as they are validated sub-scales.\u003c/p\u003e \u003cp\u003eWe measured \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003ediscrimination in healthcare\u003c/span\u003e using the 7-item Everyday Discrimination in Healthcare Scale (Peek et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Williams et al., \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e1997\u003c/span\u003e) (Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;.89), where higher summary scores (ranging 7 to 35) indicate greater perceived discrimination. We also employed a single five-point Likert scale face-valid item: \u0026ldquo;I feel like I have experienced discrimination due to looking Muslim in a healthcare setting, in my life\u0026rdquo;. For analysis, we dichotomized this measure as strongly agree/agree (n\u0026thinsp;=\u0026thinsp;45) vs neither/disagree/strongly disagree (n\u0026thinsp;=\u0026thinsp;107) to conceptually capture having ever experienced Islamophobia in healthcare.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAnalyses\u003c/h3\u003e\n\u003cp\u003eWe summarized sample characteristics and key study measures using descriptive statistics. To identify bivariate associations with our primary outcome, interest in genetic testing, we employed student\u0026rsquo;s t-tests and Chi-square tests. To evaluate multivariate associations with our primary outcome, we employed a logistic regression with backward elimination, inputting only those variables with p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 bivariate associations with interest in genetic testing.\u003c/p\u003e \u003cp\u003eTo analyze our secondary outcomes on intervention preferences and facilitators, we assessed the frequency with which participants endorsed delivery channel options and perceived facilitators. All analyses used two-tailed tests at a significance level of 0.05. Analyses were completed using SPSS 29 (\u003cem\u003eIBM SPSS Statistics for Macintosh\u003c/em\u003e, 2022).\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSample Characteristics\u003c/h2\u003e \u003cp\u003eAs displayed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, our sample had a mean age of 34.3 years (SD\u0026thinsp;=\u0026thinsp;10.9; range\u0026thinsp;=\u0026thinsp;18 to 72). The majority of the participants were South Asian (64%), female (80%), and foreign-born (62%). Among those born outside the US, the mean years in the USA was 16.5 (SD\u0026thinsp;=\u0026thinsp;11.4). The sample was socioeconomically diverse with 5% having incomes less than \u003cspan\u003e$\u003c/span\u003e20,000, 17% between \u003cspan\u003e$\u003c/span\u003e20,000 and \u003cspan\u003e$\u003c/span\u003e59,999, 17% between \u003cspan\u003e$\u003c/span\u003e60,000 and \u003cspan\u003e$\u003c/span\u003e99,999; and 34% \u003cspan\u003e$\u003c/span\u003e100,000 or more; 17% had Medicaid or no insurance; and 15% did not regularly receive any healthcare.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eSample Characteristics (n\u0026thinsp;=\u0026thinsp;158)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e(34.3, SD\u0026thinsp;=\u0026thinsp;10.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex at birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRace/ethnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAfrican, African American, Black\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral/East Asian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle Eastern/North African\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth Asian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign-born\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears in USA (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e(16.5, SD\u0026thinsp;=\u0026thinsp;11.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighest educational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSome college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduate school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousehold income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u003cspan\u003e$\u003c/span\u003e20,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e20, 000 - \u003cspan\u003e$\u003c/span\u003e59,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e60,000 - \u003cspan\u003e$\u003c/span\u003e99,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e100,000 or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull-time work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePart-time work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull-time homemaker or caregiver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed, seeking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInsurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrefer not to say\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eKey study measures\u003c/h2\u003e \u003cp\u003eOverall, 76% of the sample reported interest in cancer genetic testing (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) of whom 33% indicated strong interest. About half the sample (50.6%) had a family history of cancer. Participants reported relatively low self-rated knowledge of hereditary cancer (Mean\u0026thinsp;=\u0026thinsp;4/10; SD\u0026thinsp;=\u0026thinsp;3) and genetic testing (Mean\u0026thinsp;=\u0026thinsp;3/10; SD\u0026thinsp;=\u0026thinsp;3).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eKey Study Variables (n\u0026thinsp;=\u0026thinsp;158)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInterest in genetic testing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeither agree nor disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCancer history\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHas personal history of cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHas family history of cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of hereditary cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e(4.0, SD\u0026thinsp;=\u0026thinsp;3.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of GT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e(3.0, SD\u0026thinsp;=\u0026thinsp;3.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular healthcare \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity clinic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate clinic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo regular healthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEveryday Discrimination in Healthcare Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e(14.1, SD\u0026thinsp;=\u0026thinsp;4.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiscrimination in healthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eValue ancestral Culture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpirituality (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRating\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRating\u0026thinsp;\u0026gt;\u0026thinsp;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive religious coping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e24.1 (SD\u0026thinsp;=\u0026thinsp;4.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative religious coping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e9.0 (SD\u0026thinsp;=\u0026thinsp;3.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligiosity in daily life (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRating of 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRating \u0026lt;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligiosity in screening (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e(5.3, SD\u0026thinsp;=\u0026thinsp;3.