Consequences of genomic literacy elements on genetic testing decisions among Emirati adults: a cross-sectional study

Genomic literacy is an essential determinant of informed participation in genetic testing. Guided by Nutbeam’s Health Literacy Model, this study examined how components of genomic literacy (genetic/genomic knowledge, health numeracy, and communicative and critical health literacy) predict Emirati adults’ risk and benefit perceptions and behavioural intentions regarding genetic testing, and explored whether demographic and experiential factors moderate these relationships. A community-based cross-sectional survey was conducted among 300 Emirati adults aged 18–59 years in Ras Al Khaimah, UAE. Participants completed validated instruments assessing genomic knowledge, health numeracy, communicative and critical health literacy, and perceptions of risk and benefit. Data were analysed using descriptive statistics, Pearson correlations, and linear regression to identify predictors of genetic testing intention and result disclosure. Communicative and critical health literacy emerged as the strongest predictors of intention to undergo testing (p < 0.001). Health numeracy and genomic knowledge significantly predicted willingness to disclose positive results to partners and children. Benefit perception showed an inverse association with testing intention (p = 0.038). Demographic factors, including age, marital status, and prior genetic exposure, influenced literacy levels and decision patterns. Genomic literacy particularly communicative and critical literacy plays a pivotal role in shaping genetic testing decisions in Emirati adults. These findings highlight the need for integrated genomic education within nursing and medical curricula and culturally tailored public health interventions that strengthen literacy, numeracy, and counselling access to support informed decision-making in genomic medicine. Communicative and critical health literacy become the strongest indicators of Emirati individuals intention to undergo genetic testing. Health numeracy and genomic knowledge have a strong predictive power on the willingness of individual to reveal genetic test-based information to partners and children. A program of genomic literacy education tailored to include communication, numeracy, and critical appraisal skills is the way to promote informed decision-making related to genetic testing. Advocacy in policy is also inseparable in order to support fair access to genetic counseling services in the United Arab Emirates.