Table 1.

Contextual Sub-domains and Concepts

Sub-domains	Concepts
Healthcare System Factors
Medical care	access to and quality of care; EHR type
System features	resources and infrastructure: genomic; mix of individuals receiving care (number, payers, demographics)
	type: in/outpatient; academic/community; rural/urban; private/public
	culture: openness to change; structural discrimination
Social Determinants
Social	networks; support; resources; influence; engagement
Built environment	housing; poverty; crime; walkability; exposure to pollution, toxins, pathogens; food; racism; unequal distribution of resources (policies, systems, education, economic)
Clinician Factors
Demographics	age; race/ethnicity; sex/gender; training; specialty; experience
Psychosocial	psychosocial: stress; satisfaction; self-efficacy; reaction to medical uncertainty
	stressors/resources: time; access to information; experts; referrals; perceived racism
	attitudes, knowledge and understanding: genetic (testing, return of results, expected utility); implicit bias
Individual & Family Factors
Demographics	age; race/ethnicity; sex/gender; language; literacy; numeracy; income; employment; education; insurance; self-reported ancestry
Bio-psychosocial	biological/clinical: family history; comorbidity; genetics, including genetic ancestry
	psychosocial: depression; stress; anxiety; self-efficacy; stigma; racism; perceived racism; activation; cultural norms; family issues
	stressors/resources: family; community; occupational; financial; illness
	knowledge, attitudes and understanding: genetic testing, results & their disclosure; intervention; trust (in testing, results, providers); expected utility; activation