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003csup\u003ea\u003c/sup\u003e Categories are not mutually exclusive; participants were able to select multiple responses for where they regularly received healthcare in the past 3 years.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eBivariate associations\u003c/h2\u003e \u003cp\u003eAs displayed in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, in bivariate analyses, interest cancer genetic testing was associated with: having family history of cancer (p=.024) and being South Asian (p=.028). In terms of religion and discrimination factors, interest in cancer genetic testing was associated with: greater self-reported role of religion in cancer screening (p=.015), greater experiences of discrimination in healthcare (p=.009), and higher spirituality (p=.016). No sociodemographics were significantly associated with interest in testing; but household income (p=.058) approached significance.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eBivariate Results of Differences Between Participants Who Are Strongly Interested and Not Strongly Interested in Cancer Genetic Testing\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStrongly Interested\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot Strongly Interested\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eContinuous variables M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.0\u0026thinsp;\u0026plusmn;\u0026thinsp;11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.0\u0026thinsp;\u0026plusmn;\u0026thinsp;11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.628\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears lived in the USA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.5\u0026thinsp;\u0026plusmn;\u0026thinsp;11.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.5\u0026thinsp;\u0026plusmn;\u0026thinsp;11.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.994\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of hereditary cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of genetic testing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.056\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligiosity in cancer screening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.015*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive religious coping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.104\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative religious coping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.270\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEveryday Discrimination in Healthcare Scale \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.824\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCategorical variables n (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex at birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (78.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e86 (81.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.734\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (21.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth Asian ethnicity \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (51.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74 (69.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.028*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (48.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 (30.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorn in the USA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (46.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36 (33.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.138\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (53.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70 (66.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighest education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge; College\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (78.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69 (72.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.442\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt; College\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (27.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousehold income \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge; \u003cspan\u003e$\u003c/span\u003e100k\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (46.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (28.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt; \u003cspan\u003e$\u003c/span\u003e100k\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (36.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (41.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (17.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 (30.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (60.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (45.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot full-time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (39.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52 (54.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInsurance \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (70.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62 (60.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.106\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePublic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (22.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular healthcare \u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (26.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.286\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate clinic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (51.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (47.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.574\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCancer history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (5.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (3.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (94.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102 (96.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily history of cancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (63.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47 (44.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.024*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (36.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 (55.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eValue ancestral culture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (68.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60 (59.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.267\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (31.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (40.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpirituality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (43.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63 (63.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.016*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (56.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36 (36.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligiosity in daily life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62 (62.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.573\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38 (38.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiscrimination in healthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (43.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (22.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.009**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (56.