Equity-centered genetic testing: a marketing segmentation typology

Abstract

Background From a marketing perspective, an individual’s potential to utilize genetic testing is influenced by social determinants and healthcare system design and policies, resulting in inequitable market distortions. Methods A systematic literature review was conducted, which identified sixty articles from Scopus and Web of Science. We included articles that discussed barriers, facilitators, and individual perceptions surrounding genetic testing. Through thematic analysis, barriers and facilitators to the potential uptake of health-related genetic testing were identified. The barriers and facilitators were then filtered through a COM-B model lens for market segmentation. Results Barriers function as friction and veto-gates that can block the potential uptake of health-related genetic testing. Facilitators function as impetuses that increase motivation but cannot necessarily overcome friction or veto-gates. The barriers were related to individual, relational and societal factors. The barriers and facilitators are not opposites that cancel each other out, and as a result, they should be addressed through distinct marketing mechanisms independently via a segmentation approach. Seven market segments were identified: cost navigators, trust skeptics, linguistic outsiders, privacy and confidentiality guardians, result worriers, infrastructure sideliners and delayed adopters. Conclusion Market segments with higher barrier loads and modest facilitator strength can remain persistently underserved, producing patterned under-uptake despite need and desire. This paper reframes health-related genetic testing uptake as an equity-centred marketing problem and argues for segmenting the market based on barrier load and facilitator strength. The typology created is conceptual and unvalidated. This typology has organized operational market segments that practitioners and policymakers can use when creating policies and guidelines to increase uptake. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261302582 , Identifier CRD420261302582.