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Background  The use of genetically-informed personalized risk information for behavioral disorders, namely smoking and smoking-related behaviors, is a promising yet understudied area. The Genetics and Smoking Risk Profile, or  RiskProfile , leverages genetic and environmental information to communicate one’s risk for smoking-related diseases. Although prior studies have examined attitudes toward genetic results, little research has investigated these perceptions through a lens of in-vivo testing; that is, user-centered design feedback in response to personalized genetic results being returned contemporaneously. This qualitative study engaged current smokers in usability testing of the  RiskProfile  within the context of concurrently receiving this personalized, genetically-informed smoking cessation intervention.    Methods  Eighty-nine participants who were current smokers responded to open-ended interview questions on perceptions of smoking-related genetic information and the content and format of the  RiskProfile  intervention that they had received moments before. Data were analyzed via the conventional content analysis approach in which themes were allowed to emerge throughout the analysis.    Results  Participants were able to reference and offer design input on specific elements of the  RiskProfile . Overall, current smokers perceived the  RiskProfile  to have high potential utility. Constructive feedback that current smokers offered about the tool centered around suggested improvements to optimize its usability and technical content.    Conclusions  The detailed and constructive feedback from participants highlights that in-vivo feedback offers a useful design approach that addresses concerns of rigor and relevance when returning genetic results. This unique method demonstrated perceived utility and constructive design feedback for the  RiskProfile  among current smokers and can play an important role in optimizing the design and implementation of personalized genetic risk interventions moving forward.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12920-021-00976-1.

In-vivo design feedback and perceived utility of a genetically-informed smoking risk tool among current smokers in the community