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78 (77.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNotes. Independent samples t-tests were used for continuous variables; chi-square tests were used for categorical variables. p \u0026lt; .05 = *, p \u0026lt; .01 = **.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ea\u003c/sup\u003e The validated 7-item Everyday Discrimination in Healthcare Scale summary score (range\u0026thinsp;=\u0026thinsp;7\u0026ndash;35) measures perceived discrimination in healthcare.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eb\u003c/sup\u003e We only present a South Asian measure (\u0026lsquo;yes, South Asian\u0026rsquo; vs. \u0026lsquo;no, not South Asian\u0026rsquo;) because no other race group was sufficiently large to analyze as an individual group.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ec\u003c/sup\u003e We created three-level categorical measures for income (\u0026lt;$100k, \u0026gt;$100,000 or more, and missing) and insurance (private, public, missing), where one category captured missing responses as both had significant missing data. We included the eight individuals who had no insurance in the missing group. We compared a listwise deletion approach (i.e. restricted to complete cases) to our \u0026lsquo;missing indicator\u0026rsquo; approach. Our results did not change substantively across the approaches. Thus, we concluded that the high missingness in our income and insurance measures did not significantly affect our conclusions.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ed\u003c/sup\u003e We created binary measures for each setting. For instance, a binary measure was: \u0026lsquo;yes, regularly receive care at hospital, \u0026lsquo;no, did not receive care at hospital\u0026rsquo;. To ensure adequate cell sizes, only categories with at least 30 participants (i.e., hospital, private clinic) were retained as binary variables.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eMultivariate associations\u003c/h2\u003e \u003cp\u003eIn the initial step of a multivariable logistic regression with backward elimination, we inputted the five measures with P\u0026lt;.05 associations with genetic testing interest: being South Asian, having family history of cancer, role of religion in cancer screening, perceived discrimination in healthcare, and spirituality. As displayed in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, the final model indicates that the only variables independently associated with interest in cancer genetic testing were: spirituality (OR\u0026thinsp;=\u0026thinsp;2.72, 95% CI: 1.24, 5.96) and discrimination in healthcare due to looking Muslim (i.e., Islamophobia) (OR\u0026thinsp;=\u0026thinsp;2.81, 95% CI: 1.23, 6.39).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eResults from multivariate logistic regression\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eOdds Ratio\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e95% CI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiscrimination in health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[1.234, 6.388]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpirituality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[1.237, 5.960]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNote. We only inputted the variables that had a significant bivariate association at alpha=.05 with interest in cancer genetic testing: South Asian ethnicity, family history of cancer, religiosity in cancer screening, discrimination in healthcare (binary), and spiritualty. We outputted variables that were significant at alpha=.0549 value with interest in cancer genetic testing.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003ePreferences for receiving cancer genetic services\u003c/h2\u003e \u003cp\u003eFrom a list of seven options, participants most frequently endorsed the following preferences for receipt of genetic education (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e): a document (82%), a website (77%), doctor (76%), genetic counselor (75%), a video (72%), and a patient navigator (63%). Participants were least interested in receiving genetic information via a chatbot (29%). Those who were not strongly interested in genetic testing selected fewer options than those who were strongly interested in testing (M\u0026thinsp;=\u0026thinsp;0.81, SD\u0026thinsp;=\u0026thinsp;1.2 vs. M\u0026thinsp;=\u0026thinsp;1.94, SD\u0026thinsp;=\u0026thinsp;1.78, p\u0026lt;.001). From a menu of 14 options, participants reported that the following would most facilitate receipt of testing: informational materials (59%), insurance coverage for most/all costs (59%), at-home testing kit (52%), offering testing as part of a routine medical appointment (44%), and if the genetic testing is near home (41%) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eParticipant preferences for delivery through which to receive genetic information/counseling (n\u0026thinsp;=\u0026thinsp;158)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDocument\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e82.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVideo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e72.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWebsite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChatbot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDoctor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e75.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGenetic counselor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e75.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eEverything else\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNavigator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrefer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eParticipant endorsement of facilitators of cancer genetic testing (n\u0026thinsp;=\u0026thinsp;158)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf I receive more informational materials\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf genetic counseling was over phone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf genetic counseling was optional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf I could receive at home testing kit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf testing was a part of another routine medical appt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf the clinic was close to home\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf I had transportation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf I had childcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf clinic had flexible hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf insurance would pay most/all of the cost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf another organization would help pay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf my doctor recommended genetic testing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf I trusted my doctor\u0026rsquo;s recommendation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf my family encouraged me to get genetic testing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study aimed to explore: interest in cancer genetic testing, factors influencing interest in testing, particularly religion and discrimination factors, and cancer genetic testing intervention preferences among a community sample of American Muslims. We found notable interest in cancer genetic testing\u0026mdash;76% were interested; 33% were strongly interested in cancer genetic testing. Although multiple variables were associated with testing interest in bivariate analyses, only spirituality and perceived discrimination in healthcare due to looking Muslim (i.e. Islamophobia) were independently associated with greater interest in cancer genetic testing. In terms of preferences for the receipt of genetic information, participants most frequently endorsed the use of documents and a websites, followed by preference for doctors and genetic counselors. Future research is needed on which combinations of specialists vs non-specialists, as well as digital vs non-digital channels optimize cancer genetic service delivery.