Project Summary Religion is a primary driver of concerns with genomics and genomic healthcare (GGH). It is vital for research on the ethical, legal, and social implications (ELSI) of genomics to understand the role of religion in shaping public attitudes toward GGH. Ninety percent of the US public believes in some kind of higher power and 55% pray daily. The US public attends religious services at a rate 3 times higher than scientists in the US, who are at risk of misunderstanding the role religion plays in attitudes toward GGH. Further, Black, Hispanic, and rural populations attend religious services more frequently than the general US public. Concerns with GGH activities may lead to lower levels of engagement of GGH, which may in turn contribute to health disparities. This project aims to understand why higher levels of religious practice are associated with greater concerns with GGH activities. Additionally, this project will interview faith leaders to identify how public health genomics might engage faith communities in ways that are respectful and constructive. While some concerns with healthcare technologies may disappear with new information, others stem from worldviews, deep moral commitments, or mistrust of the healthcare system. Engaging religious communities is essential to identify which concerns can be addressed with information, which call for alternative responses, and what alternative responses might look like. Very few models exist for genomic public health engagement with religion, particularly models that directly address value-laden concerns.13,14 This project will achieve two specific aims: 1. Quantitatively examine which aspects of religion explain its influence on support for GGH activities. We will survey 4800 adults in the US to examine the association of religious variables with support for GGH activities such as prenatal genetic testing, gene editing, and mRNA vaccines. We will generate rich descriptive data and explore how and when diverse religious variables predict support for, or opposition to, GGH activities. 2. Explore how genomic public health can engage with religious communities in a way that is respectful and constructive. We will conduct in-depth interviews via Zoom with 180 faith leaders—30 from each of six groups: Evangelical, Mainline Protestant, Historically Black, and Catholic Christianity, Judaism, and Islam. These groups represent the largest religious groups in the US, comprising 90% of those with a religious affiliation. Interviews will explore several different issues: What are their views on GGH activities? Is diversity of opinion on these matters tolerated within their community? To what extent are concerns with GGH activities principled and to what extent might further information be helpful? How might genomic public health engage religious communities in a way that is both respectful and constructive?