Attitudes, Awareness and Barriers to Cardiac Genetic Testing in an Anonymous Australian Survey involving Recruitment From Alcohol/Substance-use Services and the Community

Aim We assessed determinants of willingness to undergo cardiac genetic testing in Australia, including alcohol-use patterns and socioeconomic context. Method Australian adults completed an anonymous cross-sectional REDCap survey and were recruited from the general community and alcohol/substance-use treatment services. Willingness was defined as endorsing at least one reason to test. Alcohol use was assessed using AUDIT-C, typical drinking volume, and heavy episodic drinking frequency. Associations were examined using logistic regression and reported as unadjusted ORs or age/gender-adjusted ORs (aORs). Results Of 306 participants, 236 (77.1%) were willing to undergo testing. For AUDIT-C, unadjusted significant associations were observed for family history of heart disease (OR 1.11 per 1-point increase, 95% CI 1.02–1.20; p=0.016) and hypercholesterolaemia (OR 1.11, 95% CI 1.02–1.21; p=0.019). Alcohol associations with willingness were heterogeneous: typical volume 7–9 vs 1–2 drinks/occasion was associated with lower willingness (aOR 0.03; p=0.006), while heavy episodic drinking daily/almost daily vs never/rarely was associated with higher willingness (aOR 3.63, 95% CI 1.11–13.10; p=0.034). Willingness was strongly associated with personal health benefit (OR 73.24, 95% CI 29.18–183.85), family health benefit (OR 25.35, 95% CI 9.82–65.46), and clinician recommendation (OR 17.62, 95% CI 7.33–42.35), while key barriers were life-insurance implications and cost. Conclusion Family history of heart disease and hypercholesterolaemia were associated with higher alcohol use dependency. Alcohol use also influenced willingness to undergo cardiac genetic testing, while attitudes were shaped by perceived benefit. Targeted assessment, education, and access may improve uptake.