\u003c/p\u003e \u003cp\u003eIn our sample interest in cancer genetic testing was comparable to prior samples. In previous community-based convenience samples, approximately 50\u0026ndash;90% of participants reported interest in cancer genetic testing (Botoseneanu et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Guo et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hay et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kaphingst et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Roberts et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Rubinsak et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), compared to 76% of our sample. Further, 30\u0026ndash;90% (Alvord et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Roberts et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Rubinsak et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) of these samples report \u003cem\u003estrong\u003c/em\u003e interest in testing, compared to 32% of our sample. These data suggest that nearly 70% of certain samples remain less than \u003cem\u003estrongly\u003c/em\u003e interested, with about 30% not \u003cem\u003eat all\u003c/em\u003e interested in testing. By understanding the predictors of interest, we can close gaps in cancer genetic testing interest and, potentially, uptake among American Muslims.\u003c/p\u003e \u003cp\u003eIntriguingly, factors that typically drive interest in cancer genetic testing were not predictive in our sample of American Muslims. Demographic factors such as younger age and being female, and social determinants of health such as education and income have consistently been found to strongly predict interest in cancer genetic testing (Botoseneanu et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Guo et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hay et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kaphingst et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Nordin et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Roberts et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Rubinsak et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Family history of cancer, cognitive factors (e.g., greater knowledge of hereditary cancer or cancer genetic testing) and psychosocial characteristics have also generally been associated with testing interest (Botoseneanu et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Guo et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hay et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kaphingst et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Nordin et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Roberts et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Rubinsak et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Although some of these factors were associated at the bivariate level in this study (i.e., family history of cancer), none were independently associated with test interest. It is possible that these factors were non-significant in our sample because our participants\u0026rsquo; spirituality and experiences of perceived Islamophobia in healthcare are more salient.\u003c/p\u003e \u003cp\u003eOur findings reveal that leveraging American Muslims\u0026rsquo; spirituality is perhaps more salient for influencing interest in cancer genetic testing than other factors. This is noteworthy as spirituality is rarely examined in the context of cancer genetic testing, and when it has been findings were mixed (Austin et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Botoseneanu et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Schwartz et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2000\u003c/span\u003e). One explanation for the positive link between spirituality and testing interest is that Muslims who consider themselves more spiritual may place greater value on the Islamic call to steward the body to good health (Afsah \u0026amp; Kaneko, 20231130; Padela \u0026amp; Zaidi, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Consequently, Muslims who consider themselves more spiritual may view cancer genetic testing as a proactive approach for stewarding the body to good health.\u003c/p\u003e \u003cp\u003eOne of our most striking and surprising findings was that \u003cem\u003egreater\u003c/em\u003e experiences of perceived Islamophobia in healthcare was associated with interest in cancer genetic testing. This contrasts with prior research that suggests the experience religious discrimination in healthcare deters service utilization (Samari et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). For example, a study of 240 Muslim women found that perceived Islamophobia in healthcare was linked with not having had a mammogram in the prior two years (Padela et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). One explanation for our paradoxical finding draws on Minority Stress Theory (Meyer, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2003\u003c/span\u003e) and resilience frameworks (Lewis et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). These frameworks suggest that discrimination can motivate health protective behaviors via fostering hypervigilance (Lewis et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Another explanation could reflect our highly educated sample. Individuals with higher education are more likely to report concerns of discrimination (Das, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e); further, individuals with higher education are more likely to report greater interest in genetic testing (Giri et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Roberts et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Future research with a more diverse sample in terms of education is needed to fully address this possibility.\u003c/p\u003e \u003cp\u003eThe results of this study could have clinical implications. Notably, prior \u003cem\u003ereligiously\u003c/em\u003e-tailored interventions have preliminarily shown promise for improving cancer early detection behaviors among American Muslims (Abu Khait \u0026amp; Lazenby, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Padela et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Pratt et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Examining the mechanisms for health behavior change among such religiously tailored interventions is needed, however, including given spirituality was the only significant religion-related factor in our sample. In Padela and colleagues\u0026rsquo; (Padela et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) religiously-tailored program, for example, the program increased mammography screening intention and behavior. However, the mechanisms for change were not causally examined. Similarly, Pratt and colleagues (Pratt et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) religiously tailored workshops were found to improve attitudes toward cervical cancer screening, but without examination of mechanisms of change. Nakajima and colleagues (Nakajima et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) administered a two-series workshop, that included a 25-minute video. The video improved intentions for colorectal screening. However, this study was observational and did not causally examine which spiritual and/or religious beliefs, barriers, and facilitators influenced health behavior outcomes. Future research is needed to identify which spiritual and/or religious factors influence health behavior outcomes.