Applying a theory-based framework to understand public knowledge of genetic risk factors: a case for the distinction between how-to knowledge and principles knowledge.

Objective: Using E.M. Rogers's knowledge framework as presented in his seminal innovation-decision process, this paper aims to present an overview of the general public's knowledge of genetics. It also makes a first attempt to examine the statistical validity of this framework. Methods: A sample of 2,500 members of the Dutch general population was presented with a questionnaire containing measures of 3 increasingly complex forms of knowledge: awareness knowledge, (practical) how-to knowledge and (theoretical) principles knowledge. Results: The general public seems to be moderately aware of genetic risk factors for multifactorial diseases. In general, how-to knowledge seems fair, whereas principles knowledge is limited and superficial. Additional analyses provided empirical evidence for the distinction between awareness knowledge, how-to knowledge and principles knowledge. Conclusion: The innovation-decision process, and specifically Rogers's knowledge framework, provides a useful tool for public education in genetics. Future research may build upon and extend our findings by examining the persuasion, decision, implementation, and possibly the confirmation stages of the innovation-decision process concerning genetic education.