Are public health professionals prepared for public health genomics? A cross-sectional survey in Italy

Background Despite several surveys carried out to evaluate knowledge, attitudes and professional behaviors of physicians towards predictive genetic testing, little is known about public health practitioners. This study is the first one to assess knowledge, attitudes and training needs of public health professionals in the field of predictive genetic testing for chronic diseases. Methods A cross-sectional survey of a random sample of Italian public health professionals was carried out using a self-administered questionnaire. Multiple logistic regression models were built to identify possible predictors of adequate knowledge and positive attitudes. Results A response rate of 67.4% (797 questionnaires) was achieved. Italian public health professionals have the necessary attitudinal background to contribute to the proper use of predictive genetic testing for chronic diseases, but they need additional training to increase their methodological knowledge. Knowledge significantly increases with exposure to predictive genetic testing during postgraduate training (OR = 1.74, 95% CI = 1.05-2.88), with the time dedicated to continuing medical education (OR = 1.53, 95% CI = 1.14-2.04) and with level of English language knowledge (OR = 1.36, 95% CI = 1.07-1.72). Being physicians is a negative predictor of adequate knowledge (OR = 0.54, 95% CI = 0.32-0.92). Predictors of positive attitudes were: adequate knowledge (OR = 3.98, 95% CI = 2.44-6.50), exposure to predictive genetic testing during graduate training (OR = 1.53, 95% CI = 1.03-2.26) and time dedicated to continuing medical education (OR = 1.31, 95% CI = 1.06-1.61). Physicians were more likely to show positive attitudes compared to other public health professionals (OR = 2.17, 95% CI = 1.34-3.51). Finally, About 80% of the public health professionals considered inadequate its knowledge and 86.0% believed that it should be improved through specific postgraduate courses. Conclusions Specific and targeted training initiatives are needed to develop a skilled public health workforce competent in the identification of genomic technology that is ready for use in population health and in modelling public health genomic programs and primary care services that need to be developed, implemented and evaluated. Key messages Italian public health practitioners have good attitudes that can contribute to the proper use of predictive genetic testing. Italian public health practitioners need additional training to improve their methodological knowledge.