\u003c/p\u003e \u003cp\u003eBeyond designing cancer genetic promotion interventions to leverage American Muslims\u0026rsquo; experiences of spirituality and discrimination, there may be benefits to delivering interventions via non-specialist and specialist channels. Participants preferred receiving cancer genetic testing information from: a document, website, doctor, genetic counselor, video, and patient navigator, in that order. They also reported that mailed testing kits and incorporating testing into routine medical appointments would facilitate testing. These findings highlight potentially actionable strategies to increase access to genetic testing in this population. With traditional models of genetic service delivery reliant on the scarce workforce of genetic counselors, these findings suggest that novel models that utilize non-genetics providers (e.g., primary care doctors) and asynchronous options (e.g., document, website, video) are potentially acceptable strategies for expanding access among American Muslims. Future research is needed, however, to evaluate which delivery channels are appropriate for each aspect of service delivery.\u003c/p\u003e \u003cp\u003e \u003cem\u003eLimitations\u003c/em\u003e. Our study had several limitations. The generalizability of our findings is limited as we relied on a community-based convenience sample recruited from the DC\u0026ndash;Maryland\u0026ndash;Virginia area. Additionally, our low response rate limits the conclusions that can be drawn from the study. It is important to note, that we closed the survey after approximately one-month with little repeat outreach. Further, we took measures to mitigate potential nonresponse bias, such as clarifying in the recruitment flyer that there is compensation for completing the survey and that no prior knowledge of cancer genetic testing is required. Still, the low response rate and highly select sample require that these results be interpreted with caution \u0026ndash; particularly if considering American Muslims residing outside of the Maryland-Virginia-DC area. Finally, our study assessed stated interest in GT rather than GT uptake. To inform interventions that promote cancer genetic testing in this population, future research should examine predictors of testing uptake.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study provides important exploratory insights into an under-researched population.\u003c/p\u003e \u003cp\u003eThe associations between increased spirituality, perceived religion-based discrimination in healthcare, and interest in cancer genetic testing, demonstrates potential benefits of tailoring cancer genetic testing promotion interventions among American Muslims. Future research with larger, more representative samples can build on this work to better understand the mechanisms underlying these associations and to inform strategies to tailor interventions promoting cancer genetic testing among American Muslims.\u003c/p\u003e "},{"header":"Declarations","content":"\u003ch2\u003eCompeting Interests:\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Approval was granted by the Georgetown-MedStar joint oncology Institutional Review Board (STUDY00007505).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all patients for being included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent to participate in the study was obtained from all individual participants.\u003c/p\u003e\n\u003ch2\u003eFunding:\u003c/h2\u003e\n\u003cp\u003eThis research did not receive funding.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eMRH: conceptualization, study design, project management, data curation, analysis, writing, review; SK: data management, writing; SB: data management; CD: conceptualization, review, editing; MDS: conceptualization, study design, review, editing; AHDM: conceptualization, study design, review, editing.\u003c/p\u003e\n\u003ch2\u003eAcknowledgements:\u003c/h2\u003e\n\u003cp\u003eWe are immensely thankful to our participants for their time and responses.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe authors welcome inquiries from investigators interested in possible collaboration and use of de-identified data from this study. The data has not been placed into a public repository.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbu Khait A, Lazenby M (2021) Psychosocial-spiritual interventions among Muslims undergoing treatment for cancer: An integrative review. BMC Palliat CARE 20(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12904-021-00746-x\u003c/span\u003e\u003cspan address=\"10.1186/s12904-021-00746-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbu Raiya H, Pargament KI, Mahoney A, Stein C (2008) A Psychological Measure of Islamic Religiousness: Development and Evidence for Reliability and Validity. Int J Psychol Relig 18(4):291\u0026ndash;315. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/10508610802229270\u003c/span\u003e\u003cspan address=\"10.1080/10508610802229270\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAfsah YR, Kaneko N (20231130). Barriers to cervical cancer screening faced by immigrant Muslim women: A systematic scoping review. \u003cem\u003eBMC Public Health\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 2375. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12889-023-17309-9\u003c/span\u003e\u003cspan address=\"10.1186/s12889-023-17309-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhmed H, Mushahid H (2023) Overcoming challenges to breast cancer screening among Muslim women: Addressing barriers to early detection and treatment: A correspondence. Cancer Causes Control: CCC 34(6):505\u0026ndash;507. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10552-023-01693-z\u003c/span\u003e\u003cspan address=\"10.1007/s10552-023-01693-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl Alawi S, Al Zaabi O, Heffernan ME, Arulappan J, Al Hasani N, Baluchi A, Mamari MA, A., Saadi A A. (20230228). Knowledge, attitudes and acceptance toward Human papillomavirus (HPV) vaccination: Perspectives of Muslim women and men. \u003cem\u003eVaccine\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e(13), 2224\u0026ndash;2233. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.vaccine.2023.02.063\u003c/span\u003e\u003cspan address=\"10.1016/j.vaccine.2023.02.063\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Amoudi S, Ca\u0026ntilde;as J, Hohl SD, Distelhorst SR, Thompson B (2015) Breaking the silence: Breast cancer knowledge and beliefs among Somali Muslim women in Seattle, Washington. Health Care Women Int 36(5):608\u0026ndash;616\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlkhaifi S, Padela AI, Hodge F, Brecht M-L (2023) Breast cancer screening among immigrant Muslim arab women in the United States: Analyzing relationships between beliefs, knowledge, spousal support and mammogram utilization. J Natl Med Assoc 115(3):302\u0026ndash;313\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlvord TW, Marriott LK, Nguyen PT, Shafer A, Brown K, Stoller W, Volpi JL, Vandehey-Guerrero J, Ferrara LK, Blakesley S, Solomon E, Kuehl H, Palma AJ, Farris PE, Hamman KJ, Cotter M, Shannon J (2020) Public perception of predictive cancer genetic testing and research in Oregon. J Genet Couns 29(2):259\u0026ndash;281. