Attitudinal and behavioral factors affecting willingness to engage in Alzheimer's disease biomarker testing

Abstract INTRODUCTION Ethnoracialized individuals, for example, Black/African American (AA), American Indian/Alaska Native (AI/AN), and Hispanic/Latinx (H/L), are underrepresented in Alzheimer's disease (AD) biomarker studies. We investigated whether and how ethnoracialized groups differ in their willingness to engage in preclinical AD biomarker studies. METHODS We administered an online questionnaire to 1825 adults (725 non‐Hispanic White, 599 AA, 352 AI/AN, and 149 H/L). We examined factors hypothesized to be associated with AD biomarker testing willingness: gender, family history of dementia, education level, attitudes toward research, attitudes toward genetic testing, and preventive and proactive health behavior engagement using structural equation modeling. RESULTS The unconstrained (configural) model demonstrated good overall fit to the data. However, the constrained model and nested chi‐square difference test indicated a lack of structural invariance, that is, relationships between the variables and testing willingness differed by group. DISCUSSION The findings provide impetus for tailoring engagement strategies based on contextual factors such as ethnoracialized group membership.