Abstract
There are over 1.3 million active-duty military members and close to 2 million dependents who utilize federal healthcare benefits. Service members are exempt from the Genetic Information Nondiscrimination Act and, because the needs of the service always outweigh the need for individual privacy, service members are not afforded the same level of protections as civilians. Genetics providers are faced with understanding the military system often with little formal education or experience. There has been little research assessing the knowledge, experience, and attitudes of genetics providers caring for active-duty military and/or their dependents. An anonymous survey was sent to genetics providers who provide clinical care to service members and their families. A mix of quantitative and qualitative items were used to assess knowledge of military healthcare, experiences with service members, and attitudes about policy. SPSS was used for quantitative analysis and Microsoft® Office Excel was used to analyze for themes. Of the 120 providers who responded to the survey, 27% (31) of respondents reported that they counsel service members very often or often, 14.2% (17) had received education about military healthcare, 54.7% (52) reported they felt unprepared to counsel military personnel, 30.6 % (33) reported they counsel service members differently, and 71.4% (80) reported they were more concerned about the genetic privacy of their active-duty patients than their civilian patients. Respondents who had received education about military healthcare were significantly more prepared to counsel service members (p =0.004), and were more likely to counsel their active-duty patients differently (p=0.020). Those who reported counseling patients more frequently were also more likely to report high levels of preparedness (p=0.014). Knowledge-based true/false questions were utilized to assess individuals’ knowledge of military healthcare, and 10% (12) respondents were able to accurately answer all of these questions. Respondents were also asked about patient experience. Approximately 71% (80) reported that their patients had expressed concerns that genetic test results could adversely impact their career in the military. \r To our knowledge, this was the first survey of genetics providers about their experience with active-duty military patients. Providers felt unprepared to counsel service members and few respondents were able to correctly answer questions about military healthcare. Education and experience can allow providers to feel more comfortable providing these services, and future research can illuminate challenges within this demographic.