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jgc4.1262\u003c/span\u003e\u003cspan address=\"10.1002/jgc4.1262\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAustin S, Hanson EN, Delacroix E, Bacon E, Rice J, Gerido LH, Rizzo E, Pleasant V, Stoffel EM, Griggs JJ, Resnicow K (2025) Impact of barriers and motivators on intention and confidence to undergo hereditary cancer genetic testing. \u003cem\u003eJournal of Genetic Counseling\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e(1), e1926. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jgc4.1926\u003c/span\u003e\u003cspan address=\"10.1002/jgc4.1926\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAzhar S, Wyatt LC, Jokhakar V, Patel S, Raveis VH, Kwon SC, Islam NS (2022) Associations between spiritual health locus of control, perceived discrimination and breast and cervical cancer screening for muslim american women in New York city. Clin Breast Cancer 22(4):e586\u0026ndash;e596\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBernstein I, Holinski-Feder E, Sala P, Evans DG, Lindblom A, Macrae F, Blanco I, Sijmons R, Jeffries J, Vasen H (2015) Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: First report from the prospective Lynch syndrome database. \u003cem\u003e1468\u0026ndash;3288\u003c/em\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBotoseneanu A, Alexander JA, Banaszak-Holl J (2011) To Test or Not to Test? The Role of Attitudes, Knowledge, and Religious Involvement Among U.S. Adults on Intent-to-Obtain Adult Genetic Testing. Health Educ Behav 38(6):617\u0026ndash;628. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/1090198110389711\u003c/span\u003e\u003cspan address=\"10.1177/1090198110389711\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChapman-Davis E, Zhou ZN, Fields JC, Frey MK, Jordan B, Sapra KJ, Chatterjee-Paer S, Carlson AD, Holcomb KM (2021) Racial and Ethnic Disparities in Genetic Testing at a Hereditary Breast and Ovarian Cancer Center. J Gen Intern Med 36(1):35\u0026ndash;42. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s11606-020-06064-x\u003c/span\u003e\u003cspan address=\"10.1007/s11606-020-06064-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChoudhri A, Adams-Campbell L, Bright M, Zhu J, Dash C (2024) Cancer-Related Health and Educational Needs and Faith-Based Health Beliefs in an Urban Muslim Population. J Cancer Educ. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s13187-024-02439-4\u003c/span\u003e\u003cspan address=\"10.1007/s13187-024-02439-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClarke AJ, Van El CG (2022) Genomics and justice: Mitigating the potential harms and inequities that arise from the implementation of genomics in medicine. Hum Genet 141(5):1099\u0026ndash;1107. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00439-022-02453-w\u003c/span\u003e\u003cspan address=\"10.1007/s00439-022-02453-w\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDas A (2020) Major Discrimination Experiences, Education, and Genes. J Aging Health 32(7\u0026ndash;8):753\u0026ndash;763. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/0898264319851661\u003c/span\u003e\u003cspan address=\"10.1177/0898264319851661\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Jong AE, Hendriks YMC, Kleibeuker JH, De Boer SY, Cats A, Griffioen G, Nagengast FM, Nelis FG, Rookus MA, Vasen HFA (2006) Decrease in Mortality in Lynch Syndrome Families Because of Surveillance. Gastroenterology 130(3):665\u0026ndash;671. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1053/j.gastro.2005.11.032\u003c/span\u003e\u003cspan address=\"10.1053/j.gastro.2005.11.032\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDharwadkar P, Greenan G, Stoffel EM, Burstein E, Pirzadeh-Miller S, Lahiri S, Mauer C, Singal AG, Murphy CC (2022) Racial and Ethnic Disparities in Germline Genetic Testing of Patients With Young-Onset Colorectal Cancer. Clin Gastroenterol Hepatol 20(2):353\u0026ndash;361e3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.cgh.2020.12.025\u003c/span\u003e\u003cspan address=\"10.1016/j.cgh.2020.12.025\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGiri VN, Knudsen KE, Kelly WK, Cheng HH, Cooney KA, Cookson MS, Dahut W, Weissman S, Soule HR, Petrylak DP, Dicker AP, AlDubayan SH, Toland AE, Pritchard CC, Pettaway CA, Daly MB, Mohler JL, Parsons JK, Carroll PR, Gomella LG (2020) Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019. \u003cem\u003eJournal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology\u003c/em\u003e, \u003cem\u003e38\u003c/em\u003e(24), 2798\u0026ndash;2811. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1200/JCO.20.00046\u003c/span\u003e\u003cspan address=\"10.1200/JCO.20.00046\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eG\u0026oacute;mez-Trillos S, Sheppard VB, Graves KD, Song M, Anderson L, Ostrove N, Lopez K, Campos C, Gonzalez N, Hurtado‐de‐Mendoza A (2020) Latinas\u0026rsquo; knowledge of and experiences with genetic cancer risk assessment: Barriers and facilitators. J Genet Couns 29(4):505\u0026ndash;517. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jgc4.1201\u003c/span\u003e\u003cspan address=\"10.1002/jgc4.1201\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo F, Hirth JM, Fuchs EL, Cofie LE, Brown V, Kuo Y-F, Fernandez ME, Berenson AB (2022) Knowledge, Attitudes, Willingness to Pay, and Patient Preferences About Genetic Testing and Subsequent Risk Management for Cancer Prevention. J Cancer Educ 37(2):362\u0026ndash;369. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s13187-020-01823-0\u003c/span\u003e\u003cspan address=\"10.1007/s13187-020-01823-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHasnain M, Menon U, Ferrans CE, Szalacha L (2014) Breast cancer screening practices among first-generation immigrant muslim women. J Women\u0026rsquo;s Health 23(7):602\u0026ndash;612\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHay JL, Zielaskowski K, Meyer White K, Kaphingst K, Robers E, Guest D, Sussman A, Talamantes Y, Schwartz M, Rodr\u0026iacute;guez VM, Li Y, Schofield E, Bigney J, Hunley K, Buller D, Berwick M (2018) Interest and Uptake of \u003cem\u003eMC1R\u003c/em\u003e Testing for Melanoma Risk in a Diverse Primary Care Population: A Randomized Clinical Trial. JAMA Dermatology 154(6):684. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1001/jamadermatol.2018.0592\u003c/span\u003e\u003cspan address=\"10.1001/jamadermatol.2018.0592\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u003cem\u003eIBM SPSS Statistics for Macintosh\u003c/em\u003e (Version Version 29.0). (2022) [Computer software]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIslam N, Patel S, Brooks-Griffin Q, Kemp P, Raveis V, Riley L, Gummi S, Nur PQ, Ravenell J, Cole H (2017) Understanding barriers and facilitators to breast and cervical cancer screening among Muslim women in New York City: Perspectives from key informants. SM J Community Med, \u003cem\u003e3\u003c/em\u003e(1)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaphingst KA, Bather JR, Daly BM, Chavez-Yenter D, Vega A, Kohlmann WK (2022) Interest in Cancer Predisposition Testing and Carrier Screening Offered as Part of Routine Healthcare Among an Ethnically Diverse Sample of Young Women. Front Genet 13:866062. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fgene.2022.866062\u003c/span\u003e\u003cspan address=\"10.3389/fgene.2022.866062\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLewis TT, Cogburn CD, Williams DR (2015) Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues. Ann Rev Clin Psychol 11(1):407\u0026ndash;440. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1146/annurev-clinpsy-032814-112728\u003c/span\u003e\u003cspan address=\"10.1146/annurev-clinpsy-032814-112728\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu T, Yu J, Gao Y, Ma X, Jiang S, Gu Y, Ming W (2023) Prophylactic Interventions for Hereditary Breast and Ovarian Cancer Risks and Mortality in BRCA1/2 Carriers. Cancers 16(1):103. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/cancers16010103\u003c/span\u003e\u003cspan address=\"10.3390/cancers16010103\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMajeed AM, Khan ZA, Aschebrook-Kilfoy B, Kibriya MG, Ahsan H, Padela AI (2023) Cancer Screening Differences Among Muslims and Non-Muslims: Insights from the Chicago Multiethnic Prevention and Surveillance Study. J Racial Ethnic Health Disparities 10(1):176\u0026ndash;182. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s40615-021-01208-z\u003c/span\u003e\u003cspan address=\"10.1007/s40615-021-01208-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMeyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull 129(5):674\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMittendorf KF, Knerr S, Kauffman TL, Lindberg NM, Anderson KP, Feigelson HS, Gilmore MJ, Hunter JE, Joseph G, Kraft SA, Zepp JM, Syngal S, Wilfond BS, Goddard KAB (2021) Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities. JCO Precision Oncol 5:1709\u0026ndash;1718. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1200/PO.21.00233\u003c/span\u003e\u003cspan address=\"10.1200/PO.21.00233\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoey SF, Sowtali SN, Ismail MFM, Hashi AA, Azharuddin NSM, Mohamed NC (2022) Cultural, Religious and socio-ethical misconceptions among Muslim women towards Breast Cancer Screening: A systematic review. Asian Pac J Cancer Prevention: APJCP 23(12):3971\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMogahed D, Ikramullah E, Chouhoud Y (2022) American Muslim poll 2022: A politics and pandemic status report. Inst Social Policy Underst, \u003cem\u003e25\u003c/em\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohamed B (2018) New estimates show US Muslim population continues to grow. Pew Res Cent, \u003cem\u003e3\u003c/em\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuller C, Lee SM, Barge W, Siddique SM, Berera S, Wideroff G, Tondon R, Chang J, Peterson M, Stoll J, Katona BW, Sussman DA, Melson J, Kupfer SS (2018) Low Referral Rate for Genetic Testing in Racially and Ethnically Diverse Patients Despite Universal Colorectal Cancer Screening. Clin Gastroenterol Hepatol 16(12):1911\u0026ndash;1918e2. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.cgh.2018.08.038\u003c/span\u003e\u003cspan address=\"10.1016/j.cgh.2018.08.038\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNakajima M, Haji A, Mohamud S, Ahmed O, Hodges JS, Pratt R (2022) A Culturally Adapted Colorectal Cancer Education Video for the Somali Community in Minnesota: A Pilot Investigation. Am J Health Promotion 36(3):514\u0026ndash;517. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/08901171211057690\u003c/span\u003e\u003cspan address=\"10.1177/08901171211057690\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNordin K, Bj\u0026ouml;rk J, Berglund G (2004) Factors influencing intention to obtain a genetic test for a hereditary disease in an affected group and in the general public. Prev Med 39(6):1107\u0026ndash;1114. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ypmed.2004.04.021\u003c/span\u003e\u003cspan address=\"10.1016/j.ypmed.2004.04.021\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePadela AI, Gunter K, Killawi A, Heisler M (2012) Religious values and healthcare accommodations: Voices from the American Muslim community. J Gen Intern Med 27(6):708\u0026ndash;715. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s11606-011-1965-5\u003c/span\u003e\u003cspan address=\"10.1007/s11606-011-1965-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. psyh\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePadela AI, Malik S, Ally SA, Quinn M, Hall S, Peek M (2018) Reducing Muslim mammography disparities: Outcomes from a religiously tailored mosque-based intervention. Health Educ Behav 45(6):1025\u0026ndash;1035\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePadela AI, Murrar S, Adviento B, Liao C, Hosseinian Z, Peek M, Curlin F (2015) Associations between religion-related factors and breast cancer screening among American Muslims. J Immigr Minor Health 17(3):660\u0026ndash;669. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10903-014-0014-y\u003c/span\u003e\u003cspan address=\"10.1007/s10903-014-0014-y\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. psyh\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePadela AI, Peek M, Johnson-Agbakwu CE, Hosseinian Z, Curlin F (2014) Associations between religion-related factors and cervical cancer screening among Muslims in greater chicago. J Lower Genit Tract Dis 18(4):326\u0026ndash;332. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/LGT.0000000000000026\u003c/span\u003e\u003cspan address=\"10.1097/LGT.0000000000000026\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. cmedm\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePadela AI, Zaidi D (2018) The Islamic tradition and health inequities: A preliminary conceptual model based on a systematic literature review of Muslim health-care disparities. Avicenna J Med 8(1):1\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePaiella S, Azzolina D, Gregori D, Malleo G, Golan T, Simeone DM, Davis MB, Vacca PG, Crovetto A, Bassi C, Salvia R, Biankin AV, Casolino R (2023) A systematic review and meta-analysis of germline BRCA mutations in pancreatic cancer patients identifies global and racial disparities in access to genetic testing. ESMO Open 8(2):100881. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.esmoop.2023.100881\u003c/span\u003e\u003cspan address=\"10.1016/j.esmoop.2023.100881\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParikh DA, Dickerson JC, Kurian AW (2020) Health Disparities in Germline Genetic Testing for Cancer Susceptibility. Curr Breast Cancer Rep 12(2):51\u0026ndash;58. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s12609-020-00354-3\u003c/span\u003e\u003cspan address=\"10.1007/s12609-020-00354-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeek ME, Nunez-Smith M, Drum M, Lewis TT (2011) Adapting the everyday discrimination scale to medical settings: Reliability and validity testing in a sample of African American patients. Ethn Dis 21(4):502\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePratt R, Mohamed S, Dirie W, Ahmed N, Lee S, VanKeulen M, Carlson S (2020) Testing a religiously tailored intervention with Somali American Muslim women and Somali American imams to increase participation in breast and cervical Cancer screening. J Immigr Minor Health 22(1):87\u0026ndash;95\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrince A, Cadigan J, Henderson G, Evans J, Adams M, Coker-Schwimmer E, Penn D, Van Riper M, Corbie-Smith G, Jonas D (2017) Is there evidence that we should screen the general population for Lynch syndrome with genetic testing? A systematic review. Pharmacogenomics Personalized Med 10:49\u0026ndash;60. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2147/PGPM.S123808\u003c/span\u003e\u003cspan address=\"10.2147/PGPM.S123808\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaiya HA, Pargament KI, Stein C, Mahoney A (2007) Lessons Learned and Challenges Faced in Developing the Psychological Measure of Islamic Religiousness. J Muslim Mental Health 2(2):133\u0026ndash;154. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/15564900701613058\u003c/span\u003e\u003cspan address=\"10.1080/15564900701613058\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoberts MC, Foss KS, Henderson GE, Powell SN, Saylor KW, Weck KE, Milko LV (2022) Public Interest in Population Genetic Screening for Cancer Risk. Front Genet 13:886640. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fgene.2022.886640\u003c/span\u003e\u003cspan address=\"10.3389/fgene.2022.886640\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRubinsak LA, Kleinman A, Quillin J, Gordon SW, Sullivan SA, Sutton AL, Sheppard VB, Temkin SM (2019) Awareness and acceptability of population-based screening for pathogenic BRCA variants: Do race and ethnicity matter? Gynecol Oncol 154(2):383\u0026ndash;387. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ygyno.2019.06.009\u003c/span\u003e\u003cspan address=\"10.1016/j.ygyno.2019.06.009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalhab M, Bismohun S, Mokbel K (2010) Risk-reducing strategies for women carrying BRCA1/2 mutations with a focus on prophylactic surgery. BMC Women\u0026rsquo;s Health 10(1):28\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSamari G, Alcal\u0026aacute; HE, Sharif MZ (2018) Islamophobia, health, and public health: A systematic literature review. Am J Public Health 108(6):e1\u0026ndash;e9\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSayani A (2019) Inequities in genetic testing for hereditary breast cancer: Implications for public health practice. J Community Genet 10(1):35\u0026ndash;39. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s12687-018-0370-8\u003c/span\u003e\u003cspan address=\"10.1007/s12687-018-0370-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchwartz MD, Hughes C, Roth J, Main D, Peshkin BN, Isaacs C, Kavanagh C, Lerman C (2000) Spiritual faith and genetic testing decisions among high-risk breast cancer probands. Cancer Epidemiol Biomarkers Prev 9(4):381\u0026ndash;385\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSteffen LE, Du R, Gammon A, Mandelblatt JS, Kohlmann WK, Lee J-H, Buys SS, Stroup AM, Campo RA, Flores KG, Vicu\u0026ntilde;a B, Schwartz MD, Kinney AY (2017) Genetic Testing in a Population-Based Sample of Breast and Ovarian Cancer Survivors from the REACH Randomized Trial: Cost Barriers and Moderators of Counseling Mode. Cancer Epidemiol Biomarkers Prev 26(12):1772\u0026ndash;1780. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1158/1055-9965.EPI-17-0389\u003c/span\u003e\u003cspan address=\"10.1158/1055-9965.EPI-17-0389\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuther S, Kiros G-E (2009) Barriers to the use of genetic testing: A study of racial and ethnic disparities. Genet Sci 11(9):655\u0026ndash;662. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/GIM.0b013e3181ab22aa\u003c/span\u003e\u003cspan address=\"10.1097/GIM.0b013e3181ab22aa\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTawfik SM, Elhosseiny AA, Galal AA, William MB, Qansuwa E, Elbaz RM, Salama M (2023) Health inequity in genomic personalized medicine in underrepresented populations: A look at the current evidence. Funct Integr Genom 23(1):54. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10142-023-00979-4\u003c/span\u003e\u003cspan address=\"10.1007/s10142-023-00979-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eValachis A, Nearchou AD, Lind P (2014) Surgical management of breast cancer in BRCA-mutation carriers: A systematic review and meta-analysis. Breast Cancer Res Treat 144(3):443\u0026ndash;455. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10549-014-2890-1\u003c/span\u003e\u003cspan address=\"10.1007/s10549-014-2890-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilliams DR, Yu Y, Jackson JS, Anderson NB (1997) Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination. J Health Psychol 2(3):335\u0026ndash;351. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/135910539700200305\u003c/span\u003e\u003cspan address=\"10.1177/135910539700200305\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-community-genetics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jocg","sideBox":"Learn more about [Journal of Community Genetics](http://link.springer.com/journal/12685)","snPcode":"12687","submissionUrl":"https://submission.nature.com/new-submission/12687/3","title":"Journal of Community Genetics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"cancer genetic testing, healthcare delivery, religion, discrimination","lastPublishedDoi":"10.21203/rs.3.rs-8903379/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8903379/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmerican Muslims face notable cancer disparities. Yet we know little about cancer genetic testing among this group. The current study aims to explore: 1) interest in cancer genetic testing, 2) predictors of interest, focusing on religion and discrimination factors, and 3) preferences for receiving cancer genetic education and testing among a diverse community sample of American Muslims.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe surveyed a community-based convenience sample of 158 American Muslims from the DC-Maryland-Virginia area. Our primary outcome was interest in cancer genetic testing; secondary outcomes were preferred delivery channels and facilitators for receiving genetic education and testing. Predictors included sociodemographics, cancer history, knowledge, and religion and discrimination factors. We conducted descriptive statistics, student’s t-tests, Chi-square tests, and logistic regression.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants ranged 18 to 72 years (Mean = 34). The majority were foreign-born (62%). Seventy six percent strongly agreed or agreed with interest in testing. Only spirituality (OR = 2.72, 95% CI: 1.24, 5.96) and discrimination in healthcare due to looking Muslim (OR = 2.81, 95% CI: 1.23, 6.39) were independently associated with interest in testing. Participants most preferred cancer genetic education via: a document (83%), doctor (80%), genetic counselor (80%), or a website (79%). Participants least preferred a chatbot (30%). Participants most highly endorsed as facilitators of testing: informational materials (59%), insurance coverage (59%), at-home testing kits (52%), and integrating testing into routine care (44%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion \u0026amp; Conclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAddressing religion and discrimination factors may promote access to cancer genetic testing among the under-researched population of American Muslims, as well as aligning future interventions with their preferences.\u003c/p\u003e","manuscriptTitle":"Cancer genetic testing among a diverse sample of American Muslims","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-27 19:20:40","doi":"10.21203/rs.3.rs-8903379/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-02-25T07:31:43+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-25T05:37:21+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-25T05:34:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Community Genetics","date":"2026-02-17T17:26:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-community-genetics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jocg","sideBox":"Learn more about [Journal of Community Genetics](http://link.springer.com/journal/12685)","snPcode":"12687","submissionUrl":"https://submission.nature.com/new-submission/12687/3","title":"Journal of Community Genetics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"62ee2c73-1c6b-445b-a942-dc31756aa1c7","owner":[],"postedDate":"February 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-27T19:20:40+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-27 19:20:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8903379","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8903379","identity":"rs-8903379","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}